Sexual Transmission of HCV in Heterologous Monogamous Spouses

We screened for evidence of HCV infection in healthy heterologous monogamous spouses of chronic HCV patients and studied the relation with various risk factors. A cross-sectional study of fifty healthy monogamous heterosexual spouses of HCV-positive index cases was carried out. All participants were HBV and HIV negative. The association with various risk factors was studied. Five spouses (10%) showed evidence of HCV infection. Two partners were positive for HCV antibody alone (4%) and 3 for antibody and HCV PCR (6%). No association was found between HCV infection and various sociodemographic parameters with the exception of older age categories. Intraspousal transmission of HCV may be an important source of spread of HCV infection. The reservoir of HCV-infected individuals in Egypt is sizable, and sexual transmission of HCV may contribute to the total burden of infection in Egypt. 1. Introduction The extent to which HCV infection is associated with sexual exposure has been debated extensively. The 2008 Egyptian Demographic and Health Survey [1] estimated that 15% of people aged 15–59 years in Egypt have anti-HCV antibodies and 10% have chronic HCV infection. However, this high figure is related to past transmission events and is not representative of the HCV transmission occurring in Egypt. Sexual transmission of HCV may contribute to the total burden of infection in Egypt. The objectives of this study were to detect the risk for sexual transmission of HCV infection from chronically infected subjects to their long-term monogamous heterosexual partners (50 spouses) and to identify various sexual practices associated with that risk. Spouses were carefully selected to exclude risk factors and participants were HBV (HBsAg, HBcAb, and HBsAb) and HIV antibody negative. All participants were tested for liver enzymes, HCV specific antibodies (Ortho Clinical Diagnostics, New Jersey, USA), and HCV RNA assay with real-time PCR using Qiagen extraction kit and Brilliant HCV QRT-PCR for Stratagene’s Mx3000P. Five spouses showed evidence of HCV infection, two were positive for HCV antibody alone (4%) and three were positive for HCV antibody and HCV PCR (6%). No association was found between the HCV infection status and various selected risk factors such as sex, age, duration of marriage, frequency of sexual intercourse, history of sexually transmitted diseases, and other risk factors for HCV. The only association detected was the age category where both positivity of HCV antibody and HCV PCR were associated with the older age category (>60？y). As regards the direction