Mastromatteo A M, Rapaccini G L, Pompili M, Ursino S, Romano-Spica V, Gasbarrini G, Vanini G
Department of Hygiene, Catholic University of Sacred Heart, Largo F.Vito, 1-00168 Rome, Italy.
Hepatogastroenterology. 2001 Jan-Feb;48(37):193-6.
BACKGROUND/AIMS: Several epidemiological studies have shown the existence of other routes of transmission of the hepatitis C virus besides the parenteral one, but the mechanisms involved are not yet understood. The general aim of this study was to evaluate the prevalence of hepatitis C virus infection in family contacts of infected patients and to analyze the possible risk factors and alternative transmission routes.
One hundred and thirty-eight relatives of 45 patients (index cases) affected by C virus-related chronic hepatitis were studied. The relatives were 45 spouses, 89 children and 4 cohabitants who underwent detection of serum anti-HCV antibodies; the anti-HCV-positive subjects were tested for serum HCV-RNA. The index cases, all the spouses and only other infected relatives were tested for the presence of HCV-RNA in saliva
Antibodies to hepatitis C virus were detected in 5.7% of the family members while 11.1% of the analyzed spouses were serum HCV-RNA-positive. HCV-RNA was found in 44% of the examined saliva and 39% of these were found serum HCV-RNA-negative. The prevalence of hepatitis C virus among household contacts, excluding cases with previous parenteral exposure, was 3.6%.
The epidemiological data on the intrafamilial spread of hepatitis C virus may be underestimated owing to the existence of infected relatives serum-negative but saliva-positive for the presence of the virus. The whole of these observations suggests a possible role of biological fluids in intrafamilial spread of hepatitis C virus.
背景/目的:多项流行病学研究表明,丙型肝炎病毒除经肠道外途径传播外,还存在其他传播途径,但相关机制尚不清楚。本研究的总体目的是评估丙型肝炎病毒感染患者家庭接触者中的感染率,并分析可能的危险因素和其他传播途径。
对45例丙型肝炎病毒相关慢性肝炎患者(索引病例)的138名亲属进行了研究。这些亲属包括45名配偶、89名子女和4名同居者,他们接受了血清抗-HCV抗体检测;抗-HCV阳性者检测血清HCV-RNA。对索引病例、所有配偶以及仅其他感染亲属的唾液进行HCV-RNA检测。
5.7%的家庭成员检测出丙型肝炎病毒抗体,而11.1%的被分析配偶血清HCV-RNA呈阳性。44%的检测唾液中发现HCV-RNA,其中39%血清HCV-RNA呈阴性。排除既往有肠道外暴露史的病例后,家庭接触者中丙型肝炎病毒的感染率为3.6%。
由于存在病毒血清阴性但唾液阳性的感染亲属,丙型肝炎病毒家庭内传播的流行病学数据可能被低估。所有这些观察结果表明生物体液在丙型肝炎病毒家庭内传播中可能起作用。