丙型肝炎病毒的性传播及其与乙型肝炎病毒和艾滋病毒的关系。
Sexual transmission of hepatitis C virus and its relation with hepatitis B virus and HIV.
作者信息
Tor J, Llibre J M, Carbonell M, Muga R, Ribera A, Soriano V, Clotet B, Sabriá M, Foz M
机构信息
Infectious Diseases Unit, Germans Trias i Pujol Hospital, Autonomous University of Barcelona, Spain.
出版信息
BMJ. 1990 Nov 17;301(6761):1130-3. doi: 10.1136/bmj.301.6761.1130.
OBJECTIVE
To determine the extent of transmission of hepatitis C virus in sexual partners of intravenous drug misusers and to examine the relation between the prevalences of HIV, hepatitis B virus, and hepatitis C virus infections in homosexual men and intravenous drug misusers and their sexual partners.
DESIGN
Serum samples collected between 1984 and 1988 were tested for hepatitis B virus markers and antibodies against hepatitis C virus by enzyme linked immunosorbent assay (ELISA) and for HIV antibody by enzyme immune analysis and western blotting.
SETTING
Large referral university hospital with an external AIDS clinic in the metropolitan area of Barcelona, Spain.
SUBJECTS
243 Intravenous drug misusers, 143 of their regular heterosexual partners, and 105 homosexual men.
MAIN OUTCOME MEASURES
Prevalences of hepatitis C virus, hepatitis B virus, and HIV infections.
RESULTS
In all, 178 of the 243 (73%) intravenous drug misusers, 16 out of 143 (11%) of their partners, and 17 of the 105 (16%) homosexual men had antibodies against hepatitis C virus. The presence of hepatitis C virus infection was unrelated to sex, age, the presence of HIV or hepatitis B virus infections, or the Centers for Disease Control stage of HIV. In sexual partners of intravenous drug misusers there were strong correlations between the presence of hepatitis C virus infection and that of HIV (p = 0.001) and hepatitis B virus (p = 0.013) infections.
CONCLUSIONS
Intravenous drug misusers have a high risk of acquiring hepatitis C virus, hepatitis B virus, and HIV infections, but the presence of hepatitis C virus infection seems to be unrelated to the presence of the other two viruses. Homosexual men have a high prevalence of HIV and hepatitis B virus infections with a low prevalence of hepatitis C virus infection, the presence of which is not related to that of the other two infections. Conversely, heterosexual partners of intravenous drug misusers have low prevalences of the three virus infections, but the presence of hepatitis C virus infection correlates significantly with the presence of HIV and hepatitis B infections. The rate of sexual transmission of hepatitis C virus seems to be low, even in partners of people known to be seropositive for this virus.
目的
确定丙型肝炎病毒在静脉吸毒者性伴侣中的传播程度，并研究同性恋男性和静脉吸毒者及其性伴侣中艾滋病毒、乙型肝炎病毒和丙型肝炎病毒感染率之间的关系。
设计
对1984年至1988年间采集的血清样本进行检测，采用酶联免疫吸附测定法（ELISA）检测乙型肝炎病毒标志物和抗丙型肝炎病毒抗体，采用酶免疫分析法和蛋白质印迹法检测艾滋病毒抗体。
地点
西班牙巴塞罗那大都会区一家设有外部艾滋病诊所的大型转诊大学医院。
研究对象
243名静脉吸毒者、143名他们的固定异性性伴侣以及105名同性恋男性。
主要观察指标
丙型肝炎病毒、乙型肝炎病毒和艾滋病毒感染率。
结果
243名静脉吸毒者中共有178名（73%）、其143名伴侣中有16名（11%）以及105名同性恋男性中有17名（16%）抗丙型肝炎病毒抗体呈阳性。丙型肝炎病毒感染的存在与性别、年龄、艾滋病毒或乙型肝炎病毒感染的存在以及艾滋病毒的疾病控制分期无关。在静脉吸毒者的性伴侣中，丙型肝炎病毒感染的存在与艾滋病毒（p = 0.001）和乙型肝炎病毒（p = 0.013）感染的存在之间存在强相关性。
结论
静脉吸毒者感染丙型肝炎病毒、乙型肝炎病毒和艾滋病毒的风险很高，但丙型肝炎病毒感染的存在似乎与其他两种病毒的存在无关。同性恋男性艾滋病毒和乙型肝炎病毒感染率高，丙型肝炎病毒感染率低，丙型肝炎病毒感染的存在与其他两种感染的存在无关。相反，静脉吸毒者的异性性伴侣这三种病毒感染率低，但丙型肝炎病毒感染的存在与艾滋病毒和乙型肝炎感染的存在显著相关。丙型肝炎病毒的性传播率似乎很低，即使在已知该病毒血清学呈阳性者的伴侣中也是如此。
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