丙型肝炎病毒的异性传播以及首例病例中共存的人类免疫缺陷病毒感染可能发挥的作用。一项针对423对配对的多中心研究。

Heterosexual transmission of hepatitis C virus and the possible role of coexistent human immunodeficiency virus infection in the index case. A multicentre study of 423 pairings.

作者信息

Soto B, Rodrigo L, Garcia-Bengoechea M, Sanchez-Quijano A, Riestra S, Arenas J I, Andreu J, Rodriguez M, Emparanza J I, Torres Y

机构信息

Viral Hepatitis and AIDS Study Group, Virgen del Rocio University Hospital, Seville, Spain.

出版信息

J Intern Med. 1994 Nov;236(5):515-9. doi: 10.1111/j.1365-2796.1994.tb00838.x.

DOI:10.1111/j.1365-2796.1994.tb00838.x

PMID:7964427

Abstract

OBJECTIVES

To define the role that sexual transmission plays in the spread of hepatitis C virus (HCV) infection, and to examine the influence of coexistent human immunodeficiency virus (HIV) infection on this mode of transmission.

DESIGN

A multicentre, seroprevalence study of anti-HCV performed in the stable heterosexual partners (SHP) of index cases reactive for anti-HCV.

SETTING

Department of Internal Medicine and Section of Gastroenterology of three University Hospitals, Spain.

SUBJECTS

A total of 423 stable heterosexual partners of index cases reactive for anti-HCV. This included a group of 142 intravenous drug users (IVDU), 120 of whom were coinfected with HIV. Additionally, 2886 first-time voluntary blood donors selected at random were included to compare the prevalence of anti-HCV.

MAIN OUTCOME MEASURES

Serum samples were screened for anti-HCV by a commercially available, second-generation enzyme-linked immunoassay. Tests repeatedly reactive for anti-HCV were analysed by a four-antigen, recombinant immunoblot assay. Anti-HIV was tested by enzyme immunoassay and Western blot was used for confirmation of positive cases.

RESULTS

The prevalence of anti-HCV, was 7.1% in SHP and 1.2% in random donors (P < 0.001). This prevalence was higher in SHP of index cases coinfected with HIV in comparison with that shown in the SHP of index cases only reactive for the anti-HCV (9.1 vs. 6.3%; P = 0.2), particularly when a younger and more homogeneous group such as the SHP of IVDU index cases was considered alone (9.2 vs. 0%; P = 0.1). However, the SHP of IVDU index cases coinfected with HIV were almost three times more likely to be infected with HIV than HCV (24.2 vs. 9.2%).

CONCLUSIONS

These data suggest that HCV infection may be sexually transmitted but with low efficiency, and this could be increased in the presence of coexistent HIV infection in the index case.

摘要

目的

确定性传播在丙型肝炎病毒（HCV）感染传播中所起的作用，并研究人类免疫缺陷病毒（HIV）合并感染对这种传播方式的影响。

设计

对HCV抗体呈反应性的索引病例的稳定异性伴侣（SHP）进行的多中心血清流行率研究。

地点

西班牙三家大学医院的内科和胃肠病学科。

研究对象

总共423名HCV抗体呈反应性的索引病例的稳定异性伴侣。其中包括一组142名静脉吸毒者（IVDU），其中120人合并感染HIV。此外，还纳入了2886名随机挑选的首次自愿献血者以比较HCV抗体的流行率。

主要观察指标

通过市售的第二代酶联免疫吸附试验筛查血清样本中的HCV抗体。对HCV抗体反复呈反应性的检测通过四抗原重组免疫印迹试验进行分析。通过酶免疫测定法检测HIV抗体，并用蛋白质印迹法确认阳性病例。

结果

SHP中HCV抗体的流行率为7.1%，随机献血者中为1.2%（P<0.001）。与仅对HCV抗体呈反应性的索引病例的SHP相比，合并感染HIV的索引病例的SHP中的流行率更高（9.1%对6.3%；P = 0.2），特别是当单独考虑较年轻且更同质的群体，如IVDU索引病例的SHP时（9.2%对0%；P = 0.1）。然而，合并感染HIV的IVDU索引病例的SHP感染HIV的可能性几乎是感染HCV的三倍（24.2%对9.2%）。