Caporaso N, Ascione A, Stroffolini T
Dipartimento di Internistica Clinica e Sperimentale F. Magrassi, II Università di Napoli, Italy.
J Viral Hepat. 1998 Jan;5(1):67-72. doi: 10.1046/j.1365-2893.1998.00085.x.
In 1995, the intrafamilial spread of hepatitis C virus (HCV) was evaluated among 1379 household contacts of 585 HCV antibody-positive HCV RNA-positive subjects (index cases) in Italy. All index cases were patients with histologically proven chronic liver disease. The presence of antibodies to HCV (anti-HCV) was assessed by third-generation enzyme-linked immunosorbent assay (ELISA); the polymerase chain reaction (PCR) was used to test for HCV RNA. The overall anti-HCV prevalence among household contacts of index cases was 7.3% (101/1379); it was 15.6% in spouses and 3.2% in other relatives (P < 0.05; odds ratio (OR), 6.5; 95% confidence interval (CI), 3.5-8.6). Spouses married to index cases for longer than 20 years had a significantly higher anti-HCV prevalence than those married 20 years or less (19.8% vs 8.0%; P< 0.05; OR, 2.8; 95% CI, 1.5-5.3). Parenteral risk factors were more likely to be reported in anti-HCV positive than in anti-HCV negative household contacts. After adjustment for confounders by multiple logistic regression analysis, age greater than 4 5 years (OR, 3.1; 95% CI, 1.6-5.3) and any parenteral exposure (OR, 3.7; 95% CI, 1.7-8.1), were the only independent predictors of the likelihood of anti-HCV positivity among household contacts. Spouses versus other relatives and length of marriage were both no longer associated. These findings suggest that sexual transmission does not seem to play a role in the intrafamilial spread of HCV infection.
1995年，在意大利，对585例丙型肝炎病毒（HCV）抗体阳性且HCV RNA阳性受试者（索引病例）的1379名家庭接触者进行了HCV家庭内传播情况评估。所有索引病例均为经组织学证实的慢性肝病患者。采用第三代酶联免疫吸附试验（ELISA）评估HCV抗体（抗-HCV）的存在情况；聚合酶链反应（PCR）用于检测HCV RNA。索引病例家庭接触者中抗-HCV总体患病率为7.3%（101/1379）；配偶中的患病率为15.6%，其他亲属中的患病率为3.2%（P<0.05；优势比（OR）为6.5；95%置信区间（CI）为3.5 - 8.6）。与索引病例结婚超过20年的配偶抗-HCV患病率显著高于结婚20年及以下的配偶（19.8%对8.0%；P<0.05；OR为2.8；95%CI为1.5 - 5.3）。与抗-HCV阴性的家庭接触者相比，抗-HCV阳性的家庭接触者更有可能报告有非肠道危险因素。通过多因素logistic回归分析对混杂因素进行校正后，年龄大于45岁（OR为3.1；95%CI为1.6 - 5.3）和任何非肠道暴露（OR为3.7；95%CI为1.7 - 8.1）是家庭接触者中抗-HCV阳性可能性的唯一独立预测因素。配偶与其他亲属以及婚姻时长均不再具有相关性。这些发现表明，性传播似乎在HCV感染的家庭内传播中不起作用。
