Intrafamilial distribution patterns and clinical characteristics of hepatitis C in Anti HCV seropositives using HCV PCR

ABSTRACT

BACKGROUND: The prevalence of hepatitis C in blood donors have been reported to be 1.5% to 2.0% and 85 90% of post transfusion hepatitis patients show anti HCV positive results. Most agree that hepatitis C is readily spread by way of contact with blood, but a discernible history of parenteral exposure is identified in only 40% to 50% of cases. Thus other possible nonparenteral routes of transmission such as vertical, sexual and intrafamilial contact transmission need to be explored. In this study, we investigated the clinical characteristics of anti HCV seropositives and the infection patterns of hepatitis C in their families not only by anti HCV but also by HCV PCR to explore the possibility of HCV infection through nonparenteral household contact. METHODS: Past history, physical examination, liver function tests, HCV PCR, hepatitis B viral markers, abdominal ultrasonography and liver biopsy were done in 161 anti HCV seropositives from May, 1991 to August, 1996. Of the 161 seropositives, 42 seropositives' family members, 98 subjects, were available for investigation by anti HCV, HCV PCR and liver function tests to document intrafamilial HCV infection;their respective relationships to the index seropositive were noted. RESULTS: The 161 anti HCV seropositives were classified as follows34 in the carrier group(21.1%), 41 in the acute hepatitis group (25.5%), 32 in the chronic hepatitis group(19.9%), 24 in the liver cirrhosis group(14.9%) and 30 in the hepatoma group(18.6%). The positive rates of HCV PCR were 55.2% in total, 46.1% in the carrier group, 55.0% in the acute hepatitis group, 76.4% in the chronic hepatitis group, 40.0% in the liver cirrhosis group, and 42.8% in the hepatoma group. The 98 family members were all anti HCV seronegative. The positive rates of HCV PCR in these family members were 10.2% in total, 7.1% in spouses, 28.6% in siblings, and 8.3% in children. CONCLUSION: Anti HCV seropositives were in various clinical states of liver disease due to HCV infecton. Although none of the family members showed anti HCV positive results, HCV PCR was positive in 10.2% of the family members indicating the need to perform HCV PCR to detect HCV infection.