ABSTRACT
In order to investigate the sexual transmission of the Hepatitis C Virus (HCV), the prevalence of specific antibodies in populations at high and low risk for sexually transmitted diseases (STDs) was evaluated. The population at low risk for STDs was composed of persons who voluntarily donated blood at the Hospital Universitário Clementino Fraga Filho (HUCFF) between July and November, 1990 (n = 2494). The population at high risk for STDs was drawn from an ongoing study on the natural history of Human Immunodeficiency Virus (HIV) infection (n = 210, 187 with sexual risk factors for HIV infection). All samples were screened using a first generation ELISA. Repeat reactive samples were then tested in a second generation RIBA. For all ELISA positive samples, two sex and age-matched ELISA negative controls were selected. Data pertaining to the presence of antibodies to the Hepatitis B core antigen (anti-HBC antibodies) and to Treponema pallidum were abstracted from the medical records. The prevalence of RIBA 2 confirmed HCV infection among the blood donors was 2.08%, which is well above the reported prevalence in similar populations from developed western countries. Among the HIV infected homosexuals, the encountered prevalence was 7.96% (p < 0.0005). For the whole group with sexually acquired HIV infection, the prevalence was 8.02% (p < 0.000005). Anti-HBc antibodies were more frequently present in anti-HCV RIBA-2 confirmed positive blood donors than in controls (p < 0.001). 33.3% of the HCV-positive blood donors and 11.04% controls were found to be anti-HBc positive (p < 0.0005).(ABSTRACT TRUNCATED AT 250 WORDS)
PIP: Hepatitis C virus (HCV) has an etiological role in post-transfusional Non-A Non-B Hepatitis, cirrhosis, and hepatoma. Studies have revealed an high prevalence of anti-HCV antibodies in hemophiliacs, IV drug users, and other groups at risk for parenterally transmitted infections. The authors report findings from their investigation into the sexual transmission of HCV. The prevalences of antibodies to HCV, the hepatitis B core (HBc) antigen, and to Treponema pallidum were assessed among groups of individuals at high and low risk for sexually transmitted diseases (STD). The population at low risk for STDs was comprised of 2494 volunteer blood donors at the Hospital Universitario Clementino Fraga Filho (HUCFF) over the period July-November 1990. The population at high risk for STDs was comprised of 187 adults consecutively enrolled between September 1990 and January 1991 in a cohort study of the natural history of HIV infection. Sera were screened with a first generation HCV ELISA test, with repeat reactive samples further analyzed using a second generation recombinant immunoblot confirmatory test (RIBA-2). Data on the presence of antibodies to HBc, VRDL, and HIV were abstracted from the Blood Bank records. Antibody testing against Treponema pallidum was conducted among HCV-ELISA positive blood donors and their controls using FTA-ABs. 2.08% of blood donors were infected with HCV, 7.96% of the HIV-infected homosexuals, and 8.02% of the whole group with sexually acquired HIV infection. Anti-HBc antibodies were more frequently present in anti-HCV RIBA-2 confirmed positive blood donors than in controls. 33.3% of the HCV-positive blood donors and 11.04% of controls were found to be anti-HBc positive. 17.6% of HCV-positive donors and 4.9% of controls yielded positive FTA-ABs results. 5.9% of samples from blood donors were both anti-HBc and FTA-ABs positive, while none of the controls reacted in both tests. The association between HCV, hepatitis B infection, and syphilis in individuals at low risk for parenterally transmitted diseases suggests that sexual transmission contributes to the maintenance of the endemicity of HCV in the local population.
