Interspousal transmission of hepatitis C in Thailand.
BACKGROUND: Previous studies evaluating the possibility of interspousal sexual transmission of hepatitis C virus (HCV) have yielded many conflicting results. Our study was carried out to determine the exact potential and risk factors of interspousal HCV transmission. METHODS: The spouses (54 men and 106 women; mean age +/-SD, 48 +/- 8 years) of 160 patients with HCV infection (106 men and 54 women) were serologically tested for HCV using a third-generation enzyme-linked immuno- sorbent assay (ELISA). Positive results were confirmed by reverse transcriptase polymerase chain reaction (RT-PCR). For positive couples, the cluster nucleotides of the HCV gene and genotypes were compared on the basis of restriction fragment length polymorphism (RFLP), Innogenetic Line Probe Assay (INNO-LiPA), and direct sequencing. Similarly, phylogenetic tree and sequence homology analysis was performed in order to precisely verify interspousal transmission. Risk factors promoting interspousal HCV transmission were also identified. RESULTS: Throughout a mean duration of exposure of 23 + 5 years, most of the 160 partners had their usual and unprotected sexual relationships with the index patients. HCV-associated antibodies and HCV-RNA were detected in only 3 (1.88%) of the 160 spouses. Furthermore, homology and phylogenetic tree analysis could not clearly demonstrate that any one of these 3 positive spouses was infected with the same strain of HCV as that identified in the index cases. Because a positive group remained elusive, risk factors of interspousal HCV transmission could not be determined in this study. CONCLUSIONS: According to this study, interspousal transmission of HCV seems to be very rare. HCV-positive spouses should be firmly reassured that they can maintain their normal marital life.