Does HIV Infection Favor the Sexual Transmission of Hepatitis C?

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Does HIV Infection Favor the Sexual Transmission of

Hepatitis C?

Editorial note from Jules Levin: For a while I have

been trying to draw attention to the underappreciated

risk of sexual transmission of HCV in other than

monogamous HIV-, STD-negative relationships. Without

knowing further details of this study it adds to a

growing body of evidence suggesting there is a risk of

HCV sexual transmission under certain circumstances:

when HIV, STDs & risky sexual behavior which may draw

blood unknowingly.

Filippini P, Coppola N, Scolastico C, Rossi G, Onofrio

M, Sagnelli E, Piccinino F.

Institute of Infectious Diseases, Second University of

Naples, Naples, Italy.

BACKGROUND: There are widely discrepant findings on

the sexual transmission of hepatitis C virus (HCV),

commonly transmitted by the parenteral route.

Coinfection with HCV is common in subjects infected

with HIV.

GOAL: This case-control study evaluated the prevalence

of anti-HCV in subjects with hetero- or homosexual

contact and no history of intravenous drug abuse or

blood transfusion, according to the presence or

absence of HIV infection.

STUDY DESIGN: In this case-control study, the cases

considered were 106 consecutive patients who showed

positive anti-HIV test results. For each case, two

control subjects were selected who had been screened

for HIV infection at the authors' center and found to

have anti-HIV-negative test results, and who matched

the case in terms age (+/- 5 years), gender, and risk

factor for parenterally transmitted infections.

RESULTS: The prevalence of subjects with positive test

results for hepatitis B surface antigen(HBsAg) was

similar between cases and control subjects (4.7%

versus 2.4%). Positivity for anti-hepatitis B core

antigen in connection with negative test results for

HBsAg was observed more frequently in the 106 cases

than in the 212 control subjects (33.9% versus 15.6%;

P =0.0003). Anti-HCV positivity was more frequent in

the cases than in the control subjects (15.1% versus

5.2%; P = 0.005). In particular, among subjects who

had hetero- or homosexual intercourse with a steady

partner who had positive anti-HIV test results,

anti-HCV positivity was observed in 18.7% of the 32

cases and 1.6% of the 64 control subjects (P = 0.008).

CONCLUSION: This study demonstrated that in subjects

who had only a sexual risk factor for parenterally

transmitted infections, HIV may enhance the sexual

transmission of HCV.

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