Sexual Contact with HCV Positive Partners

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Sexual Contact with HCV Positive Partners Is a Significant Risk Factor
Endoscopy Second Most Prevalent Risk Factor of Those Studied

In a study from Pontchaillou University Hospital in Rennes, France, sexual transmission and history of an endoscopic procedure emerged as the two most important risk factors among sporadic cases of HCV. These cases, which account for 30 to 40% of patients, are ones in which the mode of infection has not been clearly determined. In the other 60 to 70% of patients, infection was acquired through blood transfusion or intravenous drug abuse. According to Dr. Dominique Guyader of the Liver Disease Clinic at the hospital, the results of the study show that contact with sexual partners who are HCV positive is six times more prevalent among hepatitis C patients than in the control group. "So this is a significant risk for infection," he says. The second highest risk of the possible factors looked at was endoscopy, which occurred one and a half times more frequently in the HCV positive population than in the control population. Dr. Guyader points out, however, that he believes the problem is already being addressed. "It is now much better because we clean the endoscope very thoroughly. The problem was 10 years ago because we did not clean very efficiently I think." The researchers investigated the infection risk associated with several variables: having an HCV positive sexual partner, tattooing, acupuncture, endoscopy, surgery, high-risk invasive procedures (such as vascular or interventional radiology), and working in a health care occupation. The frequencies of these risk factors among 249 HCV positive patients were compared to their frequencies among an age and sex paired control group of healthy HCV negative patients who were seen for routine medical examinations. Patients in the HCV positive group had never received a transfusion and were not intravenous drug abusers. Surgery and high-risk invasive procedures were not found to be significantly linked to transmission of infection. "We have to be careful, however, because there is a high risk of transmission with these in the control population, and if you increase the number of those patients maybe it will become significant," says Dr. Guyader. Similarly, tattooing, acupuncture, and being a health care worker did not appear to put people at increased risk of HCV infection. The results of this study suggest that endoscopy and sexual transmission are involved in sporadic infections, underlining the importance of setting up preventive measures. For other possible risk factors for sporadic HCV infection, very large samples of patients must be studied before any conclusions may be drawn.

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