Clinical

Injection behavior, not sexual contact, accounts for couples' hepatitis C risk

Last Updated: 2007-06-07 19:43:03 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Injection behavior, rather than sexual contact, accounts for the clustering of hepatitis C virus (HCV) infection in heterosexual couples, according to a report in the June 1st issue of The Journal of Infectious Diseases.

The role of sexual transmission of HCV has remained controversial because of inconsistent findings across studies involving heterosexual couples, lead author Dr. James M. McMahon and his colleagues explain.

Dr. McMahon from National Development and Research Institutes, New York, and associates applied multilevel dyadic modeling techniques to data collected from drug-using heterosexual couples to assess multiple risk factors for HCV infection at both the individual and couple level.

Four significant risk factors for anti-HCV positivity remained in a final multivariable model: an individual's older age; history of ever injecting illegal drugs; history of ever receiving a tattoo; and a couple's recent drug injection, moderated by a partner's anti-HCV-positive status.

"Our results indicate that HCV infection is not associated with sexual risk behavior among members of long-term heterosexual couples," Dr. McMahon and his associates conclude. "This finding must be qualified by the fact that the sample consisted entirely of drug users -- a population with very different characteristics and levels of risk than other populations."

"Although disease-prevention programs aimed at decreasing unsafe injection practices in high-risk communities have met with some success in recent years," the authors add, "our findings indicate a need to expand HCV prevention efforts to address the injection practices of primary heterosexual couples."

"Aggressive pursuit of interventions to prevent HCV transmission in IDUs, including the reduction of injecting in general, will be the most effective way to combat the HCV epidemic," writes Dr. Judith A. Hahn from University of California, San Francisco/San Francisco General Hospital, in a related editorial.

"Such interventions will need to address the injecting risk that occurs within the context of close injecting partnerships," Dr. Hahn concludes.

J Infect Dis 2007;195:1572-1581,1556-1559.