Hepatitis C virus infection in patients and family members attending two primary care clinics in Puebla, Mexico

Autor: Méndez Sánchez Nahum

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López-Colombo, et al. Hepatitis C virus (HCV) transmission is mainly due to parenteral exposure. However, in absence of such risk factor, there are reports of intrafamilial spread of HCV and observational studies suggest an increased risk for households of infected subjects. This risk factor has been explored in the last two decades in different geographical areas around the world. However, there are contradictory results. Firstly, Ndong-Atome, et al. found in a cross-sectional study was conducted in Dienga, in Gabon, involving 195 household members of 14 index cases of HCV infection. The investigators found an overall prevalence of antibody to HCV among household members of infected cases of 6.7%, with a significantly higher prevalence among sexual partners (35.7%) than non-sexual partners (7%). Furthermore, the HCV strains infecting different household contacts of index cases were concordant in only 40%, each of who was a sexual partner. This, and the discordance in HCV genotypes infecting the household members, indicate a limited role for intrafamilial transmission of HCV in this population. In another study Honda, et al. evaluated the risk of hepatitis C virus transmission through household contact with chronic carriers using nucleotide sequence analysis. HCV patients (76 patients) were divided into two groups: familial transmission of HCV was studied in group A (53 patients); group B (23 patients) served as nonfamilial controls for group A. Of 88 family members of group A patients, 18 (20%) had elevated serum ALT levels, 20 (23%) had antibodies against hepatitis C virus and 16 (18%) had hepatitis C virus RNA in serum. Nucleotide sequences of the region of the hepatitis C virus genome spanning the core and envelope genes were compared among the three groups. In group B, the average nucleotide sequence homology was 91.0% ± 2.29% (a pairwise comparison was made for each of the patients; n = 253). Isolates from two family members were significantly more homologous to isolates from corresponding patients in group A than to isolates from group B patients. Of the two isolates from family members, one was from a child whose mother was a patient (97.7% homology) and one was from a spouse (98.1% homology). These results strongly suggest familial transmission of the same HCV strain.

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2014-10-30   |   529 visitas   |   Evalua este artículo 0 valoraciones

Vol. 13 Núm.6. Noviembre-Diciembre 2014 Pags. 716-718 Ann Hepatol 2014; 13(6)