HEPATITIS - SEXUAL TRANSMISSION

SEXUAL TRANSMISSION:
Sexual Transmission of hepatitis C remains controversial and probably accounts for less than 5% of cases. Risk factors for sexual transmission include multiple sex partners, prostitute use, rectal intercourse, and traumatic sex. Sexual intercourse during menstruation or without adequate vaginal lubrication may increase the transmission rate. Studies in married couples have indicated a great risk of spousal transmission with increasing duration of married. Whether this risk is secondary to Sexual Transmission, the potential role of more frequent sharing of household (razors, toothbrushes, etc) items or other factors remains to be determined.

Perinatal transmission
Perinatal transmission of hepatitis C occurs in approximately 3% to 5% of infants born to women infected with HCV. Perinatal transmission is associated with 2 independent risk factors: high viral load at time of delivery and having a mother who is HIV – positive.

Italian investigators recently reported the decreased risk of perinatal transmission of hepatitis C with cesarean section when compared with vaginal delivery. The risk of perinatal transmission of hepatitis C in a woman who is HIV-positive is estimated to be 15% to 35%. Infants born to hepatitis C- infected mothers may initially be hepatitis C antibody –positive due to passive transfer of this antibody across the placenta. This antibody may be present throughout thee first year of an uninfected newborn’s life before Disappearing. Therefore, the determination of hepatitis C infection in the newborn requires the demonstration of positive HCV RNA in the serum. Breastfeeding by mothers with hepatitis C appears to be safe, with no reported cases of viral transmission to newborns.

OTHER FACTORS:
Other groups at high risk for Hepatitis C infections include persons who received clothing factor concentrates prior to 1987, persons on hemodialysis, hemophiliacs and individuals who received either a solid organ or bone marrow transplant prior to 1992. Contamination of the ultrafiltrate dialysis membrane may help explain the high rate of hepatitis C infection seen in dialysis units.