Sexual transmission of hepatitis C virus and prevention with intramuscular immunoglobulin

Marcello Piazza, Luciano Sagliocca, Grazia Tosone, Vincenzo Guadagnino, Maria Antonia Stazi, Raffaele Orlando, Guglielmo Borgia, Domenico Rosa, Sergio Abrignani, Filippo Palumbo, Aldo Manzin, Massimo Clementi

Research output: Contribution to journalArticle

Abstract

The sexual transmission of hepatitis C virus (HCV) has long been debated. The prevalence of infected at-risk partners varies from 0% to 30%. In a prospective study, the risk of infection was quantified in steady heterosexual partners and the prophylactic effect of normal human polyvalent immune serum globulin (ISG) was evaluated. A total of 899 at-risk partners of HCV-infected patients were enrolled in a single-blind randomized controlled trial and assigned to receive every 2 months 4 mL of intramuscular ISG from unscreened donors (450 partners) or placebo (499 partners). Seven partners developed acute HCV infection (increased aminotransferase levels and appearance of HCV-RNA): six of the placebo group (incidence density [ID] 12.00/1,000 person year; 95% confidence interval [CI] 3.0 to 21.61), and only one of the ISG-treated group (ID 1.98/1,000 person year; 95% CI 0 to 5.86). The risk of infection was significantly higher in controls versus treated individuals (p = 0.03). Six couples had genotype 1b (85%), and one couple had genotype 1a; HCV sequence homology strongly supported sexual transmission. Our trial demonstrates that HCV infection can be sexually transmitted and quantifies the risk of sexual transmission: for every year of at-risk sexual relationship, almost 1% of the partners became infected. Intramuscular ISG is safe and well tolerated. Unlike ISG from screened donors, ISG from donors unscreened for anti-HCV contains high titers of anti-gpE1/gpE2 neutralizing antibodies and high neutralizing activity. Anti-HCV hyperimmune globulin could be prepared from anti-HCV-positive blood units and could be used to protect sexual partners and in other at-risk situations of exposure to HCV infection.

Original languageEnglish
Pages (from-to)611-618
Number of pages8
JournalAIDS Patient Care and STDs
Volume12
Issue number8
Publication statusPublished - Aug 1998

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Leadership and Management
  • Nursing(all)

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    Piazza, M., Sagliocca, L., Tosone, G., Guadagnino, V., Stazi, M. A., Orlando, R., Borgia, G., Rosa, D., Abrignani, S., Palumbo, F., Manzin, A., & Clementi, M. (1998). Sexual transmission of hepatitis C virus and prevention with intramuscular immunoglobulin. AIDS Patient Care and STDs, 12(8), 611-618.