Hepatitis C Virus Inter-Spousal Transmission Could be a Gate to Reduce Intrafamilial Spread and High Prevalence of HCV in Egypt

Background: It is generally agreed that HCV can be efficiently transmitted parenterally, although data on HCV transmission by non-parenteral routes such as sexual and nonsexual household contacts are conflicting. HCV is highly prevalent in Egypt. Aim: To investigate HCV transmission between spouses, the burden and the potential risk factors of sexual and nonsexual transmission to prevent intrafamilial spread. Patients and Methods: A cross-sectional study after a questionnaire, 100 male and 100 female HCV patients having confirmed HCV infection constitute the index cases. The spouses of 200 index cases and respectively100 healthy volunteers with their spouses of matched age were included as control. They were tested for serum anti-HCV ELISA and confirmed by PCR test for HCV RNA. Results: High rate of interspousal infection were detected, female spouses of male index cases were 42% positive and of females were 34%, male control 11% and their female spouses 6%. Age, duration of marriage, less educated spouses, risky sexual behavior and community risk factors showed a significant increase of HCV infection but insignificant increase with low socioeconomic levels and without significant difference between male-to-female and female-to-male transmission of HCV in spouses. Conclusions: The study revealed high intra-spousal transmission of HCV. It increases with age, duration of marriage, less educated, non skilled and in invasive sex behavior. Interspousal transmission is considered to be the main gate for intrafamilial spread and essential for strategic prevention of HCV and reduction of its complications in Egypt.