Cervicovaginal shedding of hepatitis C viral RNA is associated with the presence of menstrual or other blood in cervicovaginal fluids.

Abstract

BACKGROUND:

The role of sexual activity in hepatitis C virus (HCV) transmission remains controversial. Studies to date have not explored the relationship between HCV shedding in cervicovaginal fluids and the presence of menstrual or other blood.

OBJECTIVES:

Since cross-sectional studies may underestimate the prevalence of viral shedding, we performed a 56-day longitudinal study of cervical HCV shedding.

STUDY DESIGN:

Women self-collected cervicovaginal swabs for 56 consecutive days, while keeping a diary of menses and genital symptoms. Swabs were tested for HCV RNA and cellular DNA by quantitative PCR, and hemoglobin by spectrophotometry.

RESULTS:

Sixteen women contributed a total of 701 cervicovaginal swabs (mean collection period 48 days, range 18-56). Detection of HCV RNA was associated with detection of hemoglobin. Premenopausal women were more likely than post-menopausal women to have HCV RNA detected in cervicovaginal fluids. For premenopausal women, detection of HCV RNA was more likely during menstruation (OR=56.4) or when hemoglobin was detected in cervicovaginal fluids, even if menstruation was not occurring (OR=35.4). No woman post-hysterectomy had HCV RNA detected in cervicovaginal fluids on any day, regardless of whether hemoglobin was detected.

CONCLUSIONS:

Our findings are consistent with a low likelihood of sexual transmission of HCV. The results suggest that shedding of HCV RNA in the female genital tract is associated with the presence of blood, and requires the presence of a cervix. Clinicians should consider advising premenopausal women who are concerned about transmitting infection that infectivity may increase during menstruation.

• Authors: Chia C Wang, Linda Cook, Kenneth A Tapia, Sarah Holte, Meighan Krows, Arthur Bagabag, Anna Santos, Lawrence Corey, Keith R Jerome
• Journal: Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology (J Clin Virol) Vol. 50 Issue 1 Pg. 4-7 (Jan 2011) ISSN: 1873-5967 [Electronic] Netherlands
• PMID: 20951635 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)
• Copyright: Copyright © 2010 Elsevier B.V. All rights reserved.

Chemical References

• RNA, Viral

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Body Fluids (chemistry, virology)
• Cervix Uteri (virology)
• Female
• Genotype
• Hepacivirus (genetics, physiology)
• Hepatitis C (virology)
• Humans
• Longitudinal Studies
• Menstruation
• Middle Aged
• RNA, Viral (blood)
• Vagina (virology)
• Viral Load (genetics)
• Virus Shedding
• Young Adult