Table of Content

Current Issue

Summer 2020, Vol. 28 No. 2

Hong Kong J. Dermatol. Venereol. (2020) 28, 49-54


Original Article

Prevalence of sexually acquired hepatitis C virus (HCV) infection in sexually transmitted infection (STI) patients

性病患者中經性接觸感染丙型肝炎病毒的盛行率

CK Kwan 關志強, DPC Chan 陳珮琮, KM Ho 何景文, SS Lee 李瑞山

Abstract

Objectives: Hepatitis C virus (HCV) is commonly contracted through parenteral exposures such as needle-sharing in injection drug users (IDU) and transfusion of contaminated blood. As the significance of sexual transmission of HCV remains controversial, this study was designed to examine its prevalence in sexually transmitted infections (STI) patients, the latter considered as a surrogate of sexually active individuals who have engaged in unsafe sex. Methods: A cross-sectional study was conducted in Hong Kong at the Social Hygiene Service which operates STI clinics in the public sector. Over a 3-month period, all adult patients attending two major clinics were invited to have a blood test for HCV antibody (anti-HCV). Positive results were investigated afterwards by RNA testing, genotyping and phylogenetic analysis, coupled with their correlation with clinical histories. Results: Totally 959 STI clinic attendees were screened. Six were anti-HCV positive, giving an overall HCV prevalence of 0.6%. Four were ex-IDU with HCV genotype 6a, the same molecular identity of virus in IDU in Hong Kong. One RNA negative patient had probably contracted the virus via tattooing. An HIV co-infected patient with secondary syphilis had HCV genotype 3a that clustered with those of HIV-infected men who have sex with men (MSM) in Hong Kong. Conclusion: The risk of HCV transmission through sexual contacts in the community remains low. Its occurrence in MSM and the setting of HIV co-infection is however a cause for concern.

目的:丙型肝炎病毒主要通過非消化道接觸而感染,例如靜脈注射濫藥者共用的針頭和輸注受污染的血液。由於經性接觸傳播丙型肝炎病毒的重要性仍存在爭議,本研究旨在檢查其在性病患者中的盛行率,此群組一般被認定是不安全性行為的性活躍個體的代表。方法:在香港的社會衛生科進行了一個橫斷面研究,該服務營運著本地的公共性病診所。在三個月內,邀請了兩間主要診所的所有成年就診者進行丙型肝炎病毒抗體的血液檢查。當中陽性樣本會再進行核糖核酸測試、基因分型和系統發生分析,從而比對臨床病歷的相關性。結果:總共篩選了959名性病診所就診者。發現六例丙型肝炎病毒抗體陽性個案,總體盛行率為0.6%。四個是具有丙型肝炎病毒六甲基因型的前靜脈注射濫藥者,與香港靜脈注射濫藥者群組中發現的病毒分子身份相同。一名核糖核酸呈陰性的患者有可能是通過紋身感染了此病毒。另一名人類免疫力缺乏病毒並第二期梅毒感染患者的丙型肝炎病毒為三甲基因型,歸入香港男男性接觸者中的人類免疫力缺乏病毒患者的丙肝感染群組。結論:社區中通過性接觸傳播丙型肝炎病毒的風險仍然甚低。然而,它在男男性接觸者族群的傳播和人類免疫力缺乏病毒的合併感染情況,實令人擔憂。

Keywords: Hepatitis C virus (HCV), men who have sex with men (MSM), sexually transmitted infection (STI)

關鍵詞: 丙型肝炎病毒、男男性接觸者、性傳播感染