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Intrafamilial Transmission of Hepatitis C Virus Among Families of Infected Pediatric Oncology Patients

Sherief, Laila M. MD*; Beshir, Mohamed Refaat MD*; Salem, Ghada Muhammad MD; Sherbiny, Hanan S. MD*,‡; Soliman, Attia Abdelwehab MD*; El-komy, Mohamed A. MD*; Arafa, Muhammed MD*; Kamal, Naglaa M. MD§

The Pediatric Infectious Disease Journal: July 2019 - Volume 38 - Issue 7 - p 692–697
doi: 10.1097/INF.0000000000002299
Original Studies
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Background: Hepatitis C virus (HCV) is the most commonly encountered blood transmittable hepatitis among cancer patients. Several studies have reported clustering of HCV infections in families or household contacts of infected cases. Data about the epidemiologic aspects of intrafamilial transmission from pediatric cancer patients are scarce and still debated. We aimed to identify the magnitude of horizontal intrafamilial transmission of HCV from infected pediatric oncology patients; its prevalence, risk factors and possible routes of transmission.

Methods: One hundred fifty-seven (86 HCV positive, 71 HCV negative) pediatric oncology patients who received treatment and follow-up at Zagazig university Hospital-Egypt and their household family contacts (751) were enrolled in this cross-sectional case-control study. Blood samples were collected from 450 relatives of HCV infected cases (group 1) and 301 household contacts of HCV-negative cases (group 2) for analysis of HCV antibodies and HCV RNA to confirm positivity. Family contacts of HCV-infected cases were interviewed, and close-ended questionnaire was completed for each participant to determine risk factors and possible routes of HCV intrafamilial transmission.

Results: Significantly higher HCV prevalence and chronicity rates were documented among relatives of HCV-infected cases as compared with contacts of HCV-negative cases (12.6% and 10.6% for group 1 vs. 7% and 5.3% for group 2, respectively). Risk factors of infection were calculated by univariate and logistic regression analysis among contacts of HCV-infected cases. Female caregivers, particularly mother (OR 5.1, 95% CI: 2–13.5), contact with index cases blood, either directly without using personal protective equipment (OR 7.8, 95% CI: 2.9–23.8) or indirectly through common use of sharps (razors, scissors) (OR 8.9, 95% CI: 3.5–20.5) and nail clippers (OR 2.1, 95% CI: 1.1–5.4) and giving care to infected cases (OR 2.9, 95% CI: 1.3–16.6) represented the real predictors of intrafamilial HCV infection.

Conclusions: Intrafamilial transmission of HCV from infected children to their relatives does occur. Parenteral route is the only documented way of transmission either directly or indirectly.

From the *MD Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt

MD Community Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt

College of Applied Medical Science, University of Bisha (UB), Kingdom of Saudi Arabia

§MD Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt.

Accepted for publication January 22, 2019.

The authors have no funding or conflicts of interest to disclose.

L.S. and M.B. suggested the idea of the work and put work plan. L.S., M.B., H.S., A.S., M.E., M.A., N.K. reviewed literature, wrote the manuscript. G.S. did the statistical analysis of the study. All authors reviewed and approved the manuscript for final publication. Ethical approval and consent forms were fulfilled.

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Address for correspondence: Laila M. Sherief, MD, Professor of Pediatric Oncology, Faculty of Medicine, Zagazig University, Egypt. E-mail: lamesh25@yahoo.com.

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