Pilot study for assessment of prevalence of intrafamilial hepatitis C transmission in relation to salivary viral load among infected patients with and without chronic renal failure

Abstract

HCV-RNA in saliva of HCV patients provides a biological basis for its potential transmission. HCV viremia is particularly high in HCV patients on hemodialysis. This study aimed to evaluate the prevalence of HCV in saliva of HCV patients with and without renal failure, and the possible role of intrafamilial transmission of the virus. Twenty HCV patients were enrolled in this study. They were divided into two groups: 10 HCV infected patients without renal failure (Group I) and 10 with renal failure (Group II).  Detection of HCV-RNA by quantitative RT-PCR in serum and saliva of both groups was done. Thirty-eight family members of both groups were included for the detection of serum HCV antibody. The percentage of the saliva-positive patients for HCV was significantly higher in the renal failure group (70%) than the other group (40%) (p<0.05). There was insignificant statistical difference between the two groups as regards infectivity to their family contacts. Also there was insignificant correlation between the level of viremia and the intra familial transmission with a mean + SD (9,33,250 +24,501) in negative relatives and a mean + SD(79,912+26,879) in positive relatives (p> 0.05). But a significant correlation was revealed between the level of viremia and saliva positivity, with a mean + SD(12,95,666 + 1792) in saliva-positive patients and a mean +SD (3,74,465 + 2150) in saliva-negative patients (p< 0.05). There was a highly significant difference between infectivity of HCV saliva-positive patients and saliva-negative patients to their family contacts (p< 0.001).
Conclusion: Increased percentage of HCV detection in saliva of HCV patients with renal failure on HD may cause spreading of HCV in HD units among RF patients. Also there was increased percentage of interfamilial infectivity among the saliva-positive patients to their relatives and this suggests that saliva might have an infective role.

Keywords: Salivary; HCV; HCV PCR; Intrafamilial transmission