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

Abstract

Background and Aims: 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 epidemiological aspects of intrafamilial transmission from pediatric cancer patients are scarce and still debated. We aimed to figure-out the magnitude of horizontal intrafamilial transmission of HCV from infected pediatric oncology patients; its prevalence, risk factors and possible routes of transmission. Patients and Methods: 157 (86 HCV positive, 71 HCV negative) pediatric oncology patients 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 filled for each participant to determine risk factors and possible routes of 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% & 10.6% for group-1 Vs 7% & 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 (OR7.8, 95% CI2.9-23.8)or indirectly through common use of sharps (razors, scissors) (OR8.9, 95% CI3.5-20.5) 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. Conclusion: 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. Funding: This research did not receive any grant from any funding agency. Declaration of Interest: Authors declare no conflicts of interest. Ethical Approval: The study protocol was approved by our hospital local research and ethical committee and written informed consent was taken from each participant or his/her legal guardian before enrollment.