Background: Approximately 40% of patients infected with hepatitis C virus (HCV) have no history of blood transfusion or other high-risk practice. Other causes should be considered.
Goal: The goal was to describe sexual transmission of HCV from a chronic carrier to his female partner during unprotected vaginal intercourse after removal of an intrauterine device.
Study design: A heterosexual woman who was a regular blood donor acquired acute HCV infection from her sex partner, who was chronically infected. The study included an interview and phylogenetic analysis of sequences of virus obtained from the couple.
Results: Risk factors other than vaginal sexual relations with her partner were ruled out. Phylogenetic analysis showed that sequences from the couple clustered together in all trees generated, in comparison with local and GenBank controls.
Conclusion: The temporal relationship between removal of the intrauterine device and the acute hepatitis suggests that vaginal mucosal damage might have favored transmission of HCV. Barrier precautions should be suggested whenever damage of the vaginal tract has occurred.