A case of intraspousal transmission of HCV occurring after 50 years of marriage

Abstract

We reported a case of intraspousal transmission of HCV occurring after 50 years of marriage. A 72-year-old wife who had blood transfusion on delivery in 1955 was pointed out liver dysfunction in 1989 and had been followed up at our hospital since 1992. She was treated with interferon-α for 24 weeks in 1992 and 1994 with no response. On the other hand, a 77-year-old husband had been followed up at the near doctor because of diabetes mellitus and alcoholic liver disease since 1981. HCV Ab was negative on March 2000. On regular check-up, remarkable elevation of GOT 358 IU/l and GPT 700 IU/l was pointed out in September 2002 and referred to our hospital. Liver histology on admission was alcoholic fibrosis with hemosiderosis without piecemeal necrosis. Small amount of 3MU of interferon-α was administered b.i.w because of aging and diabetes mellitus since February 2003. HCV-RNA became negative after 7 months. Nucleotide sequence analysis of the 339 bases in the HCV NS5B gene by using serum from husband and wife demonstrated that both HCV was genotype 1b and 99.1% homology between them. Phylogenetic tree of HCV constructed by the neighhor-joining method showed that the spouses formed a significant cluster (100%). All possible routes of transmission were excluded by anamnestic evaluation except for sexual contact. From above findings, intraspousal transmission from wife to husband after 50 years of marriage was strongly suggested.