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Sexual transmission of Hepatitis C virus between HIV infected subjects and their main heterosexual partners; Actor Partner Interdependent Modelling


Overall, 60-70% of the hepatitis C virus’ (HCV) transmission routes is parenteral and in 30-40% of the cases was unknown (e.g. sexual route). Knowing of these routes in HIV infected dyads very important due to clinical and methodological reasons. Whether HCV transmits through sexual route in these dyads is controversy.

Materials and methods

Of the 1338 dyads enrolled in Behavioural Consultation Center in Shiraz, Iran in 2011, 984 couples (HIV infected subjects and their main heterosexual partners) have eligibility criteria. Random samples, 168 of 984 couples, were chosen through random generated numbers using a computer program. We used actor partner independent model (APIM) and multilevel analysis to assess multiple risk factors for HCV while partitioning the source of risk at the individual and couple level.


Age of the index samples was 38.71± 7 years and 33.2± 6.3 years for their main heterosexual partners; the mean duration of sexual relationship for couples was 11.9 (median= 8.5) years. Multivariate analysis showed that actor risk factor of intravenous drug using (IDU) (AOR= 13.03; 95% CI: 3.9- 43.82) and actor cofactors of HIV positivity (AOR= 7.1; 95% CI: 1.37- 36.97), razor sharing (AOR= 4.81; 95% CI: 1.84- 12.55), sex (AOR= 8.83; 95% CI: 3.16- 24.87), and condom use in sexual activity with main partner (AOR= 0.15; 95% CI: 0.02- 0.44) were associated with actor HCV positivity.


Health care providers need to pay special attention to sexual transmission of HCV among HIV-infected individuals and the control/preventive measures for HCV sexual transmission should be recommended.

Table 1 Multilevel logistic regression estimation of individual and couple level risk factors for actor anti-HCV positivity, final model, Shiraz (southern of Iran), 2011

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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

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Alipour, A., Rezaianzadeh, A., Hasanzadeh, J. et al. Sexual transmission of Hepatitis C virus between HIV infected subjects and their main heterosexual partners; Actor Partner Interdependent Modelling. BMC Infect Dis 14 (Suppl 2), P87 (2014).

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