Meta-Analysis of Sexual Transmission of Hepatitis C
Editor-in-Chief, HCV Advocate
Sexual transmission of hepatitis C is always a controversial topic. A new report was released that analyzed 80 studies to determine the transmission of hepatitis C through sexual contact. The authors came to the conclusion that the weight of evidence supports that there is no increased risk of hepatitis C sexual transmission among heterosexual couples in a ‘regular relationship.’ The risk of hepatitis C sexual transmission, however, increases among persons with multiple sexual partners, but this association may be ‘confounded’ by the increased likelihood of injection drug use with the increased number of sexual partners. The authors found an increased risk for women coinfected with HIV or other sexually transmitted infections and particularly for HIV-infected gay men who are having sex with other HIV-infected gay men when compared with gay men who were not infected with HIV. The increased risk of sexual transmission was associated with sexual practices that lead to “mucosal trauma (multiple sexual partners, fisting, use of sex toys) and the presence of genital ulcerative disease.” The authors concluded that “health care providers need to pay special attention to sexual transmission of HCV among HIV-infected individuals.”
This analysis of 80 studies of sexual transmission of hepatitis C adds to the body of knowledge that confirms that the risk of sexual transmission of hepatitis C among people in a stable long-term monogamous relationship is very low, some studies even finding it to be completely absent. Safer sex, however, should be encouraged in situations when blood is present, and for people who engage in high risk sexual practices. Increasing evidence , however, points to the fact that HIV positive gay men are at increased risk for sexual transmission of hepatitis C and should be counseled on safer sex practices and tested for hepatitis C.
Is sexual contact a major mode of hepatitis C virus transmission?
Tohme RA, Holmberg SD –Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Atlanta, GA. Hepatology. 2010 Jun 16. [Epub ahead of print]