Hepatitis C Is Rarely Transmitted by Sex Among Monogamous Heterosexual Partners

Individuals infected by the hepatitis C virus (HCV) have nothing to fear from sex in a monogamous, heterosexual relationship, according to a study published in the March 2013 issue of Hepatology.

The findings of the study showed that the transmission of HCV from an infected partner during sex is rare.

Medical evidence shows HCV is primarily transmitted by exposure to infectious blood, typically through IV drug use. However, there are conflicting reports regarding sexual activity and HCV transmission, with some studies suggesting that exposure to infected blood during sex -- through bodily fluids such as vaginal secretions, semen or saliva -- may carry a minimal infection risk.

“Generally the risk for transmitting HCV to sex partners is very low,” says lead author Norah Terrault, MD, University of California at San Francisco, San Francisco, California. “Yet, lack of quantitative data about the risk of HCV transmission with sexual activity remains a limitation for doctors counselling their patients on safe sex practices.”

To specifically quantify the risk of HCV transmission from a chronically infected individual to their sex partner, researchers recruited 500 anti-HCV-positive individuals, who were negative for HIV, and their long-term heterosexual partners. Couples were surveyed about lifetime risk factors for HCV infection, sexual practices of the couple, and sharing of personal items. The team analysed blood samples to determine the presence or absence of active virus in the blood and compared the HCV strains in those couples with HCV present.

The majority of HCV-infected individuals who participated in the study were non-Hispanic whites, had a median age of 49 years, and sexual activity with their partners ranging from 2 to 52 years. HCV prevalence among partners was 4%, with 9 couples having similar viral strains, and viral samples from 3 couples were highly related which is consistent with HCV transmission between the partners.

The maximum incidence rate of HCV transmission by sex was 0.07% per year or roughly 1 per 190,000 sexual contacts that researchers based upon 8,377 person-years of follow-up.

The team did not identify any specific sexual practices linked to HCV infections among the couples.

“Our study provides clinicians with important information for counselling chronic HCV patients in long-term sexual relationships, supporting the current recommendations that couples not change their sexual practices if they are in a monogamous heterosexual relationship,” said Dr. Terrault.

SOURCE: Wiley