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Hepatitis C and Sex

October 18, 2004

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One of the most frequent questions I hear from newly diagnosed Hepatitis c patients is whether or not they could pass this disease on to their loved ones through sexual intercourse. I am also frequently contacted by people in relationship with Hepatitis c patients. They have heard the disease was sexually transmitted and are afraid of contracting it themselves.

There has been much confusion and misinformation about this subject out there. Even the Centers for Disease Control (CDC) website states that sexual transmission is possible (although unlikely).

This new study (cited below) basically proves once and for all that there is no real risk of sexual transmission as long as blood to blood contact is avoided. This is good news, and it also points to the wisdom of staying up to date with emerging knowledge about hepatitis C. More is being discovered and clarified about this disease on an ongoing basis. Even the smallest of these discoveries can directly impact our lives as hepatitis c patients.

Incidentally, this finding does not mean you should be cavalier or nonchalant about the fact you have this infectious and potentially deadly disease. Sharing toothbrushes or razor blades are still considered risky activities. And high risk sexual behavior that might cause any blood to blood contact is to be rigorously avoided. To be safe, be sensible.

No Evidence of Sexual Transmission of Hepatitis C among Monogamous Couples: Results of a 10-Year Prospective Study

The risk of sexual transmission of hepatitis C virus (HCV) infection was evaluated among 895 monogamous heterosexual partners of HCV chronically infected individuals in a long-term prospective study, which provided a follow-up period of 8,060 person-years. Seven hundred and seventy-six (86.7%) spouses were followed for 10 yr, corresponding to 7,760 person-years of observation.

One hundred and nineteen (13.3%) spouses (69 whose infected partners cleared the virus following treatment and 50 who ended their relationship or were lost at follow-up) contributed an additional 300 person-years.

All couples denied practicing anal intercourse or sex during menstruation, as well as condom use. The average weekly rate of sexual intercourse was 1.8.

Three HCV infections were observed during follow-up corresponding to an incidence rate of 0.37 per 1,000 person-years. However, the infecting HCV genotype in one spouse (2a) was different from that of the partner (1b), clearly excluding sexual transmission.

The remaining two couples had concordant genotypes, but sequence analysis of the NS5b region of the HCV genome, coupled with phylogenetic analysis showed that the corresponding partners carried different viral isolates, again excluding the possibility of intra-spousal transmission of HCV.

The authors conclude, “Our data indicate that the risk of sexual transmission of HCV within heterosexual monogamous couples is extremely low or even null. No general recommendations for condom use seem required for individuals in monogamous partnerships with HCV-infected partners.”

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