The risk of sexual transmission of hepatitis C virus has not been thoroughly
investigated but appears to be minimal. Some studies have shown no risk
of passing hepatitis C on to a sexual partner, others have shown only a
very low risk. The United States Centers for Disease Control and
Prevention (CDC), as well as the British Columbia Centre for Disease
Control do not recommend a change in sexual practices for those engaged
in a long-term relationship with one sexual partner. However, people with
acute illness and multiple sexual partners may be at greater risk and
should use condoms to reduce the risk of acquiring or transmitting
hepatitis C as well as other sexually transmitted infections. The risk is
increased if the HCV positive partner is immunocompromised because the
virus titer in the blood may be increased under those circumstances. Sex
during the menstrual period should be avoided, due to the blood contact
at that time. There is also some speculation about the possibility of
transmission piggybacked on the genital herpes virus through genital
lesions.
The reason that many studies say “multiple sexual partners” when referring to
the risk of sexual transmission of HCV is that people who have multiple
sexual partners have a greater risk of contracting other sexually
transmitted diseases which can cause open sores and lesions. And with
those open sores and lesions you are at greater risk for blood
contact. Also, it is thought that the hepatitis C virus tends to
“piggyback” on the herpes virus, and if you have herpes you are at much
greater risk of contracting or transmitting the virus.
According to a report in the Archives of Internal Medicine, sexual transmission
of HCV occurs at a rate of about 1% per year in at-risk partners, and
shows that periodic serum immune globulin prophylaxis for sexual partners
is protective.
Transmission of the virus “...occurred only in partners of HCV-infected
patients with active liver disease,” the researchers report. They add an
“intriguing” finding that patients who became infected during the study
were older and had longer relationships with their partners compared with
those who did not become infected. - Arch Intern Med 1997;157:1537-1544
A report from Health Canada, “Hepatitis C Prevention and Control: A Public
Health Consensus,” June 1999, p.6, recommends that:
A recent study in The Lancet, 356:9223:42-43 (June 2000) detected the hepatitis C virus in the semen of infected men. The doctors concluded that “the presence of HCV-RNA in semen is a strong argument in favour of HCV sexual transmission from men to women.” However, HCV viral loads detected in semen were low, which suggests that the risk of HCV sexual transmission is probably also low.
