Is Hepatitis C a Sexually Transmitted Disease?

The hepatitis C virus could be transmitted during sex if there were blood present, but it is not considered a sexually transmitted disease. Some studies in which it was claimed that HCV was sexually transmitted are known to be flawed because the group tested (mostly prostitutes) also had other risk factors, such as lifestyle risks (sharing of razors, manicure equipment, toothbrushes) and, most notably, intravenous drug use.

According to Health Canada, however, “The risk of infection through sexual intercourse with a carrier is estimated at 2.5% over 20 years. Transmission from mother to child is uncommon, and the question of risk to breast-fed infants of infected mothers is unresolved.”1

Hepatitis C is spread mainly by blood-to-blood contact. Thus it is conceivable that sharing a toothbrush or a razor--or even deep-kissing after dental flossing--might be more risky than actual sex!

Other studies suggest that body fluids of patients with chronic hepatitis C are rarely, if ever, contaminated with the hepatitis C virus. This may help to explain the infrequent transmission of this disease by sexual or close physical contact. 3

We conclude that heterosexual transmission of hepatitis C is

extremely uncommon, despite frequent and unprotected sexual intercourse. 2

Some Guidelines for Sex & HCV

If someone has Hep C, it might be passed to another person through sex, but probably only if there is contact with blood and/or lesions. The presence of herpes sores, etc., may make it easier to pass on hepatitis C through sex.

The current recommendations (2003) from the Public Health Agency of Canada:4

1. People with multiple partners should always practice safer sex.

2. Long-term monogamous couples should decide for themselves about routine condom use.

USE OF BARRIERS

Safer sex principally means using latex condoms or female condoms and lubricant if you have penetrative sex, or having sex without penetration. This is “safer,” not safe sex, because there will always be a tiny risk (for example, condoms can break), but the risk can be made so small that it does not interfere with enjoyment of sex. As well as preventing Hep C transmission, safer sex protects against most other sexually transmitted infections (STDs) and AIDS. Some STDs can do serious long-term damage if they are not treated promptly. Safer sex will also help prevent pregnancy.

Extra lubricant should probably be used to help prevent damage to the membranes or to the condom. Don’t use a lot, or the condom could come off. Water-based lubricants, such as KY jelly, are safe to use with latex condoms. Oil-based lubricants, such as Vaseline or massage oils, will damage latex and make the condom unsafe.

Notes

1. Gully & Tepper, “Hepatitis C,” CMAJ May 15, 1997 (vol 156, no 10): 1427

2. Gordon; Patel, et al. Am J Gastroenterology 87: 1849-51 (1992).

3. Fried, Shindo, et al., “Absence of hepatitis C viral RNA from saliva and semen of patients with hep c,” Gastroenterology. 1992 Apr. 102(4 Pt 1), P 1306-8.

4. www.phac-aspc.gc.ca/hepc/hepatitis_c/drhepc.html#sex

 

 

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