From the Guidelines
Hepatitis C virus (HCV) can be sexually transmitted, but the risk is relatively low, especially in monogamous heterosexual relationships, as noted in the 2016 guidelines 1. The primary routes of HCV transmission are through parenteral exposure, including transfusion of contaminated blood or blood products, organ transplantation, injection drug use, and unsafe medical procedures. However, sexual contact with an HCV-infected person is also a recognized route of transmission, particularly in high-risk situations such as among men who have sex with men, especially those with HIV co-infection, or during rough sex that may cause tissue damage 1. Some key points to consider regarding HCV transmission include:
- The risk of HCV transmission through sexual contact is higher with multiple sex partners and unsafe sex practices, such as anal sex or sex with partners who have other sexually transmitted diseases 1.
- For monogamous heterosexual couples where one partner has HCV, the risk of sexual transmission is estimated to be very low, ranging from 0-3% per year 1.
- The use of barrier methods like condoms can further reduce the already low risk of sexual transmission, especially during menstruation or if either partner has open sores or other STIs 1.
- HCV-infected individuals should be counseled to avoid sharing personal items that may come into contact with blood, such as toothbrushes and dental or shaving equipment, and to cover any bleeding wounds to prevent contact with others 1. Overall, while HCV can be sexually transmitted, the risk is relatively low compared to other routes of transmission, and individuals can take steps to reduce their risk of transmission, such as practicing safe sex and avoiding sharing personal items that may come into contact with blood 1.
From the Research
HCV Transmission
- HCV can be transmitted through various means, including parenteral and sexual transmission 2, 3, 4
- The risk of sexual transmission of HCV is generally considered to be low, with rates ranging from 0 to 3% 2
- However, certain groups such as men who have sex with men (MSM), sex workers, and individuals with HIV or HBV co-infection are at a higher risk of sexual transmission of HCV 2, 3
Risk Factors for Sexual Transmission
- The number of lifetime sexual partners and high-risk sexual practices are predictive of HCV seropositivity 4
- Other sexually transmitted infections and HIV seropositivity also increase the risk of HCV transmission 4
- The presence of genital erosive lesions or traumatic sexual intercourse with abrasion of the genital mucosa may enhance the risk of sexual transmission of HCV 4
HCV Transmission in Specific Populations
- In monogamous heterosexual relationships, the risk of HCV acquisition is lower (0 to 0.6% per year) compared to individuals with multiple partners or those at risk for sexually transmitted diseases (0.4 to 1.8% per year) 4
- Men who have sex with men (MSM) are at a higher risk of sexual transmission of HCV, particularly those with HIV co-infection 3