What Can Explain The Rates Of Sexually Acquired Hepatitis C Infection
Another theory on why higher rates of hepatitis C may be seen in HIV-positive men is that HIV is more sexually infectious than hepatitis C, so gbMSM having types of sex that pass both infections are more likely to get HIV before hepatitis C.6,15 An additional theory is that the higher rates of hepatitis C infection among HIV-positive gbMSM may be random.6,15 Once hepatitis C entered the population of gbMSM living with HIV, hepatitis C may have been ring-fenced around gbMSM living with HIV through practices such as serosorting .6,10,15 Research analyzing strains of hepatitis C virus to trace patterns of infection supports this theory. The studies suggest there was a rapid expansion of gbMSM-specific hepatitis C virus strains in Europe after 1996, which followed the introduction of highly effective antiretroviral therapy for HIV.6,26 The studies also suggest that hepatitis C was being passed among gbMSM living with HIV and that there was minimal overlap with strains of hepatitis C virus among injection drug use networks.26
Hepatitis C Symptoms & Treatment
FAST FACTS:
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Hepatitis C is mainly passed on through using contaminated needles and syringes or sharing other items with infected blood on them. It can also be passed on through unprotected sex, especially when blood is present.
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You can prevent hepatitis C by never sharing needles and syringes, practising safer sex, and avoiding unlicensed tattoo parlours and acupuncturists.
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Hepatitis C will often not have any noticeable symptoms, but a simple blood test carried out by a healthcare professional will show whether you have hepatitis C.
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In the early stages, some peoples bodies can clear a hepatitis C infection on their own, others may develop chronic hepatitis C and will need to take antiviral treatment to cure the infection.
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Without treatment, chronic hepatitis C can lead to permanent liver damage.
Hepatitis C is part of a group of hepatitis viruses that attack the liver.
Some groups are more at risk of getting hepatitis C than others, including people who use drugs, people in prisons, men who have sex with men, health workers and people living with HIV.
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What Is A Sexually Transmitted Disease
The definition of a sexually transmitted disease is A bacterial or viral infection transmitted from an infected person to an uninfected person through sexual contact. Examples of sexually transmitted viruses and bacteria are chlamydia, gonorrhoea, herpes, human papillomavirus infection, HIV/AIDS, and syphilis.
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Why Getting Tested Is Important
A blood test is one of the only ways to confirm a diagnosis of hepatitis C. Additionally, hepatitis C often has no visible symptoms for many years.
Because of this, its important to be tested if you believe youve been exposed to the virus. Getting a timely diagnosis can help ensure you receive treatment before permanent liver damage occurs.
Poor Infection Control For Tattooing And Piercing
The notes that HCV may be transmitted by receiving tattoos or piercings from unregulated settings with poor infection control standards.
Commercially licensed tattooing and piercing businesses are generally thought to be safe.
More informal settings may not have adequate safeguards to help avoid the spread of infections. Receiving a tattoo or piercing in settings such as in a prison or in a home with friends carries a of HCV transmission
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Recommendations For Service Providers
Integrate hepatitis C education into existing sexual health and HIV services for gbMSM:
- Know hepatitis C risk factors. Educate gbMSM about the sexual transmission of hepatitis C. Encourage gbMSM having sex that could lead to hepatitis C to:
- use a new condom for each partner, including on sex toys
- use a new glove for each partner when fisting
- use individual lube containers and regularly apply lube
Integrate hepatitis C testing services into existing sexual health and HIV services:
Integrate sexual health and harm reduction services and programs to support gbMSM:
References
Hepatitis Testing And Treatment
The good news for sexually active individuals in regard to hepatitis is that its possible to protect both yourself and your partner through simple means. Getting vaccinated for hepatitis A, B, and D will greatly lower the risks associated with spreading hepatitis through sexual contact. Furthermore, seeking out regular STD tests particularly when you begin seeing a new partner can help you stay on top of your sexual wellness and mitigate the effects of many STD-related issues.
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Ways You Wont Spread Hepatitis C
There are some ways in which you wont spread HCV, though. Go ahead and let your significant other have a bite of your sandwich or dessert. According to the CDC, hepatitis C isnt spread by sharing silverware or drinking glasses, or through water or foods. Showing affection by holding hands, hugging, or kissing is also safe, Lee says. And although germs from sneezing or coughing might cause you to get a cold, they wont give you hepatitis C.
Sexual Transmission And Hepatitis B
Hepatitis B can be transmitted through sexual activity. Unvaccinated adults who have multiple sex partners, along with sex partners of people with chronic hepatitis B infection, are at increased risk for transmission. Injection-drug use and sexual contact are other common modes of hepatitis B transmission in the United States.
Among adults seeking treatment in STD clinics, as many as 10%40% have evidence of past or current hepatitis B virus infection. Many of these infections could have been prevented through universal vaccination during delivery of STD prevention or treatment services. Offering vaccination to all adults as part of routine prevention services in STD treatment facilities has been demonstrated to increase vaccination coverage among adults at risk for hepatitis B infection, as the behavioral risk factors for STDs and hepatitis B are similar.
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Can Males Transmit Hcv To A Fetus
It is unlikely that males can transmit HCV to the fetus through sperm during conception.
A 2004 review of studies investigating assisted reproduction found that while some studies have detected HCV in sperm, the evidence suggests that ejaculated sperm is usually safe to use in fertility treatments, such as in vitro fertilization.
Building Healthy Sexual Relationships
Rule number one for a healthy sexual relationship: Be open and honest. I believe in transparency, says Talal. This conversation can be difficult, but its important to have. Part of discussing your status is talking about what exposure you may have had to hepatitis C, even in the distant past.
Its a good opportunity for you to share both your sexual history and your past experiences with other ways the virus can be transmitted, such as injecting drugs or being exposed to items that may have infected blood on them, including needles, razors, and toothbrushes.
Dr. Sherman explains that even if you consistently use condoms during sex, other activities, such as sharing needles or straws to inject or snort drugs, increase your risk of spreading hepatitis C. People do not want to hear about this, he says. Its difficult to get the word out about risk.
If you and your partner find that hepatitis C is disrupting your relationship or sex life, you might also want to consider working with a marriage and family therapist or sex therapist.
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Factors That May Impact Local Applicability
All studies cited in this review were conducted in high-income countries in Western Europe as well as in the U.S., Canada and Australia. Because of the similarities of HIV and HCV epidemics among men who have sex with men in these countries, the review findings are highly relevant and transferable to the Canadian context.
How Can You Prevent Hepatitis B And Hepatitis C
Hepatitis B: Vaccination is the best way to prevent all of the ways that hepatitis B is transmitted. People with HIV who do not have active HBV infection should be vaccinated against it. In addition to the 3-dose series of hepatitis B vaccine given over 6 months, as of 2017, there is a 2-dose series given over 1 month.
Hepatitis C: No vaccine exists for HCV and no effective pre- or postexposure prophylaxis is available. The best way to prevent hepatitis C infection is to never inject drugs or to stop injecting drugs by getting into and staying in drug treatment. If you continue injecting drugs, always use new, sterile needles or syringes, and never reuse or share needles or syringes, water, or other drug preparation equipment.
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What Are The Rates Of Sexually Acquired Hepatitis C Infection Among Gbmsm
gbMSM living with HIV
In the early 2000s, reports began to appear of hepatitis C outbreaks among populations of gbMSM living with HIV where the vast majority of the men did not report typical blood-related risks for transmission, such as injection drug use or medical/dental care in countries where universal precautions to prevent hepatitis C infection have not been consistently implemented.6,15 These were the first reports to suggest that hepatitis C could be passed through sex. Over time, as more research was published globally on rates of hepatitis C infection among gbMSM living with HIV, it became accepted that sex was a pathway for transmission of hepatitis C among gbMSM living with HIV.6,10,16
Two international systematic reviews reported that the hepatitis C prevalence rate among HIV-positive gbMSM with no history of injection drug use is about seven in 100.17,18 This is higher than the estimated prevalence rate of five in 100 among gbMSM with/without HIV in a survey across five cities in Canada.19
HIV-negative gbMSM
HIV-negative gbMSM have much lower rates of new hepatitis C infections than HIV-positive gbMSM. Rates ranged from 0.4 to 1.5 new hepatitis C infections per 1000 person-years among HIV-negative gbMSM.16
What Are The Symptoms Of Hepatitis And Can It Be Treated
Scientists have reported an unusual spike in hepatitis cases among children, with 60 cases in children under 10 years of age being investigated in England.
A further 11 children under the age of five in Scotland have been admitted to hospital with the inflammatory liver condition.
Hepatitis is usually the result of a viral infection or liver damage cause by alcohol, and symptoms include yellowing of the eyes and skin , loss of appetite, a high temperature, dark urine, and feeling unusually tired all the time.
Scientists say that the children infected have been screened for the common viruses that are known to cause hepatitis but none of these viruses have been detected.
Non-A-to-E hepatitis is a rare condition and there does seem to be a mini-epidemic/kick-up in the number of cases at the present time, general paediatrics professor at University College London, Alastair Sutcliffe, said.
A consequence of the lockdown with sudden increased exposure to the causative agent in a non-immune population seems the most plausible explanation, he added.
According to the World Health Organisation , hepatitis B and C affect approximately 500 million people around the world, causing around 1.5 million deaths every year.
One in three people are said to have been exposed to either or both of the viruses, while the majority of people infected with the virus are not aware of it.
WHO states that hepatitis is preventable, treatable, and in the case of hepatitis C, curable.
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Acute Hepatitis B Infection
There is no specific treatment for acute hepatitis B, and most people recover within one to two months. Usually, you can manage symptoms at home with painkillers if necessary. Your healthcare professional should advise you to have regular blood tests and physical check-ups. Most people make a full recovery from acute hepatitis B.
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What Are The Odds Of Contracting Hep C Sexually
The odds are pretty low. But your risk level depends on your situation.
One 2012 study on 500 straight, monogamous couples found that the rate of hep C transmission through sex was just 0.07 percent per year.
The CDC and WHO both point out that men who have sex with other men may have a higher risk of contracting hep C, but neither have exact data on the odds.
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Can People With Hep C Be Blood Donors
You are ruled out as a blood donor if you have had hepatitis C, even if you have no symptoms. All blood donations in the U.S. are tested for hepatitis C antibodies, which will indicate whether the person has had HCV in the past. This is essential to prevent the transmission of HCV to the blood recipients.
Prevention And The Treatment Potential
Currently, there is no vaccine to prevent HCV infection. However, the recent availability of DAA for the treatment of chronic HCV with cures rates over 95% has created optimism towards HCV elimination. In many countries treatment is now available for all individuals with a chronic HCV infection, irrespective of fibrosis stage . Modelling studies were the first to demonstrate that rapid scaleup of DAA might limit onward transmission and chronic HCV prevalence and incidence among MSM could decline , , . However, for substantial reductions a decline in risk behaviour is needed as the scaleup of DAA is counterbalanced by ongoing risk behaviour, resulting in initial and reinfections , , . In addition, early treatment, including treatment of acute infection, might further reduce HCV incidence , . As treatment is costly and treatment uptake varies considerably across countries , effective behavioural interventions for MSM at risk of infection are urgently needed. Qualitative research among HIVpositive MSM with a cured HCV infection in the preDAA era showed that the strongest motive to implement risk reduction strategies was the reward of avoiding HCV retreatment and its side effects , but this may have changed with the less burdensome DAA treatment. Also sexual risk norms within the MSM population, HCV stigma and nondisclosure of HCV status forms barriers to safer sex, and drug use directly impedes the selfefficacy of MSM to take risk reduction measures .
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How Do I Test For Hepatitis C
A simple blood test will show whether you have the virus. You may also be given an extra test to see if your liver is damaged.
If youve got hepatitis C you should be tested for other STIs. It’s important that you tell your recent sexual partner/s so they can also get tested and treated. Many people who have hepatitis C do not notice anything wrong, and by telling them you can help to stop the virus being passed on. It can also stop you from getting the infection again.
How Do You Get Hepatitis B
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sharing toothbrushes and razors
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sharing needles for shooting drugs, piercings, tattoos, etc.
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getting stuck with a needle that has the Hep B virus on it.
Hepatitis B can also be passed to babies during birth if their mother has it.
Hepatitis B isnt spread through saliva , so you CANT get hepatitis B from sharing food or drinks or using the same fork or spoon. Hepatitis B is also not spread through kissing, hugging, holding hands, coughing, sneezing, or breastfeeding.
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Contaminated Food And Water
Hepatitis A is most commonly passed on by eating food prepared by someone with the virus whose hands have not been washed properly. You can also get it by drinking dirty water and by eating raw or undercooked shellfish from dirty water.
You can protect yourself by:
- Washing your hands each time you go to the toilet, before you prepare or eat food, after coughing or sneezing, or handling rubbish or other dirty items.
- Peeling and washing all your fresh fruit and vegetables avoiding raw or undercooked meat and fish avoiding all drinks if youre not sure if theyre safe with or without ice.
- If tap water isnt safe and bottled water isnât available, boil tap water before drinking it.
- People living in places with poor sanitation and hygiene are at a greater risk of hepatitis A infection. You may also be exposed to hepatitis A through your work, for example, sewage workers, staff in institutions where levels of personal hygiene may be poor , people working with animals that may be infected with hepatitis A and daycare centres.
Encouraging Others To Get Tested For Hepatitis C
While the odds of passing on the hepatitis C virus are low, you should still tell anyone at risk that you have hepatitis C. You should tell sexual partners, spouses, and family members. Your infection may be difficult to discuss, but anyone at potential risk must know. That way, they can get tested and treated if needed. Read more on why you should get tested for hepatitis C.
Show Sources
Paul Berk, MD, professor of medicine and emeritus chief of the division of liver disease, Mount Sinai School of Medicine, New York City chairman of the board, American Liver Foundation.
Alan Franciscus, executive director, Hepatitis C Support Project and editor-in-chief of HCV Advocate, San Francisco.
Thelma King Thiel, chair and CEO, Hepatitis Foundation International.
David Thomas, MD, professor of medicine, Johns Hopkins School of Medicine, Baltimore.
Howard J. Worman, MD, associate professor of medicine and anatomy and cell biology, College of Physicians and Surgeons, Columbia University, New York City.
The American Gastroenterological Association.
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