Projected Sample Size And Other Statistical Analyses
Prior to study initiation, widths of confidence intervals around a prevalence estimate were calculated for a range of sample sizes. Given a 2%5% prevalence of HCV infection in sexual partners, the widths of CIs would be between 1% and 2% for a projected sample size of 1,000 couples and between 4% and 7% for a projected sample size of 300 couples.
Prevalence of anti-HCV positivity and 95% CIs were calculated for the partners of index subjects. Incidence of sexually acquired HCV infection was estimated per number of sexual contacts . Incidence density of HCV infection was calculated as the number of potential transmission events per total person-years of sexual relationship reported among partners. Duration of the sexual relationship was summed among the 500 partners to determine the total person-years of observation.
Fact : Safe Sex Practices Are Your Best Bet
In a monogamous, heterosexual, long-term relationship, condoms may not be required, says Dr. Diaz. But even then, your doctor may recommend erring on the side of caution and practicing safe sex until both partners are shown to be negative for HCV. Taking medications as prescribed, being tested for other STDs, and staying in communication with your doctor about safe sex practices can all go a long way toward lowering your transmission risks.
Understanding The Different Types Of Hepatitis And Your Risks
Your liver does more than break down the nutrients in the foods and beverages you ingest. It also filters toxins out of your blood, synthesizes proteins, stores glycogen, vitamins, and minerals, and metabolizes medications, vitamins, and nutritional supplements.
Hepatitis, or inflammation of the liver, impairs your livers ability to function. At the Rivas Digestive Center in Hollywood, Florida, board-certified gastroenterologist John M. Rivas, MD, specializes in accurately diagnosing and treating different types of hepatitis.
Learn what you need to know about the different types of viral hepatitis, whether youre at risk, and the treatments available.
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If Youve Got Hep C Spitting Can Be A Felony
Last week, an Ohio man who has the hepatitis C virus was sentenced to 18 months in prison for spitting at Cleveland police and medics.
Matthew Wenzler, 27, was reportedly lying on a Cleveland street across from a downtown casino in January. When police and emergency medical technicians tried to put him on a stretcher to take him to a hospital, he spit saliva mixed with blood repeatedly at them, hitting an officer in the eye.
Advocates for people living with diseases like hepatitis C and HIV say these laws add to the stigma that patients already face and studies suggest the laws are not effective at stopping the spread of disease.
This person is now facing a year and a half of incarceration for something that didnt harm anyone and didnt pose a risk of harm to anyone, said Kate Boulton, a staff attorney at the Center for HIV Law and Policy.
Roughly two-thirds of states, according to the Center for HIV Law and Policy, have laws that make it a crime to knowingly expose others to HIV, the virus that causes AIDS. Many of these laws were passed in the 1980s and 1990s when fear and stigma about HIV were high and contracting the disease was considered a death sentence.
In recent years, about a dozen states have added hepatitis C to the list of medical conditions for which people can face criminal prosecution if they knowingly expose others by engaging in certain activities like sex without disclosure, needle-sharing or organ donation.
Can You Pass Hepatitis C To A Sex Partner
Sex and Sexuality
Yes, but it is not likely. Compared to hepatitis B virus and the human immunodeficiency virus , it is less likely that you will spread the hepatitis C virus to your sex partner.
If you have one long-term sex partner, and one of you has hepatitis C and one of you does not, you do not need to change your sex habits at all. But, if either you or your partner is worried about the small chance of spreading the hepatitis C virus, you can use latex condoms. This will make it almost impossible to spread the virus. Long-term partners of people with hepatitis C should get tested for the virus. If the test is negative, you will probably not need to repeat it.
If you have more than one sex partner, you are more likely to spread the virus. In this case, reduce the number of sex partners you have, practice safer sex, and always use latex condoms.
There have been outbreaks of sexually transmitted HCV infection among men who have HIV and who have sex with men. It is recommended that men who have sex with men use condoms to reduce the risk of sexually transmitted HCV and other sexually transmitted infections.
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Historically Many People Were Not Tested
Previous testing recommendations only encouraged testing for those who were thought to be at risk. Those who were screened for hepatitis C included: anyone who had ever injected illegal drugs people who had received an organ transplant or a blood transfusion before 1992, anyone who was given clotting factor concentrates made before 1987, children who were born to infected mothers, patients who were part of a long-term kidney dialysis program, people who were diagnosed with HIV, anyone with symptoms or who had an abnormal liver enzyme test, people who received an organ transplant from a donor who was later diagnosed with hepatitis C, and those who worked in the medical field and may have been exposed to the virus.
Although seemingly expansive, that criteria missed a large number of infected individuals, and they remain undiagnosed. Many people who are at risk are reluctant to identify their risk factors. Others are entirely unaware that they have an infection, because they dont have symptoms, and they dont know they are at risk. This is especially true with those who were exposed as infants or as children.
Fact : Risk Of Sexual Transmission Is Generally Low
Just like the other blood-to-blood transmission scenarios, risk through sex is very low, says Dr. Diaz. For example, the Hepatitis C Association notes that fewer than 3% will contract HCV through unprotected sex with a heterosexual, monogamous HCV-positive partner.
Theres also an extremely small chance of transmission through bodily fluidslike oral sex or even just kissingbut you would need to have some type of open sore that allows the virus to get into your bloodstream. Your partner would need an open sore, too. Although its theoretically possible, theres never been a reported case of that kind of transmission, Dr. Diaz says.
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It’s Different Than Hepatitis A And B
Each form of hepatitis has its own specific virus that spreads and is treated differently. “Hepatitis simply means inflammation of the liver, or that the virus has an affinity for hurting the liver,” Reau says.
- Hepatitis A is an acute, short-term infection that often does not require treatment.
- Hepatitis B hides deep in the body and, like hepatitis C, is treated in a variety of ways, from antiviral medications to liver transplants.
“The viruses are different, but all of them should be taken very seriously since they can lead to significant liver disease and even death,” she adds.
The Types Of Viral Hepatitis
There are five main types of viral hepatitis known as hepatitis A , hepatitis B , hepatitis C , hepatitis D , and hepatitis E . That said, there have been cases of acute hepatitis that could not be attributed to one of these five types of hepatitis viruses, alcohol, drugs, or autoimmune disease, which lead researchers to try to find another cause.
Though the etiology of these viruses have not yet been fully established, researchers have identified three other types of viral hepatitis , which they have named hepatitis F , hepatitis G , and transfusions transmitted virus . As relatively new diseases and viral discoveries, information about them and how they work is relatively scarce. We do know, however, that cases of TTV have only been associated with hepatitis in people who have had a blood transfusion.
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Can You Be A Blood Or Organ Donor
People with hepatitis C cant currently donate blood. The American Red Cross eligibility guidelines prohibit people who have ever tested positive for hepatitis C from donating blood, even if the infection never caused symptoms.
According to the Department of Health and Human Services , information on organ donation, those with underlying medical conditions shouldnt rule themselves out as organ donors. This reflects new guidelines for organ donation announced by the HHS.
People with HCV are now able to be organ donors. This is because advances in testing and medical technology can help the transplant team determine which organs or tissues can be safely used for transplantation.
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.
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Who Should Get Tested
Since universal screening of blood and blood products did not occur until 1992, anyone who had a blood transfusion or organ transplant before that time should be tested. It is recommended that people be tested for hepatitis C if they were/are:
- Born between 1945 and 1965
- Exposed to blood and body fluids
- Sharing toothbrushes, razors, nail clippers or other personal items with an infected individual
- Using and/or sharing needles to inject drugs
- Receiving tattoos and body piercings with unsterile needles
- Women thinking about becoming pregnant
- Born to an infected mother
- Receiving long-term hemodialysis
- Having unprotected sex with multiple sex partners or have a history of sexually transmitted diseases
Do Women Have A Higher Risk Of Getting Infected With Hepatitis Through Sexual Contact
Sex does not determine the risk of being infected with hepatitis through sexual contact. The presence of behavioral and other risk factors may make a person vulnerable to getting hepatitis by sexual contact. Some studies, however, suggest that it is easier for a man to transmit HCV to a woman than vice versa. Furthermore, MSM are 10 to 15 times more at risk of getting infected with hepatitis B than the general population.
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When To Seek Medical Advice
See your GP if you persistently have any of the later symptoms above, or if they keep returning. They may recommend having a blood test that can check for hepatitis C. Read more about diagnosing hepatitis C.
None of the symptoms above mean you definitely have hepatitis C, but its important to get them checked out.
You should also speak to your GP about getting tested if theres a risk youre infected, even if you dont have any symptoms. This particularly includes people who inject drugs or have done so in the past.
Read about the causes of hepatitis C for more information about whos at risk of having the infection.
How Is Hepatitis C Treated
Treatment for hepatitis C depends on how long you have had the virus.
People with acute infection do not always need treatment because their immune system may clear hepatitis C on its own. If you test positive during the acute stage, your doctor may ask you to come back after a few months to re-test and to see if you need any treatment.
If you develop chronic infection, you will need treatment to help clear the virus. Treatment with drugs called direct-acting antivirals can cure hepatitis in most cases. These are usually taken for 8-12 weeks. Your doctor will also check your liver for any damage.
If youve had hepatitis C in the past, youre not immune to future infections which means you can get it again. You can also still get other types of hepatitis and having hepatitis C together with another type is more serious.
If youve already had hepatitis C, its advisable to have the vaccination against hepatitis A and B to protect your liver from further damage.
Whether you have symptoms or not, dont have sex until your healthcare professional says you can.
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What Can I Do If I Think I Have Hepatitis C
A doctor or sexual health clinician can test you to see if you have hepatitis C. If you do, effective treatment with fewer side effects than the older medicine is available and you can discuss how to avoid infecting your sexual partners or people you live with.
It can take three to six months before the blood test for hepatitis C will be able to detect signs of infection in your blood. For people with HIV who may be immunocompromised, the antibody may not be detectable and it may be necessary to request an RNA test which detects the virus.
How Is Hep C Transmitted
Hepatitis C is transmitted through contact with an infected persons blood. Rule of thumb is: Wherever there is direct exposure to blood or the potential for exposure to blood, the risk is higher for transmission of hepatitis C. With this fact in mind, we can say with 100% certainty that hugging presents zero risk of transmission of hepatitis C.1,2
Kissing on the mouth, whether done with closed lips or open mouth, is a very low risk activity. However, the risk for transmission of hepatitis C increases if either person has an open sore or cut on their lips or on the inside of their mouth.2
Oral sex is considered a low-risk intimate activity.2 However, engaging in oral sex when there is an open sore or cut on the lips or in the mouth of the person performing oral sex or an open sore or cut on the genitals of the person receiving oral sex is risky. The only sure way to completely reduce risk of transmission of hepatitis C during oral sex is through the use of condoms or dental dams on the genitalia of the receiving partner.
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Fact : Hcv Usually Has No Symptoms
One important aspect to keep in mind with HCV is that it can be in your system for a long time without becoming active, Dr. Diaz says, and often people who are diagnosed are unsure how they got infected. Thats because symptoms are rarethats a big part of why it can spread so easily. Because of that, consider getting tested as part of a regular checkup, especially if youre in a high-risk group and/or youre a Boomer.
Should You Get Tested
The CDC recommends that anyone over the age of 18 get tested for Hepatitis C. But you should especially consider being tested if you:
- Were born between 1945 and 1965
- Have used injected drugs
- Were born to a mother who had hepatitis C
- Were treated for a blood clotting problem before 1987
- Got a blood transfusion or organ transplant before July 1992
- Have been a long-term hemodialysis patient
- Work in health care or public safety and were exposed to blood through a needle stick or other sharp object injury
If you get tested and find out you have hepatitis C, tell your sex partner and anyone else who may have been exposed to your blood, including through drug use.
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Safe Sex And Sexually Transmitted Diseases
All sexually active people should consider safe sex because of the risk of contracting a sexually transmissible infection. STIs include conditions such as genital herpes, HIV, hepatitis B, gonorrhoea, syphilis, chlamydia, crabs and genital warts.
If you have any condition that involves scratching, sores or blisters the possibility of blood-to-blood contact and transmission of STIs is increased.
How Do You Get Hepatitis B
sharing toothbrushes and razors
sharing needles for shooting drugs, piercings, tattoos, etc.
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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What Are The Chances Of Getting Hepatitis C From Sex
Hepatitis C can spread through sexual intercourse, but it’s rare. And it’s extremely rare among monogamous couples. In fact, the CDC considers the risk of sexual transmission between monogamous couples so low that it doesn’t even recommend using condoms. Also, there’s no evidence that hepatitis C is spread by oral sex. But you should avoid sharing razors, toothbrushes, and nail clippers, and sex during menstruation.
If you have HIV or if you have multiple partners, you should take precautions. Using condoms will protect you and your partners.
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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