Sexual Transmission And Viral Hepatitis
Certain adults who are sexually active should be vaccinated against hepatitis B.
CDC and the Advisory Committee on Immunization Practices recommend hepatitis B vaccination for
- sexually active people with more than one sex partner during the previous 6 months
- people seeking evaluation or treatment for a sexually transmitted disease
- sex partners of people with hepatitis B and
- men who have sex with men .
CDC recommends one-time hepatitis C testing of all adults and regular testing for people with risk factors.
Hiv And Hepatitis B And Hepatitis C Coinfection
Hepatitis B and hepatitis C are liver infections caused by a virus. Because these infections can be spread in the same ways as HIV, people with HIV in the United States are often also affected by chronic viral hepatitis.
Viral hepatitis progresses faster and causes more liver-related health problems among people with HIV than among those who do not have HIV. Liver disease, much of which is related to HBV or HCV, is a major cause of non-AIDS-related deaths among people with HIV.
Given the risks of hepatitis B or hepatitis C coinfection to the health of people living with HIV, it is important to understand these risks, take steps to prevent infection, know your status, and, if necessary, get medical care from someone who is experienced in treating people who are coinfected with HIV and HBV, or HIV and HCV.
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What Are The Symptoms Of Hepatitis C
You may have hepatitis C and not have any signs or symptoms.
For those who do have symptoms, you may experience:
- nausea and vomiting
Hepatitis C can lead to liver damage, as it causes swelling . This swelling causes scarring of the liver, which affects how the organ functions.
Liver scarring can worsen . This increases your chances of getting liver cancer.
How quickly your liver undergoes damage will depend on if you:
- have a human immunodeficiency virus co-infection
About 60% to 70% of people with hepatitis C do not develop symptoms until their liver has already been damaged.
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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.
Hepatitis C : Can It Be Sexually Transmitted
DOCTORâS VIEWS ARCHIVE
Topic: Hepatitis C, June 2000
Dr. Lee:Who are at increased risk of getting hepatitis C? Can hepatitis C be transmitted sexually?
Dr. Edward Block:Blood transfusion used to be a major risk factor. Fortunately, as a result of the increased stringency requirements, blood transfusions are no longer a major risk factor in this country. So, our viewers should know that if they should ever require a blood transfusion, they should feel fairly secure because the risk for hepatitis C exposure from blood transfusion is very small.
At this time, the principal risk for acquiring hepatitis C appears to be the use of injection drugs, primarily IV drug abuse. IV drug users comprise upwards of 40% of those who are diagnosed with new cases of hepatitis C. Other high-risk activities include other drug use . People with multiple sex partners are also considered to be at high risk .
Dr. Lee:As opposed to, letâs say, sexual transmission of Hepatitis B.
Dr. Edward Block: Yes, as opposed to hepatitis B, the risk of sexual transmission of hepatitis C is small.
There is probably some small risk of sexual transmission here and certainly it would be prudent to tell our viewers that if they are known to be hepatitis C positive and are single that they should take appropriate precautions, such as the use of condoms.
People receiving tattoos are also felt to be at risk, particularly if needles have been reused.
Back to Doctorsâ Dialogue Index
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How Do You Treat Hepatitis C
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 people develop chronic infection, they will need treatment to help clear the virus. Where available, 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.
Parenteral Routes: Transmission Of Hepatitis B Hepatitis D And Hepatitis C
Hepatitis B, C, and D viruses are all transmitted by what is known as the parenteral route. Parenteral simply means that these viruses can be introduced by all routes except through the intestinal tract, which leaves the door wide open in terms of possible exposure. Letâs look at the possible transmission routes for each of these types of hepatitis virus more closely.
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Complications Of Hepatitis C
If the infection is left untreated for many years, some people with hepatitis C will develop scarring of the liver .
Over time, this can cause the liver to stop working properly.
In severe cases, life-threatening problems, such as liver failure, where the liver loses most or all of its functions, or liver cancer, can eventually develop.
Treating hepatitis C as early as possible can help reduce the risk of these problems happening.
How Is It Treated
To recover, you should eat a well-balanced, low fat diet, and make sure you rest and get some exercise. It is best to avoid alcohol and drugs, as well as sexual contact, until you are better. If you are using any other medicines, check with your doctor that they dont affect your liver.
There are vaccines available for hepatitis A and hepatitis B. These stop you getting the infection if the first place.
There are now some antiviral treatments for hepatitis C, so talk to your doctor about these.
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Why It’s Important To Get Tested
Because hepatitis C is a highly infectious virus, the CDC recommends that adults 18 years or older get tested for hepatitis C at least once in their lifetime. This is also true for pregnant people during each pregnancy.
To test whether you have a hepatitis C infection, your healthcare provider will perform a hepatitis C antibody test to determine whether you have antibodies that were created in response to the infection.
If your test is positive, your healthcare provider will also perform a hepatitis C RNA test, which accurately determines whether you have a current infection.
Once it is determined you have an HCV infection, your healthcare provider will recommend the best course of treatment. For most people, treatment with antiviral drugs will be started. There are effective treatments that can cure HCV and prevent liver damage.
Fact : Youll Have To Monitor For Hepatitis C Even After Being Cured
Hepatitis C is curable in most patients. Either your body will clear the infection on its own, or antiviral treatments will do the job, says Alina Allen, M.D., a gastroenterologist in the department of gastroenterology and hepatology at the Mayo Clinic, in Rochester, MN. But once youve had HCV, the antibodies will remain in your system for life, she says, and you can be re-infected the same way you were originally. So being cured doesnt mean becoming immune to the virus. That sounds dramatic, but dont think of HCV as an enemy that cant be vanquished. Instead, consider it a reason to be tested periodically, Dr. Allen recommends.
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Is Sex Safe If One Person Has Hepatitis C
While the risk of transmitting the hepatitis C virus through sex is low, some sexual activities do increase the risk. Here’s what to know to stay safe.
Sofie Delauw/Stocksy
If you or your partner has been diagnosed with hepatitis C, you dont have to swear off sex. Hepatitis C is spread through blood-to-blood contact, and although certain sexual behaviors may increase the risk of hepatitis C, the virus is only rarely spread through sexual transmission.
That doesnt mean you should throw caution to the wind: Although treatable, hepatitis C is a serious illness that can harm the liver and lead to cirrhosis, liver failure, liver cancer, and other health complications. Whats more, it usually doesnt cause symptoms and can go undetected for years even decades.
The risk comes down to whether sex results in mucosal tears in body tissues, such as to the or the rectum, says Andrew H. Talal, MD, MPH, a hepatologist and professor in the department of medicine at the University at Buffalo Jacobs School of Medicine and Biomedical Sciences, part of The State University of New York.
Even the smallest tear in the skin or tissue gives the hepatitis C virus a way to travel from one body and enter the other. You need to always think about blood being exchanged thats where you need to be careful, Dr. Talal adds.
General Tips For Prevention
Refrain from engaging in IV drug use and be cautious with all procedures that involve needles.
For example, you shouldnt share needles used for tattooing, piercing, or acupuncture. The equipment should always be carefully sterilized for safety. If youre undergoing any of these procedures in another country, always make sure the equipment is sterilized.
Sterile equipment should also be used in a medical or dental setting.
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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.
Enteric Routes: Transmission Of Hepatitis A And Hepatitis E
The Hepatitis A and hepatitis E viruses are both transmitted by enteric, that is digestive or by fecal, routes. This is also known as the fecal-oral route. To be exposed to these viruses, you must ingest fecal matter that is infected with the virus. While there are several ways in which this fecal-oral route can be established, poor hygiene and poor sanitary conditions in some countries lead to higher rates of infection of these viruses.
As a result, some areas of the world, like India, Bangladesh, and Central and South America, are particularly prone to the hepatitis E virus. About one-third of people in the United States have been exposed to the hepatitis A virus.
It is believed that the hepatitis F virus may also be spread by enteric routes.
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Fact : You Cant Get Tested Right After Sex
Some STDs can be detected soon after unprotected sex, but HCV isnt one of them, Dr. Diaz explains. The virus antibody generally appears 12 weeks after exposure, she says, but your doctor may wait a few additional months to be sure. In part, thats because about 15% to 30% of people clear the virus on their own in that time frame with no major health impacts, Dr. Diaz says. So, if youve had sex with someone with HCV, youll likely be advised to wait for that amount of time before being tested.
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Contaminated Needles And Infected Blood
You can get hepatitis C from sharing contaminated needles, syringes and other injecting equipment during recreational drug use. Banknotes and straws used for snorting may also pass the virus on.
Being exposed to unsterilised tattoo and body piercing equipment can also pass hepatitis C on. Occasionally, you can get it from sharing a towel, razor blades or a toothbrush if there is infected blood on them.
Hepatitis C infection is also passed on in healthcare settings, from needle stick injuries or from medical and dental equipment that has not been properly sterilised. In countries where blood products are not routinely screened, you can also get hepatitis C by receiving a transfusion of unscreened blood and blood products.
You can prevent hepatitis C by:
- never sharing needles and syringes or other items that may be contaminated with infected blood
- only having tattoos, body piercings or acupuncture in a professional setting, where new, sterile needles are used
- following the standard infection control precautions, if youre working in a healthcare setting.
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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 .
Is Hepatitis C Sexually Transmitted
Can hepatitis C be spread through sexual contact?
Hepatitis C is a contagious liver disease caused by the hepatitis C virus . The disease can be passed from person to person.
Researchers in found that 1 out of every 190,000 instances of heterosexual sexual contact led to HCV transmission. Participants in the study were in monogamous sexual relationships.
HCV may be more likely to spread through sexual contact if you:
- have multiple sexual partners
- participate in rough sex, which is more likely to result in broken skin or bleeding
- dont use barrier protection, such as condoms or dental dams
- dont use barrier protection properly
- have a sexually transmitted infection or HIV
Theres no evidence that HCV can be spread through oral sex. However, it may still be possible if blood is present from either the person giving or receiving oral sex.
For example, a slight risk may exist if any of the following are present:
- menstrual blood
- any other breaks in the skin in the involved areas
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Risk Of Perinatal Hcv Transmission
Perinatal transmission of hepatitis C occurs in approximately 5 to 6% of pregnant women with HCV who have viremia, a rate significantly lower than with perinatal transmission of hepatitis B or HIV. The timing of perinatal HCV transmission is poorly understood, but intrauterine, intrapartum, and postnatal transmission are possible, with the majority of infants likely becoming infected in utero or around the time of delivery. In a systematic review of 77 studies published between 1990 and 2000, investigators calculated a 4.3% rate of mother-to-infant transmission among women with HCV viremia. A more recent systematic review and meta-analysis of 109 articles reported a 5.8% risk of perinatal HCV transmission among women who are HCV antibody positive and HCV RNA positive.