Sex & Hepatitis C

Research into the link between hepatitis C and sex

The studies and articles cited on this page are among the sources for the information on this web site. The studies are frequently cited in the ongoing discussion and debate over transmission of hepatitis C via sexual relations.

Studies on spread of hepatitis C (HCV) via sexual relations

Sexual transmission of hepatitis C virus among monogamous heterosexual couples
N. Terrault, J. Dodge, E. Murphy, J. Tavis, J. Kiss ... Study of 500 HCV-positive subjects and their partners (2013).
Quote: "(We found) an extremely low estimated risk for HCV infection in sexual partners (and a) lack of association with specific sexual practices. ... Based on 8,377 person-years of follow-up, the maximum incidence rate of HCV transmission by sex was 0.07% per year."

Is heterosexual transmission an important risk factor for hepatitis C?
M. Klevens, D. Daniels, K. Iqbal, C. Vonderwahl. Survey by CDC and various state health departments (2010).
Quote: "Most acute HCV cases and (those with more than one) heterosexual partners also had other risks. Heterosexual transmission may not be an important risk factor."

Effects of a couple-based intervention to reduce risks for HIV, HCV, and STIs ...
N. El-Bassel, L. Gilbert, A. Terlikbayeva ... Randomized controlled trial of 300 drug-using couples in Kazakhstan (2014).
Quote: "Assignment to risk reduction (program) significantly lowered the incidence of HCV infection."

Sexual transmission of Hepatitis C
G. Neumayr, A. Propst, H. Schwaighofer, G. Judmaier and W. Vogel. Department of Internal Medicine, University of Innsbruck, Austria (1999).
Quote: "Our study finds no convincing evidence for the heterosexual transmission of hepatitis C."

Risk factors for hepatitis C virus seropositivity in heterosexual couples (PDF)
D. H. Osmond, N. S. Padian, H. W. Sheppard, S. Glass, S. C. Shiboski and A. Reingold. Department of Epidemiology and Biostatics, University of California, San Francisco (1993).
Quote: "These results provide little evidence of HCV sexual transmission but are consistent with infrequent sexual transmission."

Risk factors for hepatitis C infection ...
Youyin Choy, Lisa Gittens-Williams, Joseph Apuzzio, Joan Skurnick, Carl Zollicoffer, Peter G. McGovern. Departments of Obstetrics, Gynecology and Women's Health, UMDNJ-New Jersey Medical School, Newark, N.J. (2003)
Quote: "Our finding ... adds support to the concept that hepatitis C is 'not' transmitted efficiently through sexual contact."

Incident Hepatitis C Virus Infection in Men Who Have Sex With Men
Mallory Witt, Eric Seaberg, Annie Darilay, Stephen Young, Chloe Thio ... Department of Medicine, Johns Hopkins University, Baltimore (2013)
Quote: "The spread of HCV among both HIV-infected and -uninfected MSM in the United States has been ongoing since the beginning of the HIV epidemic."

Hepatitis C infections among HIV-infected men who have sex with men
A. Urbanus, T. van de Laar, I. Stolte, J. Schinkel ... Study of 3,125 patients at the STI clinic Amsterdam. AIDS Journal (2009).
Quote: "We found a high and increasing HCV prevalence in HIV-infected (men who have sex with other men). ... Rough sexual techniques and use of recreational drugs were associated with HCV-infection."

Little evidence of sexual transmission of hepatitis C virus infection
M A Balogun, M E Ramsay, J V Parry ... PHLS CDSC, Immunisation Division, London (2003)
Quote: "(The study of clinic patients) suggests that the majority of hepatitis C infections have been acquired in adult life, mostly by injecting drug use, and that the hepatitis C virus is rarely transmitted sexually."

Absence of hepatitis C viral RNA from saliva and semen ...
Fried MW, Shindo M, Fong TL, Fox PC, Hoofnagle JH, Di Bisceglie AM. National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health (1992).
Quote: "(Our) findings 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."

Sexual Transmission of HCV between Spouses
Veysel Tahan, Cetin Karaca, Beytullah Yildirim, Aysun Bozbas ... Marmara University School of Medicine, Altunizade; Istanbul University Medical Faculty, Department of Gastroenterohepatology ... Turkey. (2005)
Quote: Our study did not find an increased risk of acquiring HCV for the spouses. ... Our study showed a relatively lower seroprevalence rate of 2% among the spouses of (chronic hepatitis C) patients.

Prevalent and Incident Hepatitis C Virus Infection among HIV-Infected Men
Shikha Garg, Lynn Taylor, Chris Grasso, Kenneth Mayer. Study of HIV-infected men at Fenway Institute, Boston (2013)
Quote: "Sexually transmitted hepatitis C virus infection is an emerging epidemic among HIV-infected men. ... Prevalent and incident HCV was common in this HIV-infected population (at a Boston clinic) despite engagement in care."

Hepatitis C: Sexual or Intrafamilial Transmission?
Cavalheiro Nde P, De La Rosa A, Elagin S, Tengan FM, Araújo ES, Barone AA. Hepatitis Laboratory, Infectious Diseases Departament University of São Paulo, Brazil (2009).
Quote: "The shared use of personal hygiene items suggests the possibility of intrafamilial transmission of infection (instead of sexual relations)."

Molecular Evidence of Horizontal Transmission of Hepatitis C Virus Within Couples
Isabel Maria Vicente Guedes de Carvalho-Mello, Jose Eymard Medeiros Filho ... Butantan Institute, University of São Paulo, Brazil (2009).
Quote: "Nine couples with a stable relationship and without other risk factors for HCV infection and 42 control patients were selected ... a common source of infection was observed in both members of five couples. These data strongly support HCV transmission within couples."

Prevalence and risk factors of hepatitis C in HIV-negative homosexual men ...
Fengyi Jin, Garrett P. Prestage, Susan C. Kippax, John M. Kaldor, Greg J. Dore, Andrew E. Grulich. National Centre in HIV Epidemiology and Clinical Research, Wales (2005). Quote: "The prevalence of HCV in this cohort was about the same as in the general population ... there was no evidence for sexual transmission."

Lack of evidence of sexual transmission of hepatitis C among monogamous couples
Vandelli, C., Renzo, F., Romano, L., Tisminetzky, S., Palma, M. de, Stroffolini, T., Ventura, E., Zanetti, A. Dipartimento di Medicina Interna, Universita di Modena e Reggio Emilia, Modena, Italy (2004).
Quote: "Our data indicate that the risk of sexual transmission of HCV within heterosexual monogamous couples is extremely low or even null. No general recommendations for condom use seem required for individuals in monogamous partnerships with HCV-infected partners."

(Study of commercial sex workers in South Korea)
Seun-Seog Kweon, Min-Ho Shin. Seonam University College, South Korea ... (2006). Quote: "None of the variables associated with sexual activity ... were associated with the presence of antibodies to HCV. ... Although we cannot rule out the role of sexual activity as an independent risk factor for HCV infection, we suggest that sexual activity is less of a risk factor than are acupuncture or diabetes ... "

Articles about sex's role in transmission of hepatitis C

Sexual Transmission of Hepatitis C: Practical Recommendations
Myung, Patricia; Mallette, Carol; Taylor, Lynn; Allen, Scott; Feller, Edward (2003)
Quote: "Although HCV can also be transmitted sexually, this occurs much less frequently than with hepatitis B, another blood-borne viral pathogen."

Sex and Hepatitis C Transmission
Norah A. Terrault, M.D., The American Journal of Gastroenterology (2005)
Quote: "The issue is not whether the virus can be transmitted by sexual contact but rather what the magnitude of the risk is and what factors influence the risk of transmission."

'Explosion' of Sex-Spread Hepatitis C in HIV-Positive Men
Daniel J. DeNoon, WebMD (2011)
Quote: "We have uncovered an emerging epidemic of sexual transmission of hepatitis C. And the main reason is men having anal sex without a condom."

Hepatitis C strategy for England

Department of Health (2005)
Quote: "There is evidence that both homosexual and heterosexual transmission of hepatitis C may occasionally occur."

HCV transmission rate higher among MSM with HIV
Infectious Disease News (2013)
Quote: "HCV transmission among MSM has been ongoing for at least three decades in both HIV-infected and HIV-uninfected men."

Sexual Transmission of Hepatitis C
Edwin J. Bernard. AIDS Treatment Update (2002).
Quote: "There is new evidence that sexual transmission of HCV is on the rise, particularly amongst gay men with HIV."

HIV and Hepatitis C Virus Coinfection: 7th Retrovirus Conference Update
Michael Marco (2000).
Quote: "There are some convincing reports that gay men with numerous sexual partners who engage in high-risk behavior are at increased risk for becoming HCV-positive."

Reports on sexual problems with hepatitis C therapies

Decline in Male Sexual Desire, Function, and Satisfaction During and After Antiviral Therapy for Chronic Hepatitis C
Lorna M. Dove, Raymond C. Rosen, Darmendra Ramcharran, Abdus S. Wahed, Steven H. Belle, Robert S. Brown, Jay H. Hoofnagle (2009)
Quote: "Sexual impairment is common among men with chronic hepatitis C undergoing therapy with pegylated interferon and ribavirin and should be considered as a potential side effect of antiviral therapy."

Sexual Dysfunction is Highly Prevalent Among Men with Chronic Hepatitis C Virus Infection and Negatively Impacts Health-Related Quality of Life
Ann Danoff, Oona Khan, David W. Wan, Lainie Hurst, Daniel Cohen, Craig T. Tenner, Edmund J. Bini (2006)
Quote: "Sexual dysfunction is highly prevalent in men with chronic HCV infection, is independent of depression, and is associated with a marked reduction in (health-related quality of life)."