Is sexual contact a major mode of hepatitis C virus transmission?

Hepatology
Early View (Articles online in advance of print)
Published Online: 16 Jun 2010
Copyright © 2010 American Association for the Study of Liver Diseases

Rania A. Tohme 1 2 *, Scott D. Holmberg 1

1 Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Atlanta, GA
2 Epidemic Intelligence Service, Office of Workforce and Career Development, Centers for Disease Control and Prevention, Atlanta, GA

email: Rania A. Tohme (rtohme@cdc.gov)
*Correspondence to Rania A. Tohme, 1600 Clifton Road NE, Centers for Disease Control and Prevention Mailstop G-37, Atlanta, GA 30333

Potential conflict of interest: Nothing to report.

fax: 404-718-8585

Abstract

Medical opinion varies considerably regarding the transmission of hepatitis C virus (HCV) through sexual contact. Based on the study design, representativeness of the study population, and the methods used for case ascertainment, we analyzed 80 qualifying reports regarding the evidence for or against sexual transmission. Regarding heterosexual transmission, the weight of evidence is that there is no increased risk of sexual transmission of HCV among heterosexual couples in regular relationships. This risk increases among persons with multiple sexual partners (adjusted odds ratio [aOR] 2.2-2.9), but this association may be confounded by increased likelihood of injection drug use with increased number of partners. There appears to be a real increased risk for women coinfected with human immunodeficiency virus (HIV) or other sexually transmitted infections (aOR 3.3-3.9) and especially for HIV-infected gay men who are having sex with one another compared with HIV-uninfected men (aOR 4.1-5.7). HIV-infected gay men increase their risk of such transmission in association with practices that lead to mucosal trauma (multiple sexual partners, fisting, use of sex toys) and the presence of genital ulcerative disease. Conclusion: This review should inform, and not distract from, recommendations to reduce the risk of HCV transmission. Health care providers need to pay special attention to sexual transmission of HCV among HIV-infected individuals. HEPATOLOGY 2010

Received: 4 March 2010; Accepted: 8 June 2010

Digital Object Identifier (DOI)
10.1002/hep.23808 About DOI

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