Can I Get Hepatitis C by Having Sex?

Hepatitis C is transmitted through your blood

Man unwrapping condom
Is hepatitis C virus spread by sex?. IAN HOOTON/SPL/Science Photo Library/Getty Images

Hepatitis C is not commonly transmitted during sex, but can still happen. Hepatitis C, like HIV, is spread through direct contact with infected blood. Overall, hepatitis C is thought to be ten times more infectious than HIV, yet the risk of hepatitis C being transmitted sexually is lower than that of HIV. 

Hepatitis C is a viral infection that was not isolated until the late 1980s. Prior to that time, symptoms related to the infection were known only as "non-A, non-B hepatitis." Hepatitis C isn't a single disease, it's a collection of at least six different strains of hepatitis C.

Identifying which strain a person has is important when determining treatment and prognosis.

Unlike hepatitis B, which most often does its damage and leaves, hepatitis C infection becomes a chronic infection about 80 percent of the time. Worldwide it's estimated that 170 million people carry the virus, at least three million carriers in the United States alone.

Ways Hepatitis C Can Be Transmitted

Hepatitis C is spread through direct contact with infected blood. This can happen through: 

  • Blood transfusions, organ transplants, and clotting factor infusions: Before an effective hepatitis C test was developed in the early 1990's, hepatitis C (then called non-A non-B hepatitis was transmitted quite often with blood transfusions and especially clotting factor infusions. Now with testing, the risk of contracting the virus through a transfusion is only one in two million.
  • IV drug use
  • Needlestick injuries
  • Mother-infant transmission (The rate of mother-child transmission is around 4 percent.)
  • Sexual contact
  • Household contact (Transmission is rare with casual contact and usually involves a shared item carrying blood, such as a shared razor or a shared toothbrush.)
  • Unknown (Up to 30 percent hepatitis C cases have no discernible risk factors.)

    The risk of contracting hepatitis C via sexual intercourse is unclear, but it appears that the risk is increased by having multiple sexual partners, an STD, or HIV infection. Because so many people have developed hepatitis C without being exposed to any known risk factors, it's now recommended that all adults born between 1945 and 1965 be tested.

    It is difficult to quantify the number of people who acquire hepatitis sexually versus other means. One study found that long-term monogamous partners of someone infected with hepatitis C picked up the infection around 4 percent of the time. Scientists compared the specific strains of virus to see how often both members had the same virus and found it occurred around 0.6 percent of the time. Based on this study it appears that, statistically, hepatitis C transmission will occur in around 1 out of every 190,000 sexual encounters. In contrast, an earlier study found no evidence of sexual transmission.

    Diagnosing Hepatitis C

    When the hepatitis C virus enters your body, it hangs around for around six or seven weeks before causing any problems. During this time, you may develop a mild flu-like illness, or, you may have no symptoms at all. Symptoms, if present, can last anywhere from a few weeks up to five months.

    The virus may then continue to damage the liver without symptoms. Infections that continue beyond six months are considered chronic. Chronic inflammation can lead to cirrhosis, liver failure, and liver cancer. Around 20 to 30 percent of people with long-standing chronic infections will develop these complications. 

    A simple blood can screen for the virus. If the test is positive, further testing will be needed to confirm you are actually infected with the virus. Unfortunately, screening tests cannot distinguish between whether you had the infection in the past or if you have a chronic infection.

     

    Sources:

    Centers for Disease Control and Prevention. Testing Recommendations for Hepatitis C Virus Infection. 2016.

    Terrault, M., Dodge, J., Murphy, E. et al. Sexual Transmission of Hepatitis C Virus Among Monogamous Heterosexual Couples: The HCV Partners Study. Hepatology. 2013. 57(3):881-9.

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