http://uk.gay.com/article/3456Sexually-transmitted hepatitis C is common
Gus Cairns
www.guscairns.com2 March, 2005
There has been a lot of argument as to how often hepatitis C, an infection normally associated with needle-sharing and tattoos, is transmitted via sex.
Surveys of heterosexual couples where one partner has hep C have found transmission to be extremely rare. However clinics in London and other European cities have reported outbreaks of hepatitis C among gay men.
It has been suggested that the difference might be explained if only traumatic or ‘exotic’ sex like fisting makes infection likely.
But a Swiss study of people with HIV at the 12th Retrovirus Conference in Boston, USA last week, suggests that getting hepatitis C through sex is pretty common, at least in people who already have HIV.
The Swiss HIV Cohort is one of the most intensively-studied groups of positive people in the world, and contains the majority of Swiss people diagnosed with the virus.
Every six months they are asked about their sexual behaviour, and every two years they are tested for hepatitis C.
The study picked nearly 2,900 people who were negative for hepatitis C and who were not injecting drug users, and followed them for four years from April 2000 to April 2004.
During that time 14 of the 1550 gay men became hep C positive and eight of the 1350 heterosexuals.
The infection rate this revealed was about 0.2% a year in both heterosexuals and gay men – but about 0.7% a year in gay men who reported unprotected sex.
In comparison the HIV infection rate in gay men in London (and the overall rate in the USA) is about 2% year. This implies that anything between 10,000 to 20,000 of the UK’s quarter-million or so cases of hep C could have been caught through sex.
We still don’t know if particular sexual practices carry the hepatitis C risk, and it’s possible that some of the Swiss cases could have been caught through other known risks such as tattooing and sharing cocaine straws.
But unsafe sex is clearly a bigger risk for hep C than had previously been thought.
Tuning from the big to the small picture, French researcher Marie-Laure Chaix told the conference about a rare type of hepatitis C infection found in 12 HIV positive gay men in France.
The first case was picked up in 2001 and the last in 2004, and 10 of the 12 viruses they have are all extremely closely related, proving either a cluster of hep C acquisitions from an index case (a ‘patient zero’) or an ongoing chain.
The 10 had subtype 4 of hep C, which is a relatively uncommon type in France and the developed world, causing about 15% of infections.
The men had all had previous negative hepatitis C tests and they were all early infections, with the average time between a negative and positive test of six months.
Two had symptoms of jaundice but all the others were picked up on only because liver function tests gave odd results.
This hep C strain has also proved difficult to treat. Ten patients were treated but not one had his hep C cured. Genotypes 1 and 4 are the toughest types to treat and only one of the patients got the new and more effective pegylated interferon (the others got ordinary interferon).
But London clinics have found a high success rate in treating recently co-infected gay men and the French doctors don’t know why this one seems to be a tough nut to crack.
HIV ANONYMOUS
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