What to know about sexual transmission of hepatitis C

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It is unlikely that hepatitis C can be transmitted to others through sex, but it is possible.

According to the Centers for Disease Control and Prevention (CDC), the risk of spreading the hepatitis C virus (HCV) through sex increases for:

• men who have sex with men
• people with multiple sexual partners
• people who engage in rough sex
• people who have a sexually transmitted disease
• people living with HIV

Scientists believe that HCV spreads via blood-to-blood contact. So, sexual activity in which there is a potential exposure to blood increases the chances of transmitting HCV, according to the Hepatitis C Trust in the United Kingdom.

Behavior that increases the risk of transmitting HCV may include:

• vaginal sex while a person is menstruating
• sharing sex toys that an individual has used in their anus
• fisting not protected by a barrier method
• sex among more than two people
• rough vaginal sex that could cause bleeding
• using drugs during sex
• anal sex not protected by a condom or other barrier method

The Hepatitis C Trust also noted a higher prevalence of HCV among individuals who are HIV positive. Their research suggests that someone with hepatitis C who is HIV positive may have a higher viral load of HCV, which could increase the risk of HCV transmission during sex.

The term “hepatitis” means an inflammation of the liver. The inflammation may damage the liver, which is the largest internal organ in the body. The liver filters the blood and breaks down harmful substances.

Infection with a virus is the most common cause of hepatitis. If a person contracts HCV, the disease is called hepatitis C, or hep C for short.

Hepatitis A and hepatitis B are other types of hepatitis that result from viral infection. Hepatitis A, B, and C differ in the way they spread, their effect on the liver, and their method of treatment, according to the CDC.

Learn more about the differences between hepatitis B and C here.

For some individuals with hepatitis C, the infection is short term, and they get better without treatment. But more than half of people with hepatitis C will have a long-term or chronic infection.

Chronic hepatitis C can cause long-term health problems. These may include:

• liver damage
• cirrhosis (scarring of the liver)
• liver failure
• liver cancer

HCV causes hepatitis C. A person may contract HCV by coming into contact with the blood of someone else who has the condition. Even microscopic amounts of blood may be enough to spread the virus.

In the United States, the most common way for someone to contract hepatitis C is by sharing drug-injection equipment, such as needles or syringes.

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), other ways a person may contract hepatitis C include:

• coming into contact with the open sores or blood of a person with the condition
• using the toothbrush, nail clippers, or razor of a person with the condition
• getting a tattoo or piercing with non-sterile instruments or inks
• getting an accidental stick with a needle from someone with hepatitis C

About 6% of babies born to people with hepatitis C will develop hepatitis C.

Contracting hepatitis C from a blood transfusion or organ transplant is now rare due to routine testing of the blood supply in the U.S., according to Medline. These routes of transmission were more common before 1992.

Hepatitis C often produces no symptoms. A person might not know they have hepatitis C until liver problems develop, which might not happen until decades after the initial infection.

Sometimes an individual will experience symptoms 1–3 months after contracting HCV, according to NIDDK. These symptoms may include:

• fever
• fatigue (lack of energy)
• jaundice (yellowing of the eyes and skin)
• dark yellow urine
• gray- or clay-colored stools
• joint pain
• loss of appetite
• abdominal pain
• nausea
• vomiting

Since 2013, several direct-acting antiviral drugs for received approval for the treatment of hepatitis C. These drugs, which attack the virus, can cure many cases of hepatitis C, according to NIDDK.

The antiviral drugs for hepatitis C include:

• glecaprevir and pibrentasvir (Mavyret)
• ledipasvir/sofosbuvir (Harvoni)
• daclatasvir (Daklinza)
• elbasvir/grazoprevir (Zepatier)
• ombitasvir/paritaprevir/ritonavir (Technivie)
• simeprevir (Olysio)
• sofosbuvir (Sovaldi)

A person typically takes the antiviral drugs for 8–24 weeks. The drugs can be expensive, but prescription drug plans may help pay for them.

Learn more about drugs for hepatitis C here.

Someone with symptoms of hepatitis C should contact a healthcare professional.

Because hepatitis C often does not cause symptoms, the CDC recommends that all adults have a hepatitis C test at least once. Even though hepatitis C might not be producing symptoms, the virus may still be damaging a person’s liver.

The CDC recommendation also calls for hepatitis C screening each time a person becomes pregnant.

For people with risk factors for hepatitis C, such as individuals who inject drugs and share injection equipment with others, the CDC recommends periodic testing for hepatitis C.

Someone who thinks they may be at higher risk for getting hepatitis C should ask their doctor for a test. The CDC says doctors should provide hepatitis C screening to anyone who requests it.

For someone with hepatitis C, the chances of spreading the virus to a sexual partner are low. But the risk of HCV transmission may be higher for some types of sexual activity.

Using latex condoms can help reduce the risk of hepatitis C transmission during sex.

A person may be able to eliminate the risk for spreading hepatitis C by seeking treatment with antiviral drugs that can cure the disease.