ASHM Report Back
Clinical posts from members and guests of the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) from various international medical and scientific conferences on HIV, AIDS, viral hepatitis, and sexual health.
Sexual transmission of hepatitis C: who should we be testing and how often?
Hepatitis C was first discovered in 1989.
Overall worldwide prevalence of 2.8%.
Most infections are acquired parenterally, with a significant amount of vertical transmission.
A large well powered study showed a very low sexual transmission rate among heterosexual monogamous relationships (0-0.6%/year, condoms not required but should be advised that they will reduce the risk).
What about MSM?
Hepatitis C incidence in HIV positive MSM has increased exponentially.
Risk factors are intravenous drug use, condomless anal sex independant of intravenous drug use, and syphilis infection independent of intravenous drug use.
There is also sexual transmission of hepatitis C in HIV negative MSM related to chemsex who are on PrEP.
More likely with rough sex and fisting.
Reinfection rates are common.
Screening is recommended annually in HIV positive individuals.
In HIV negative individuals we probably don’t need to screen for hepatitis C routinely, but should consider it in people on PrEP.