Sexual transmission of HCV seen in Indian women with genital ulcers and men who have sex with men

Michael Carter
Estimated reading time 2 minutes
This article is more than 21 years old.

Women who have had a history of genital ulcers and men who reported sex with other men were found to be at increased risk of being infected with hepatitis C virus through sex, according to a study conducted amongst Indian slum-dwellers published this week in the online edition of Clinical Infectious Diseases.

The study lends support to the view that sexual transmission of hepatitis C virus is possible, say the investigators. It had been thought that sexual transmission of hepatitis C was very difficult and rare. However, increasing numbers of HIV-positive gay men, whose only risk activity was unprotected sex, have been diagnosed with hepatitis C in the UK.

In a study involving over 1620 slum dwellers in the Indian city of Chennai, investigators hypothesised that individuals with ulcerative sexually transmitted infections and men who had sex with other men would be at increased risk of acquiring hepatitis C from sex. The study excluded injecting drug users.

Glossary

genital ulcer disease

Any of several diseases that are characterised by genital sores, blisters or lesions. Genital ulcer diseases (including genital herpes, syphilis and chancroid) are usually sexually transmitted.

herpes simplex virus (HSV)

A viral infection which may cause sores around the mouth or genitals.

odds ratio (OR)

Comparing one group with another, expresses differences in the odds of something happening. An odds ratio above 1 means something is more likely to happen in the group of interest; an odds ratio below 1 means it is less likely to happen. Similar to ‘relative risk’. 

exclusion criteria

Defines who cannot take part in a research study. Eligibility criteria may include disease type and stage, other medical conditions, previous treatment history, age, and gender. For example, many trials exclude women who are pregnant, to avoid any possible danger to a baby, or people who are taking a drug that might interact with the treatment being studied.

chlamydia

Chlamydia is a common sexually transmitted infection, caused by bacteria called Chlamydia trachomatis. Women can get chlamydia in the cervix, rectum, or throat. Men can get chlamydia in the urethra (inside the penis), rectum, or throat. Chlamydia is treated with antibiotics.

Hepatitis C was detected in 2% of men and 3% of women. Most of the study participants (53%) were women, and 71% were married. The number of reported life-time sexual partners was low (between one and six), although 95% of sex was unprotected.

None of the hepatitis C-positive individuals was coinfected with HIV, or the bacterial sexually transmitted infections trichomonas, gonorrohea, or chlamydia.

Twenty four women tested positive for hepatitis C. Women reporting a history of genital ulcers had an adjusted odds ratio of 3.88 (95% CI, 0.94 – 16.00) of being infected with hepatitis C compared to women with no genital ulcers.

Compared to hepatitis C-uninfected men, the 15 hepatitis C-positive men were over three times (OR 3.85, 95% CI, 1.19 – 12.6) more likely to report sex with other men, and over three times more likely to have antibodies for herpes simplex virus-2 (HSV-2) (OR 3.61 (95% CI, 1.00 – 13.1).

The investigators conclude that their data suggest that although hepatitis C is not easily transmitted sexually, “genital ulcers and anal trauma may increase the risk.” They recommend that health care providers should stress the importance of using condoms and lubricants.

Further information on this website

Hepatitis C - overview

Hepatitis C a new health risk for gay men according to UK doctors - news story

Herpes simplex - overview

Sexual health - factsheets

References

Marx MA et al. Association of hepatitis C virus infection and sexual exposure in southern India. Clinical Infectious Diseases 37 (online edition), 2003.

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