Epidemiology and treatment of sexually transmitted acute hepatitis C.

PURPOSE OF REVIEW: In recent years outbreaks of sexually acquired acute hepatitis C virus infections have been observed in HIV-infected men who have sex with men. The reasons are unclear as both viruses have been known for more than a decade and sexual transmission of hepatitis C has been rare.

RECENT FINDINGS: For effective sexual transmission of hepatitis C several factors comprising HIV infection, concomitant sexually transmitted infections and sexual practices with a risk of mucosal damage appear to be important. Sexual transmissions have also been described in HIV-negative individuals, underlining the fact that the degree of mucosal damage, facilitating blood to blood transmission, is the key risk factor. After acquisition of acute hepatitis C a spontaneous resolution is observed in 25% of HIV-infected individuals. Early treatment with pegylated interferon and ribavirin results in sustained virological response rates in 60-75% of patients.

SUMMARY: Sexual transmission of hepatitis C has occurred more frequently in recent years within a highly selected population. A surge of classic sexually transmitted infections as well as behavioural changes appear to have fuelled this epidemic.