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Sex and drugs and HCV?
  1. W ROSENBERG
  1. Department of Medicine and
  2. Division of Cell and Molecular Medicine
  3. Universtiy of Southampton
  4. 811 Level D, South Block
  5. Southampton General Hospital
  6. Tremona Road
  7. Southampton SO16 6YD, UK
  8. email: wmr@soton.ac.uk

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Patients infected with hepatitis C virus (HCV) often ask whether they might pass the virus to their sexual partners and some ask whether they might have acquired their infection through sex. Common sense would suggest that HCV, like hepatitis B and HIV, can be transmitted through sexual contact. The issues surrounding HCV and sex can be honed into a series of focused questions. Does sexual contact carry a risk of transmitting HCV? If so, how big is the risk? Does the size of the risk vary between groups of patients? Do specific behaviours influence the size of this risk? We are close to knowing the answers to some of these questions, the answers to others are surmised but none is known with certainty.

Convincing evidence of sexual transmission requires a history of contact, the absence of other opportunities for infection, a credible temporal association, and viral genetic evidence that both partners were infected with the same virus. High quality case reports might hold the answer.1 Soon after HCV was cloned, reports of sexual transmission began to appear in the literature and it is now widely assumed that HCV can be passed through sex but few reports satisfy all criteria. In particular, it is rarely possible to exclude all other potential routes of transmission, even ones seemingly as innocuous as the shared use …

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