STDs Expert Forum
Hepatitis C risk?
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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Hepatitis C risk?

I've been with my current girlfriend for six months.  She is originally from Kazakhstan but now lives in the US.  A few years ago she was diagnosed with asymptomatic hepatitis C - the test triggered by the result from a liver function test.  She has never done anything high risk but suspects the infection was acquired some years ago in Kazakhstan when she had a procedure involving blood products.  She was comprehensively treated for this in the US and was told by her doctor here that she has 'cleared' the virus (not sure of the precise term this doctor used).  We've used condoms for sex so far but would prefer to stop.  I am unclear on whether I am at risk of contracting anything here if we started having unprotected sex.  My PCP recommended not to discontinue condom use but he's not an expert in the field.  Web searches are unconclusive.  We've both been tested for all other STDs and are clear but I don't understand the risk here and don't want to take an unnecessary risk.  I would appreciate an opinion.
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Welcome to the forum.

Contrary to popular beliefs, hep C is not considred an STD and the hepatitis C virus is not sexually transmitted -- at least sexual transmission has never been proved, with the single exception of transmission through traumatic/bloody rectal sex among gay men.  There is a slightly higher frequency in the spouses of persons infected with HCV, but only after several years of sharing households and the transmission risk probably is related more to blood exposures between partners than to sex.

Therefore, I agree your partner's infection was acquired by blood exposure, not sex. However, I'm puzzled by her doctor that she had cleared the virus.  My understanding is that HCV is never truly cleared -- that many (most? all?) infected persons continue to carry the virus.  However, this is not my area of expertise.  (As I said, HCV is not considered sexually transmitted, and I'm an STD expert.)  My strong advice is that your partner seek out a liver disease expert, such as a gastroenterologist or infectious diseases specialist; if you live near a major medical center, you probably can find someone who is a full time hepatologist (liver disease specialist).  Then follow that person's advice about whether your partner still has an active, transmissible infection, and to monitor the health of her liver.

Although sexual transmission is not the norm and probably accounts for few cases, it is possible that the virus can be transmitted sometimes by vaginal sex.  But there is no research to know whether or not condoms are protective.  For peace of mind, you might continue to use condoms for now, until you have expert advice from an appropriate specialist.

Good luck--  HHH, MD
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H. Hunter Handsfield, M.D.Blank
University of Washington
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