My husband recently found out that he has contracted the hepatitis C virus. When I asked the doctor about sexual relations, he assured us that our active sex life was fine and that no protection would be required. He did suggest, though, that I be tested. However, some articles say that the virus can be spread through sexual relations. What is the right answer?

Sue

Hepatitis C is a very common cause of chronic hepatitis. Over time, the complications of hepatitis C infection may include chronic liver inflammation, scarring of the liver (cirrhosis) and the possibility of liver cancer in a small percentage of patients.

The hepatitis C virus is spread in a number of ways, with blood-to-blood contact being the most effective route of transmission. Before a screening test for this virus was available, it was the most common type of hepatitis spread via blood transfusions. Now, the risk of receiving infected blood through a transfusion is extremely low. Today, most infections can be traced to the sharing of needles by drug abusers or to tattoos that have been made with unsterile needles. Other at-risk groups include hemodialysis patients exposed to unsterile needles and health-care workers who sustain needle-stick injuries.

Although blood transmission is the easiest way for the virus to spread, up to 40 percent of infected patients have no obvious risk for the infection. The issue of sexual transmission remains controversial. Various studies have looked at the risk of sexual transmission by studying patients who are infected and their uninfected sexual partners. The estimated risk varies widely depending on the study, ranging from 0-27 percent. In most of the studies in which both partners had no other risk factors for exposure, the risk was in the lower range (0-10 percent) of this estimate.

It is also important to mention that concurrent infection with HIV, the virus that causes AIDS, greatly increases the chance of hepatitis C transmission. So, any person with hepatitis C also should be tested for HIV.

To answer your specific question, although sexual transmission of hepatitis C does not occur as often or as efficiently as blood transmission, it does occur and cannot be ignored. You and your husband should discuss these issues with a gastroenterologist who specializes in hepatology (liver diseases) to get more information about hepatitis C and treatment options.