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Cited by 144Hepatitis C virus researchHIV/AIDS Research and InterventionsHIV, Drug Use, Sexual Risk

Increased numbers of acute hepatitis C infections in HIV positive homosexual men; is sexual transmission feeding the increase?

Open access
Browne, R·2004·Sexually Transmitted Infections
DOI 10.1136/sti.2003.008532PMC PMC1744861
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Abstract

HIV transmission among men who have sex with men through oral sexWhile the risk of transmission through oral sex for men who have sex with men (MSM) is low, discrepancies remain between study findings and there is uncertainty about the exact degree of risk. 1 Between July 2001 and September 2003, a total of 4150 MSM were newly diagnosed with HIV infection in England, Wales, and Northern Ireland and reported to the Communicable Disease Surveillance Centre in London.Reports for 1359 cases received during this time included the question ''Does the patient believe himself to have been infected through oral sex?''The remaining 2791 cases had only laboratory reports or earlier clinician report forms where this question was not asked.The oral sex question was answered for 688 (50.6%) of the 1359 cases, of which for 625 (90.8%) the response was no, and yes for 63 (9.2%) cases.For 671 cases this information was not recorded even though the question was included on the form.All 63 cases where the patient believed himself to have been infected with HIV through oral sex were further investigated by a discussion with the clinician or healthcare provider.From these further discussions during the follow up, 27 (42.8%)cases were believed to have been infected from unprotected anal intercourse.Of the remaining 36 cases, 16 (2.3%)claimed to have had only oral sex as their risk for acquiring HIV, with 20 (2.9%) cases always reporting protected anal sex but unprotected oral sex.Previous negative testing history and HIV status of partners was taken into account when discussing possible HIV risk with clinicians or healthcare providers.It is difficult to quantify oral sex risks and this could be an obstacle to accuracy 1-3 ; none of these individuals were re-interviewed for this study and risk was assessed by clinician and note review only.There may be recall difficulties surrounding condom use, including whether they were used, or if used, coming off or splitting, or brief anal-penile contact that was not considered relevant or remembered.In addition, there was limited information about whether ejaculation had occurred or about breaks in the oral mucosa.However, 16 cases reported no anal sex and 20 cases reported only protected anal sex and unprotected oral sex.In total this represents 5.2% of those MSM reports where the question was answered.We are aware that, for half, the question was not answered, and if we classified those reports as not infected through oral sex, then 2.6% (36 of 1359) were probably infected through this route.The indication given by these UK surveillance data is that oral sex carries a small but real risk.

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  • Risk of HCV infection increases commensurate with increasing numbers of sex partners among heterosexual persons and MSM with HIV infection, especially if their partners are also coinfected with HIV.

    “Certain studies have revealed that risk increases commensurate with increasing numbers of sex partners among heterosexual persons (1337,1338,1351–1353) and MSM with HIV infection (1349,1354–1357), especially if their partners are also coinfected with HIV (237,1340,1354–1356,1358).”

    From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [1355]

    The LETTERS section (page unavailable) says multiple sexual partners have been associated with HCV infection and describes HCV seroconversion among HIV-positive MSM in association with high-risk sexual behavior. It does not establish that risk rises in proportion to the number of partners, or that risk is especially high when those partners are HIV/HCV-coinfected. The heterosexual-persons clause has separate citations in the citing sentence and is not assessed against this source. (LLM, conf=0.84)

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Research works printed but not linked: 7

  1. Rothenburg RB, Scarlett M, del Rio C, et al. Oral transmission of HIV. AIDS 1998;12:2095-105.
  2. Richers J, Grulich A, Ellard J, et al. HIV transmission among gay men through oral sex and other uncommon routes: case series of HIV seroconverters, Sydney. AIDS 2003;17:2269-71.
  3. Robinson EK, Evans BG. Oral sex and HIV transmission. AIDS 1999;13:737-8.
  4. Matthews-Greer J, Caldito G, Adley S, et al. Comparison of hepatitis C viral loads in patients with or without human immunodeficency virus. Clin Diagn Lab Immunol 2001;8(4):690-4.
  5. Potterat JJ, Markewich GS, Rothenberg R. Prepubertal Infections with Neisseria gonorrhoeae: clinical and epidemiological significance. Sex Transm Infect 1978;5:1-3.
  6. Lipsitt HJ, Parmet AJ. Nonsexual transmission of gonorrhoea to a child. (Letter) N Engl J Med 1984;311:470.
  7. Singh V, Rastogi S, Garg S, et al. Polymerase chain reaction for detection of endocervical Chlamydia trachomatis infection in Indian women attending gynaecology outpatient department. Acta Cytol 2002;46:540-4.

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Authors
Browne, R.
Affiliations
Chelsea and Westminster Hospital (GB)
Corresponding author
Browne, R
Venue
Sexually Transmitted Infections
Publisher
BMJ
Published
2004-08-01
Volume
80
Issue
4
Pages
326-327
ISSN
  • 0007-134X (ISSN-L)
  • 1368-4973
DOI
10.1136/sti.2003.008532
PMC
PMC1744861
OpenAlex
W2122049929
Cited by
144
References
16
Citations by year
2026: 1 · 2025: 1 · 2024: 4 · 2022: 1 · 2021: 3 · 2020: 3 · 2019: 6 · 2018: 1 · 2017: 2 · 2016: 12 · 2015: 6 · 2014: 7 · 2013: 9 · 2012: 7
FWCI
7.60
Type
journal article
Language
en
Open access
Locations
  • Sexually Transmitted Infections (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • HighWire Press Open Archive (submittedVersion)
Funders
  • Postgraduate Institute of Medical Education and Research, Chandigarh
  • National AIDS Control Organisation
Topics
  • Health Sciences › Medicine › Hepatology › Hepatitis C virus research
  • Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
  • Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
Keywords
hepatitis C, HIV, men who have sex with men, sexual transmission, HIV incidence, unprotected anal intercourse, condom use, HIV risk perception
MeSH terms
Acute Disease, Adult, Female, Hepatitis C, Humans, Male, Retrospective Studies, Risk Factors, Sexual Partners, Incidence, AIDS-Related Opportunistic Infections, Homosexuality, Male

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