Medical Research: What are the main findings of the study?
Dr. Bradshaw: Over 40% of men with hepatitis C (HCV) infection have HCV RNA in their semen, although the level of RNA was much lower than blood (usually 4 log less than blood).
Neither HIV nor acute hepatitis C led to increased shedding of HCV RNA in semen. Interestingly, however, in acute HCV, HIV-positive men with higher blood levels of HCV RNA were more likely to shed RNA in their semen.
Medical Research: What was most surprising about the results?
Dr. Bradshaw: In men who attended a follow up visit and gave a second semen sample, nearly three quarters had hepatitis C RNA detected in their semen at least once in the study ie a very high level of shedding of HCV in semen compared to other studies.
Medical Research: What should clinicians and patients take away from your report?
Dr. Bradshaw: Hepatitis C can be detected in the semen of many HCV-infected men. As HIV itself wasn’t associated with increased detection of hepatitis C in semen, the high level of sexual transmission of HCV seen in HIV-positive but not HIV-negative communities may be driven by other factors such as high risk sexual and drug-taking behaviours in HIV-positive MSM. Nevertheless, HIV-positive MSM should be counselled that semen may contain potentially infectious hepatitis C .
Medical Research: What recommendations do you have for future research as a result of this study?
Firstly, work looking at the infectivity of seminal HCV RNA would be important.
Secondly, we were not able to recruit many HIV-negative men with acute hepatitis C . Further work with this group would help shed light on any differences with HIV-positive men with acute HCV.