Route of HCV transmission in HIV-positive gay men is unlikely to be from semen

Simon Collins, HIV i-Base

The mechanism for high rates of hepatitis C (HCV) transmission in HIV-positive gay men is unknown with little data on whether HCV levels in semen had a similar risk factor to HIV viral load, especially during acute infection.

Joanna Turner and colleagues presented a new study to inform this field. [1]

Paired blood and semen samples were collected from 5 acute and 9 chronic HCV cases in HIV-positive men. At baseline 0/5 acute and 2/9 chronic cases had detectable HCV RNA in semen. Of all samples tested 2/10 (20%) of acute cases and 4/23 (17%) of chronic cases (p=NS) had detectable HCV RNA in semen.

However, when detected, HCV RNA viral loads were low: <30 IU/mL (acute cases) and <230 IU/mL (chronic cases) and did not correlate with plasma HCV viral load

Taken together, this lead the researcher to suggests that the quantity of seminal HCV virus is not a significant factor in determining the rate of HCV transmission, even during acute infection. Recruitment to the study is ongoing.


HCV levels in semen have been previously reported. [2] Results from the larger study will be important to understand whether infection from semen is likely to occur at these low levels.


1. Turner J et al. Hepatitis C viral load in semen of HIV-positive men during acute and chronic hepatitis C infection. 2nd Joint Conference of BHIVA with BASHH, 20–23 April 2010, Manchester. Oral abstract O5.

2. See this earlier report in HTB from 2003.

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