Viral Hepatitis and Gay and Bisexual Men

Two men together

Outbreaks of hepatitis A have been and are occurring among men who have sex with men in several different US cities.  The good news is that hepatitis A is easily preventable with a safe and effective vaccine.  So here’s what you need to know about hepatitis A and other common types of viral hepatitis.

Hepatitis A

Hepatitis A is a contagious liver disease that results from infection with the hepatitis A virus. Hepatitis A can be spread from sexual contact, or when the virus is ingested from contact with objects, food, or drinks contaminated by the stool of an infected person.

Hepatitis A infection can range in severity from a mild illness lasting a few weeks to a severe illness lasting several months. Most people who get infected recover over time without any lasting health effects.  However, hepatitis A can cause serious liver damage and even death for some people, especially those who have other underlying health issues.

Since 1996, CDC has recommended the hepatitis A vaccination for men who have sex with men.  Unfortunately, vaccination rates among gay men remain low, even though 10% of new cases occur among this group. Hepatitis A outbreaks among gay men have been reported for years in the US and in Europe.  Currently, there are outbreaks occurring both among gay men and among people who are homeless and people who inject drugs.

Hepatitis B

Hepatitis B is another type of viral hepatitis that occurs with higher rates among gay and bisexual men. In fact, almost 20% of new hepatitis B cases occur among men who have sex with men. Like hepatitis A, this virus can also be transmitted sexually. The hepatitis B virus spreads through contact with the blood or body fluids of someone who is infected. Once infected, many adults will clear the virus and have no lasting health effects. However, a small percentage of those infected will go on to develop a chronic infection, which can lead to liver damage and even liver cancer over time. The good news is that hepatitis B is also easily prevented with a vaccine. The hepatitis B vaccine can be given separately or in combination with the hepatitis A vaccine. Because of higher rates of infection among gay men, CDC also recommends a blood test to determine if a person is or has been infected with hepatitis B. The vaccine only works for people who have never been infected with the hepatitis B virus.

Hepatitis C

Hepatitis C is the most common type of viral hepatitis in the US and is spread when the blood from a person infected with the hepatitis C virus enters the body of someone who is not infected. Today, most people become infected with hepatitis C by sharing needles, syringes, or any other equipment to inject drugs. While rare, sexual transmission of hepatitis C is possible. Having a sexually transmitted disease or HIV, sex with multiple partners, or rough sex appears to increase a person’s risk for hepatitis C. Hepatitis C can also be spread when getting tattoos and body piercings in unlicensed facilities, informal settings, or with non-sterile instruments.

There is no vaccine for hepatitis C and testing for hepatitis C is not recommended for gay and bisexual men unless they were born from 1945 through 1965, have HIV, or are engaging in risky behaviors. The best way to prevent hepatitis C is by avoiding behaviors that can spread the disease, especially sharing needles or other equipment to inject drugs. Left untreated, infection with the hepatitis C virus can lead to cirrhosis and even liver cancer.