What should I know about viral hepatitis and sex?
Hepatitis is a type of inflammation that affects the liver. Common symptoms include jaundice (yellowing of the skin), diarrhea, nausea, and vomiting.
Some cases of hepatitis are mild and have no symptoms, while more severe cases can lead to cirrhosis of the liver or liver cancer.
Hepatitis viruses are the most common cause of hepatitis, but other types of infections, toxic substances (e.g. alcohol, drugs), and rare autoimmune diseases can also cause hepatitis.
Hepatitis of viral origin is usually caused by one of five viruses: A, B, C, D, or E. Most of these viruses can be transmitted sexually:
| Type | How is it transmitted? |
How might sex increase a person’s risk? |
| Hepatitis A (HAV) |
Contact with feces from an infected person. |
HAV can be transmitted through any sexual activity involving the anus, including anal sex, anilingus (oral stimulation of the anus) or the use of sex toys. |
| Hepatitis B (HBV) |
Contact with infected blood, vaginal fluids, saliva, and semen. |
HBV can be transmitted through vaginal, oral, and anal sex. It may also be transmitted through the use of sex toys. Deep kissing could be risky. |
| Hepatitis C (HCV) |
Contact with infected blood |
Any sexual activity that might involve bleeding, cuts, or sores. |
| Hepatitis D (HDV) |
Occurs in people infected with hepatitis B. |
Sexual activity with a person who is infected with hepatitis B. |
| Hepatitis E (HEV) |
Contact with contaminated water or food. |
Hepatitis E is not thought to be sexually transmitted. |
Scientists have studied the ways hepatitis might affect sexual function.
In 2014, researchers reported that women with chronic hepatitis C infection were more likely to be diagnosed with sexual dysfunction than healthy women. The findings were based on participants’ scores on the Female Sexual Function Index (FSFI), a tool that assesses women’s sexual desire, arousal, vaginal lubrication, orgasm, pain, and satisfaction.
In addition, a 2019 study found that men with chronic hepatitis C infection had poorer scores on the International Index of Erectile Function (IIEF) compared to healthy men. The IIEF evaluates erectile and orgasmic function, sexual desire, intercourse satisfaction, and overall sexual satisfaction.
Healthcare providers are encouraged to discuss sexual issues with their patients who have hepatitis.
Reducing Risk
The following steps may reduce the risk of sexually transmitted hepatitis:
- Get tested for hepatitis and know your partner’s status.
- Use a condom and/or dental dam during every sexual act.
- Limit your number of sexual partners.
- Get vaccinated against hepatitis A or B. (Vaccines are not currently available for hepatitis types C, D, and E.)
Resources
- Centers for Disease Control and Prevention - “Hepatitis B & Sexual Health”
(October 2013)
https://www.cdc.gov/hepatitis/hbv/pdfs/HepBSexualHealth.pdf - “Sexual Transmission and Viral Hepatitis”
(Page last reviewed: July 1, 2020)
https://www.cdc.gov/hepatitis/populations/stds.htm - The Journal of Sexual Medicine - “Association Between Viral Hepatitis and Erectile Dysfunction: A Population‐Based Case‐Control Analysis”
Chung, Shiu‐Dong, MD, et al.
(May 1, 2012)
https://www.jsm.jsexmed.org/article/S1743-6095(15)33984-9/fulltext - “Female Sexual Dysfunction Among Egyptian Patients with Chronic Hepatitis C”
Elshimi, Esam, MD, et al.
(March 1, 2014)
https://www.jsm.jsexmed.org/article/S1743-6095(15)30704-9/fulltext - “Male Sexual Dysfunction Among Egyptian Patients with Chronic Hepatitis C Virus Infection Before and After Direct-Acting Antiviral Drugs”
Elshimi, Esam, MD, et al.
(March 1, 2019)
https://www.jsm.jsexmed.org/article/S1743-6095(19)30311-X/fulltext - National Institute of Diabetes and Digestive and Kidney Diseases - “Hepatitis (Viral)”
https://www.niddk.nih.gov/health-information/liver-disease/viral-hepatitis - WebMD.com - “Hepatitis and Sex: Frequently Asked Questions”
(Reviewed: June 19, 2020)
https://www.webmd.com/hepatitis/hepatitis-and-sex-frequently-asked-questions - World Health Organization - “What is hepatitis?”
(September 1, 2019)
https://www.who.int/news-room/q-a-detail/what-is-hepatitis
