Hepatitis C. Issues for women and their partners.

BACKGROUND: A large proportion of injecting drug users in Australia have been found to have hepatitis C virus (HCV). Many of these are women who as a result of the disease have specific concerns related to risk of transmission to spouses and children and questions regarding what contraception they can use. OBJECTIVE: This paper reviews the literature to examine the relationship between hepatitis C and: limitations on contraceptive use; whether sexual transmission can occur between couples; whether transmission occurs within households; rates of vertical transmission; whether transmission can occur through breastfeeding. DISCUSSION: While the prevalence of hepatitis C is low in women (except where a known history of injecting drug use exists) a small risk of sexual and vertical transmission exists when viral loads are high (such as in acute phases of the disease) or when the infected person is immunocompromised. New technologies such as polymerase chain reaction (PCR) testing may allow better advice to be given about the transmissibility of disease. Hormonal contraception may worsen liver function and general practitioners need to take this into account when discussing contraceptive options with their patient.