Hepatitis C virus among genitourinary clinic attenders in Scotland: unlinked anonymous testing

Our objective is to gauge the prevalence of hepatitis C virus (HCV) antibod ies among a population at risk of contracting sexually transmitted infectio ns (STIs) and, thus, the efficiency with which the virus is transmitted sex ually. The investigators undertook an unlinked anonymous HCV antibody testi ng study of residual syphilis serology specimens taken from attenders of ge nitourinary clinics in Glasgow, Edinburgh and Aberdeen during 1996/97. The results were linked to non-identifying risk information. Anti-HCV prevalenc es among non-injecting heterosexual men and women, and non-injecting homose xual/bisexual males ranged between 0 and 1.2%; the only exception to this w as a 7.7% (4/52) prevalence among homosexual/bisexual males in Aberdeen. Th e overall anti-HCV prevalence for homosexual/bisexual males was 0.6% (4/668 ), for heterosexual males 0.8% (32/4135), for heterosexual females 0.3% (10 /3035) and for injecting drug users 49% (72/148). Only 3 (all female) of th e 46 non-injectors who were antibody positive were non-UK nationals or had lived abroad. HCV antibody positive injectors were less likely to have an a cute STI and more likely to know their HCV status than non-injectors; no di fferences in these parameters were found between positive and negative non- injectors on anonymous HCV antibody testing. Our findings are in keeping wi th the prevailing view that HCV can be acquired through sexual intercourse but, for most people, the probability of this occurring is extremely low. I nterventions to prevent the spread of HCV should be targeted mainly at inje cting drug user (IDU)populations.