A new report is calling for raised awareness of the risks posed by hepatitis C to gay men living with HIV.

The National AIDS Trust said the implications of hepatitis C and HIV co-infection on health can be severe, with liver disease one of the major causes of serious illness and fatality in HIV-positive people.

According to the Trust’s report, 7% of HIV positive gay men are co-infected with hepatitis C. In most cases, no symptoms are experienced after infection.

Generally, about 25% of people infected with hepatitis C clear the virus naturally from their blood during acute infection but three quarters will go on to develop chronic hepatitis C, which targets the liver.

And of those who successfully clear hepatitis C through treatment, a significant percentage are re-infected within a short time.

The charity said infections among gay men are largely due to sexual risk factors, thought to include unprotected anal sex, fisting, use of sex toys, group sex and said drug use may also have a role.

The report criticises the lack of an explicit national strategic approach to tackling this issue and says the stigma around hepatitis C in the gay community and amongst people with HIV hampers prevention efforts and harms gay men.

Deborah Jack, Chief Executive of NAT, said: “The rate of HIV-positive gay men co-infected with hepatitis C in the UK is too high. It is crucial for this to be addressed as a strategic priority in gay men’s health promotion.

“It is vitally important that, as recommended, all people diagnosed with HIV are annually screened for hepatitis C infection and this should be made a requirement in the commissioning of all relevant services (in a recent audit only 66% had had an annual test). Clinics and health promoters need to provide intensive advice and support to gay men at significant risk of hepatitis C transmission. To that end, consensus is urgently needed on the key risk factors for sexual transmission so clear and appropriate recommendations can then be made.

“We also strongly urge gay men not to rely on their sexual partners’ disclosure of their HIV or hepatitis C status as a high proportion are unaware they are infected, which is certainly fuelling onward transmission. And even when diagnosed, disclosure can be difficult – we need to start challenging hepatitis C stigma as well as HIV stigma – both are unfair, ill-informed and destructive.”

Symptoms which do occur in the initial ‘acute’ stage of hepatitis C, which lasts for about six months after infection, include diarrhoea, nausea and jaundice.

Longer term, about half of people with hepatitis C can experience symptoms such as generally feeling unwell, extreme tiredness, weight loss, intolerance of fatty food, and depression.

The Trust’s report is available here for download as a PDF.