Hepatitis means inflammation of the liver. At this point, the liver inflammations caused by viruses are meant, the “viral hepatitides”. There are different types, with different risk depending on the type of sexual activity.
In recent years, cases of hepatitis A have emerged in men who have sex with men in some European countries. Hepatitis A almost never becomes chronic. However, the burden the acute symptoms of the disease pose are considerable. The hepatitis A vaccination provides reliable protection and is covered by health insurance for men who have sex with men.
When traveling to countries with unfavorable hygienic conditions, there is a risk of contracting hepatitis A through contaminated drinking water, juices, or insufficiently cooked food. In this case, however, health insurance companies do not cover the bill for the hepatitis A vaccination.
Hepatitis B can be transmitted during all forms of sexual activity, i.e. oral sex, sexual intercourse and anal sex. Another risk is blood contact (e.g., sharing drug paraphernalia). If you have hepatitis B vaccine protection, there is no risk of infection. In Switzerland, however, older adults in particular are underprotected against hepatitis B, and there are also vaccination gaps among younger people. Vaccination protection is especially important for men who have sex with men and for people with sex partners from Africa or Asia (as HBV infections are more common among them, often acquired at birth/ in childhood).
The course of acute hepatitis B infection can vary widely, from nonspecific and mild signs to massive symptoms lasting weeks. When disease develops in adulthood, chronic infection develops in 5 to 10%. To prevent progression of the disease with the risk of cirrhosis or liver cancer, continuous use of hepatitis B drugs may then be required.
Hepatitis C is primarily transmitted by blood. Sexual transmission is possible, but in Switzerland is seen almost only in concurrence with HIV infection among men who have sex with men. With intravenous drug use (heroin, crystal meth, other substances), there is a risk not only from sharing needles and syringes, but also from sharing water, stirring tools, or spoons.
The acute disease is often not recognized because it causes few and atypical signs of disease. 25% of infected persons recover from the disease spontaneously. In the chronic phase, cirrhosis of the liver may develop, usually after decades. This can be prevented by hepatitis C therapy, which is successful in almost 100% of cases.