Chromy D, Schmidt R, Mandorfer M, et al. - Researchers investigated the actual routes of hepatitis C virus (HCV) transmission during high-risk sex practices and associated drug use in the Western world. Among 47 prospectively enrolled patients with HCV, 89% were HIV positive (+) (42/47) and 85% (40/47) were male, 58% (23/40) of whom were MSM. Rectal and nasal fluids of both HIV+ and HIV-negative HCV patients with high serum HCV-RNA, commonly had detectable HCV-RNA; this was noted independent of the suspected route of HCV transmission. Accordingly, they suggest high-risk sex practices and sharing of nasal drug-sniffing “tools” as possibly important HCV transmission routes, particularly in patients with high serum HCV-RNA. ROC-curve analysis led to establishing of serum HCV-RNA cutoffs for ruling in/out any HCV+ swab sample at 6.02 log IU/mL and 4.02 log IU/mL, respectively.