Do sins of sacrilege need to be confessed differently than other sins? Are sins of sacrilege forgiven during a good confession?
Catechism of the Catholic Church:
2120 Sacrilege consists in profaning or treating unworthily the sacraments and other liturgical actions, as well as persons, things, or places consecrated to God. Sacrilege is a grave sin especially when committed against the Eucharist, for in this sacrament the true Body of Christ is made substantially present for us.
Sacrilege, while a grave sin, is treated the same as other grave sins in confession with one exception:
Can. 1367 A person who throws away the consecrated species or takes or retains them for a sacrilegious purpose incurs a latae sententiae excommunication reserved to the Apostolic See…
As long as the sacrilege is not against the Holy Eucharist it can be forgiven in the normal course of events in the sacrament of confession. If the sacrilege is committed against the Holy Eucharist then it is punished with automatic excommunication that can only be lifted by the Holy See. The sacrilege in this case must be a physical sacrilege against the sacred host, it does not apply to simply receiving the Eucharist unworthily.