Hepatitis C

How is it spread?

Hepatitis C virus is spread by direct blood-to-blood contact with an infected person. Most people are infected through sharing used needles or other drug injection equipment (‘works’), sharing straws or bills for snorting drugs (i.e., cocaine), sharing crack pipes, or from receiving a blood transfusion or blood products before 1992. It can also be spread by unsterilized tattoo or body piercing equipment (needles, ink), haemodialysis, or accidental needle-stick injuries. Less commonly, hepatitis C is spread through sexual contact, sharing household items such as razors or toothbrushes, or through birth from a mother infected with hepatitis C.

What are the symptoms?

Because hepatitis C progresses slowly, 70-80% of infected people experience no symptoms for up to twenty years. You may not know you have the infection until damage has already been done to your liver. If initial symptoms do occur, they tend to be very mild and resemble the flu. Symptoms may include tiredness, nausea, loss of appetite, fever, headaches, abdominal pain, dark urine, and jaundice (yellowish skin or eyes).  People with symptoms tend to experience them about 6 to 12 weeks after exposure to the virus.

Others may experience long-term health concerns such as fatigue, lack of energy, or digestive problems.

How is it diagnosed?

Hepatitis C is diagnosed through a blood test. The initial screening test for hepatitis C is known as the antibody test. A positive antibody test result means you have been exposed to the hepatitis C virus in the past and does not mean that you are now immune or protected against hepatitis C. An additional blood test (called an RNA test) is required to determine if there is active virus in the blood.

How is it treated?

Treatment for hepatitis C is available and can help up to 60% of people get rid of the virus.  A healthcare provider can help people decide if treatment is right for them. If people are treated for hepatitis C and get rid of the virus, they can still be infected again.

There are six main genetic types of hepatitis C.  Duration of treatment can range from six months to one year depending on which type of hepatitis C you have.  If treatment is not successful, you can make certain changes to your life to stay healthy and reduce liver damage.

What are the complications?

Chronic or long-term infection may lead to scarring of the liver called cirrhosis.  The chance of developing cirrhosis increases with the length of infection.  After 20 years, about 2 out of 10 people with hepatitis C will have cirrhosis.  Cirrhosis can lead to liver failure or liver cancer in a small number of people. People who develop cirrhosis or liver cancer may be candidates for a liver transplant.

About 20% of people living with HIV are also infected with hepatitis C which can increase the rate of liver damage and make treatment decisions for both infections more complicated.

What about my sexual partner(s)?

The risk of getting hepatitis C through sexual contact is very low unless a person engages in blood and piercing play, has rough sex (like fisting) or sex during a woman’s period. Having open sores or sexually transmitted infections (like syphilis, herpes and HIV) greatly increases the risk.

Prevention

At this time there is no vaccine for hepatitis C.

People who are infected with hepatitis C should avoid alcohol as this can accelerate the liver damage associated with hepatitis C.  People who are infected with hepatitis C should also receive vaccinations for hepatitis A and B.

The best way to reduce the spread of hepatitis C is to always  have your own drug-use equipment and personal hygiene items since the hepatitis C virus can live up to four days outside the human body.

Although the risk is low for most sexual activity, engaging in safer sex, i.e. using condoms and dental dams, reduces this risk even further.