Hepatitis C Virus fact sheet

Summary

• Hepatitis C is a virus that causes inflammation and damage to the liver.
• This virus is present in the blood of an infected person and can be spread through blood-to-blood contact.
• In Australia, hepatitis C is most often spread through the sharing of drug injecting equipment.
• New treatments have greatly improved health outcomes for people with hepatitis C. Once treated and cured you cannot pass the infection on to other people.
• See your doctor immediately if you have any symptoms or if you think you have been put at risk of infection.
• Prevention is still very important - you can become reinfected with hepatitis C after clearing the virus, or after treatment.
• There is no vaccine to prevent hepatitis C infection, but treatment is effective for more than 95 per cent of people.

Symptoms of hepatitis C

Many people may not feel ill when first infected with hepatitis C. Others may find their urine becomes dark and their eyes and skin turn yellow (this is known as jaundice), or they may experience a minor flu-like illness.

These symptoms may disappear within a few weeks, but this does not necessarily mean that the infection has been cleared.

Twenty to 30 per cent of people who have been infected may clear the virus from their blood with no treatment within six months. These people no longer have the hepatitis C virus and are not infectious, but will still have hepatitis C antibodies in their blood life-long. Hepatitis C antibodies signify past, cleared infection, but do not offer any immunity against hepatitis C so people can become reinfected after clearing the virus, or after treatment.

Chronic hepatitis C

When the initial infection lasts for more than six months, it is called chronic hepatitis C. Chronic hepatitis C does not usually cause any symptoms until many years after infection.

Symptoms of chronic hepatitis C can include:

• mild to severe tiredness
• loss of appetite
• nausea and vomiting
• soreness in the upper right side of the stomach (under the ribs)
• fever
• increased moodiness and depression
• joint pain or swelling
• skin rash.

In many cases, people who have chronic hepatitis C do not feel ill.

Most people infected with hepatitis C continue to carry the virus in their blood (that is, they have chronic infection). About 15 to 20 per cent of people who have chronic hepatitis C will develop cirrhosis, which is severe scarring of the liver. This may take 20 to 40 years, or more to develop. A small number of people with cirrhosis may then develop liver cancer.

Spread of hepatitis C

Hepatitis C is spread through blood-to-blood contact. The most common way people become infected with hepatitis C in Australia is by sharing drug-injection equipment such as needles, syringes, spoons and tourniquets.

Hepatitis C may also be spread through:

• tattooing and body piercing using equipment that has not been properly cleaned, disinfected or sterilised
• needlestick injuries in a healthcare setting
• receiving blood transfusions in Australia prior to February 1990, when hepatitis C virus testing of blood donations was introduced
• unsterile medical procedures, blood transfusions or blood products and mass immunisation programs provided in a country other than Australia
• pregnancy or childbirth – there is a five per cent chance of a mother with chronic hepatitis C infection passing on the virus to her baby during pregnancy or childbirth
• Breastfeeding, which is safe unless nipples are cracked or bleeding
• sharing toothbrushes, razor blades or other similar personal items that could have small amounts of blood on them
• one person’s blood meeting open cuts on another person
• sexual transmission – sexual transmission rates of hepatitis C are very low, however the risk is increased with certain sexual practices or circumstances where there is the possibility of blood-to-blood or anorectal fluid-to-blood contact (for example, sex during menstruation, group sex, the use of sex toys, fisting or the use of anorectal douching equipment) that can lead to tears in the mucosal membrane or exposure of open cuts or wounds on the skin to hepatitis C in anorectal fluid.

Hepatitis C is NOT spread through

• kissing
• sharing food, cups or cutlery
• shaking hands or day-to-day physical contact.

Preventing the spread of hepatitis C

At present, there is no vaccine available to prevent a person from being infected with hepatitis C.

To prevent the spread of hepatitis C:

• Always use sterile needles and syringes. These are available for free of from needle and syringe program outlets.
• If you inject drugs, never share needles and syringes or other equipment such as tourniquets, spoons, swabs or water.
• When cleaning and removing blood spills, use standard infection control precautions at all times
• If you are involved in body piercing, tattooing, electrolysis or acupuncture, always ensure that any instruments that pierces the skin is either ‘single use’ or has been cleaned, disinfected and sterilised since its last use
• Always wash your hands before and after injecting.

Diagnosis of hepatitis C

An antibody blood test can tell you whether or not you have been infected with hepatitis C. It may take two to three months (or sometimes longer) from the time of infection before a blood test can detect antibodies to hepatitis C.

If you have a positive hepatitis C antibody test, specialised laboratories can do an additional test, called hepatitis C PCR, to determine if the virus is still present in your blood or liver. This hepatitis C PCR test should follow for anyone who has positive hepatitis C antibodies.

A liver ultrasound or fibroscan can also be used to assess if you have any liver damage.

All people who think they may be at risk of hepatitis C infection, or have possibly had past exposure to hepatitis C, should see their general practitioner (GP) for a hepatitis C test.

Treatment of hepatitis C

New treatments have greatly improved the outcomes for people with hepatitis C. These treatments can cure more than 95 per cent of individuals with chronic hepatitis C. There are several new tablets that are used in combination to treat all hepatitis C strains (genotypes).

These new tablet medications are available and subsidised on the Australian Pharmaceutical Benefits Scheme (PBS) and can be prescribed by specialists and general practitioners. An assessment of your liver health, which includes blood tests and possibly a non-invasive test for liver damage (called a Fibroscan), may be performed.

There are some side effects with hepatitis C medicines; however, the new tablets are generally very well tolerated.

Most of the side effects that were common with the older interferon injection based treatments – including mental health side effects – are not seen with the new tablet medications.

It is important to talk with your doctor about treatment options and potential for interactions with other medications, herbal preparations and other drugs.

In general, people who have hepatitis C will feel better if they:

• get treated and cure the virus
• avoid drinking alcohol
• eat a well-balanced, low-fat diet
• do regular exercise (although always rest when tired)
• consult their doctor regularly.

Further information

• Red Thread - Hepatitis Information line on 1800 437 222
• TasCHARD hepatitis C information
• Call the Public Health Hotline – Tasmania on 1800 671 738 to speak to a clinical nurse consultant

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