Hepatitis C

Hepatitis C is a viral infection of the liver caused by the hepatitis C virus. Hepatitis means inflammation of the liver. There are other viruses that cause inflammation of the liver including hepatitis A, B, D and E.

Symptoms

Most people have no symptoms at all when they are first infected with hepatitis C. If there are symptoms, they usually develop within two weeks to six months of exposure to the virus and can include:

• flu-like symptoms
• loss of appetite
• nausea
• vomiting
• tiredness
• abdominal pain
• yellowing of the skin and eyes (jaundice)
• dark urine
• pale stools.

These symptoms usually only last a few weeks.

Infection time

A small number of people with hepatitis C will clear the virus naturally within the first 6 months of having the infection without any specific treatment. These people are no longer infectious and cannot pass the virus on to others. However, most people with hepatitis C will develop a chronic or long-term infection and require treatment to clear the virus.

Without treatment, inflammation of the liver caused by chronic hepatitis C may result in permanent liver damage or liver cancer. People with chronic hepatitis C usually appear well for many years but may develop symptoms as their liver damage progresses.

People who have been infected and cleared the hepatitis C virus do not have life-long immunity and can be reinfected.

Diagnosis

Hepatitis C infection can be diagnosed by a blood test which is available from your doctor. It may take a few weeks from the time of exposure before the test can determine whether you have the infection.

How hepatitis C is spread

Hepatitis C is spread through blood-to-blood contact i.e. when the blood of a person with hepatitis C enters the bloodstream of another person. It only takes a very small amount of infected blood to pass the virus on.

Hepatitis C virus is most commonly passed on through sharing equipment used to inject drugs including:

• needles
• syringes
• spoons
• tourniquets.

The virus may also be passed on by:

• exposure to non-sterile tattooing, piercing or acupuncture equipment e.g. tattooing within correctional facilities
• accidental needle-stick injury or blood splash e.g. in the health care setting
• sharing personal items which have blood on them such as toothbrushes or razors
• exposure to blood through direct contact with an open wound or cut
• from mother to baby during pregnancy or at the time of birth
• during breastfeeding if the mother’s nipples are cracked or bleeding.

While it is generally not considered a sexually transmissible infection, hepatitis C can be passed on during sex if there is potential for blood-to-blood contact e.g. anal sex without a condom.

Who is at risk of infection

There is no vaccine for hepatitis C. The only way to prevent acquiring hepatitis C is to avoid exposure to infected blood.

Hepatitis C can be prevented by:

• never sharing injecting equipment. Only use sterile injecting equipment once and dispose of it safely after use
• ensuring that practitioners performing tattoos, piercing and acupuncture use sterile equipment and are licensed
• not sharing razors, toothbrushes or other personal items which can transfer blood
• always wearing gloves and protective clothing when dealing with blood or body fluids to ensure that blood does not come in contact with the skin
• always using condoms with new or casual sexual partners or for sex that might involve blood-to-blood contact.

Treatment

There is a new generation of anti-viral medication available to Australians living with chronic hepatitis C. The new medications are more effective, easier to take and have fewer side effects than the older medications. The Australian Government has listed these new medicines on the Pharmaceutical Benefits Scheme (PBS), ensuring they are accessible and affordable to people with hepatitis C. The new medications result in a cure for 90-95% of people.

If you have been diagnosed with hepatitis C you should:

• have a liver health assessment and discuss treatment options with your doctor as soon as possible
• have regular medical/specialist follow up appointments
• limit or avoid alcohol and maintain a healthy lifestyle
• consider getting vaccinated against hepatitis A and hepatitis B to minimise damage to the liver
• contact Hepatitis ACT for further information and support.

More information

For more information about hepatitis C contact:

• your doctor
• Hepatitis ACT
• the Health Protection Service, Communicable Disease Control Information Line during business hours on 02 5124 9213.

Hepatitis C is a notifiable disease.

Acknowledgement

Heymann DL. Control of Communicable Diseases Manual. 20th edn. Washington: American Public Health Association, USA; 2015.