Hepatitis C

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What is Hepatitis C?

Hepatitis C (Hep C) is a blood borne virus that can cause inflammation and damage to the liver. Hepatitis means inflammation (swelling) of the liver. The liver, located just under the right ribs, helps the body to process food, drugs (both prescribed and recreational) and alcohol. The liver also plays an important role in your immune system and healing. Approximately 30% of people who acquire Hepatitis C 'clear' the virus spontaneously from their body during the first year of infection. For those who do not clear the virus, Hepatitis C becomes a chronic condition. An individual can have the virus for many years without experiencing any symptoms although the virus is present in their blood and can be spread by blood to blood contact. Currently there is no vaccine for Hepatitis C but treatment is available and can be effective. 

 

HOW IS HEPATITIS TRANSMITTED?

Hepatitis C is transmitted through blood-to-blood contact. The most common mode of transmission in Australia is by sharing drug-injecting equipment such as needles, spoons and syringes and tourniquets.
Less common but potential sources for Hepatitis C infection include transmission from:

  • unsterile / unclean tattoo or body piercing equipment.
  • surgical procedures. Some people in Australia have acquired Hepatitic C from surgical procedures or unclean vaccinations in countries outside Australia.
  • blood transfusions. The risk of acquiring Hepatitis C from a blood transfusion in Australia declined markedly after 1990 when all blood donations were screened for the virus - see www.Transfusion.com.au for further information.
  • Needle stick injury in the health care setting is another potential risk for acquiring Hepatitis C. 
  • Sharing toothbrushes, razor blades or other personal items that have come in contact with Hepatitis C infected blood is a rare but possible Hepatitis C risk. 
  • Pregnancy or childbirth carries a very small risk. On rare occasions the mother with Hepatitis C may pass the virus to their babies during pregnancy, or at the time of birth, but less than 1 in 20 babies are infected if the mother has Hepatitis C.
  • Breastfeeding is considered safe, however bleeding or cracked nipples can carry a very small risk so feeding should be avoided during these times.
  • Sexual contact - Hepatitis C is not considered a sexually transmitted Infection and condoms are not routinely recommended to prevent heterosexual transmission of Hepatitis C. However, condoms should be used if there is fresh blood (including menstrual blood).
    The exception to the statement that Hepatitis C is not sexually transmitted is in HIV+ve men. Because of the interactions between HIV and Hepatitis C, sexual transmission of Hepatitis C between men with HIV is quite common.

WHAT ARE THE SYMPTOMS?

Many people may not feel ill when first infected with the Hepatitis C virus. Others may find their urine becomes dark and their eyes and skin may turn yellow (jaundice) or may experience minor ‘flu-like’ symptoms. These symptoms may resolve within a couple weeks but this does not mean that the virus has also gone.

When the person has had the virus for more than six months the illness is called chronic Hepatitis C. Symptoms of chronic Hepatitis C are non-specific and may include:

  • mild or severe lethargy (tiredness)
  • loss of appetite
  • nausea and vomiting
  • soreness in upper right part of the belly (under the ribs)
  • fever or flu-like symptoms
  • pain in the joints
HOW CAN I PREVENT HEPATITIS C?
At present there is no vaccine available to prevent a person from being infected with Hepatitis C.
Ways to avoid coming in contact with Hepatitis C include:
  • Never share needles, syringes or any other equipment such as tourniquets, spoons, swabs or water as they can also be contaminated. New needles and syringes are available from some chemists and Needle and Syringe Program outlets. To find out where you can obtain new needles and syringes, contact DirectLine on 1800 888 236. 
  • Avoid sharing personal items such as toothbrushes, razors, nail files or nail clippers/scissors, as these can puncture the skin and have small amounts of blood on them.
  • If you are involved in body piercing, tattooing, electrolysis or acupuncture, always ensure that any instrument that pierces the skin is sterile.
  • Health care workers should follow infection control guidelines at all times. 
  • Wherever possible, wear single-use gloves if you give someone first aid or clean up blood or body fluids. 
  • Although Hepatitis C is not considered to be a sexually transmissible infection in Australia, always practice ‘safe sex’ if blood is going to be present. 
IS THERE A TEST FOR HEPATITIS C?

An antibody blood test can tell you whether or not you have ever been infected with Hepatitis C. We recommend you have a test for Hepatitis C, 8-12 weeks from the time you may have been infected. In people who are immunocompromised a repeat test may be recommended at 6 months. This is a very rare event and your Doctor will advise you.

If you have a positive Hepatitis C antibody test, an additional test called Hepatitis C PCR Is done to determine if the virus is still present in your blood or liver. This is an important test to have as some people who have actually cleared the virus may not realise this.

WHAT IS THE TREATMENT?

Combination treatments using medications called direct acting antivirals have greatly improved the outcomes for people with Hepatitis C. These treatments can clear the virus in up to 95% of people.. Talk to your GP or liver specialist who can further advise you about when is best to treat your infection. In general, people who have Hepatitis C will feel better if they:

  • Avoid drinking alcohol and using drugs which are processed in the liver
  • Eat a well-balanced, low fat diet
  • Do regular exercise 

It is important to understand that if you have had Hepatitis C infection and cleared the virus, you can still acquire the infection again. Also, there are 6 different types of Hepatitis C, If you are infected with one type, you can still acquire other types through taking risks, and this may make it more difficult to treat your Hepatitis C. In short, being safe is important whether you have Hepatitis C or not.

Where to get Help

Information on Hepatitis C and safe drug use:

  • Australian Injecting and Illicit Drug Users League: www.aivl.org.au
  • Harm Reduction Victoria: www.hrvic.org.au
  • Direct Line Tel. 1800 888 236 – for information about where to get clean needles and syringes for drug users

REFERENCES

Australasian Society for HIV. Viral hepatitis and Sexual HealthMedicine, 2016 consensus statement. : www.crmpub.ashm.org.au/product/Australian recommendations for the management of hepatitis C virus infection_2FCA7E813ADFE51181073863BB2E1DB0/HCV_consensus_statement_2016.pdf

The Department of Health, Fourth national Hepatitis C strategy 2014 – 2017:
www.health.gov.au/internet/main/publishing.nsf/Content/ohp-bbvs-hepc

 

DISCLAIMER:
This fact sheet is designed to provide you with information on Hepatitis C. It is not intended to replace the need for a consultation with your doctor. All clients are strongly advised to check with their doctor about any specific questions or concerns they may have. Every effort has been taken to ensure that the information in this pamphlet is correct at the time of printing.
Last Updated July 2016