What is Hepatitis C?
Hepatitis C is a disease caused by a virus. Hepatitis C virus is one of many different viruses that can infect the liver. It lives in liver tissue and blood and can cause severe scarring and damage to the liver. This can have long-lasting health effects.
About 80% of people infected with hepatitis C develop chronic (long-lasting) infection. Without treatment, some people eventually develop liver failure or cancer of the liver.
About 20% of people infected with hepatitis C virus recover or ‘clear’ the infection without specific treatment.
What are the symptoms?
Most people have no symptoms when they are first infected with hepatitis C. If there are symptoms, they usually develop within one to three months of infection and can include:
- loss of appetite;
- nausea, sometimes with vomiting;
- abdominal pain;
- yellowing of the skin and eyes (jaundice); and
- dark urine and pale stools.
These symptoms last from days to a few weeks and then get better without treatment but this doesn’t mean that the virus has gone.
People with chronic hepatitis C infection usually appear well for many years but may develop symptoms as their liver damage progresses.
How is it spread?
Hepatitis C is spread when the blood of an infected person enters the bloodstream of an uninfected person. The amount of blood might be so small that it’s invisible to the eye. This can happen through:
- any form of skin penetration if contaminated equipment is used, including: sharing needles, syringes and other injecting equipment; needle stick injuries; tattooing; body piercing; acupuncture; or other procedures using contaminated instruments;
- transfusion of infected blood or blood products;
- sharing personal items that may have blood on them such as toothbrushes, razors, or sex toys; or
- blood from an infected person coming into direct contact with an open wound of another person.
Rarely, hepatitis C may also be transmitted:
- from mother to child during pregnancy or childbirth; or
- during sex without a condom, particularly in people with HIV infection.
Hepatitis C is not transmitted by casual contact like hugging or holding hands; kissing on the cheek; coughing or sneezing; sharing food; or sharing eating utensils.
Who is at risk?
In Australia, people who may have a higher risk of hepatitis C infection are those who:
- inject drugs, or have injected drugs in the past;
- have been in prison;
- had a blood transfusion in Australia before February 1990, or more recently in another country;
- have a mother with hepatitis C infection;
- have a sexual partner with hepatitis C infection and are HIV positive;
- have had haemodialysis
- were born in, or have had medical procedures in a country with a high prevalence of hepatitis C;
- have had a tattoo or body piercing done by someone with poor infection control practices; or
- have had other blood to blood contact with another person.
How is it prevented?
There is no vaccination to prevent hepatitis C. Prevention involves avoiding exposure to blood that may contain hepatitis C.
The best way to protect hepatitis C is to avoid any possible blood-to-blood contact by:
- never sharing needles, syringes and other injecting equipment;
- ensuring tattoo, acupuncture, and body piercing equipment is sterile;
- only undergoing surgical, podiatry, or dental procedures with practitioners registered with the Australian Health Practitioner Regulation Agency (or overseas equivalent);
- preventing contact with other people’s body fluids (e.g. use gloves to dress wounds and to clean up spills of blood and other body fluids);
- always use condoms, gloves or dental dams during sex if blood may be present; and
- never sharing personal items such as razors, toothbrushes, combs and nail clippers.
Sterile needles and syringes can be obtained from your local needle and syringe program. These are free, anonymous and confidential services. You can also get sterile needles and syringes from some pharmacies.
How is it diagnosed?
Hepatitis C is diagnosed by finding antibodies to hepatitis C in a blood test. People with antibodies against hepatitis C then need further testing to see if the virus is still present in the blood (PCR test) and if the virus is causing damage to the liver (liver function tests, fibroscan).
How is it treated?
New treatments for hepatitis C became available in Australia from 1 March 2016. These medicines, called direct acting antivirals (DAAs):
- are highly effective with a cure rate of over 90%;
- have few side effects;
- need to be taken for only 12 weeks for most people, or for 24 weeks in some instances; and
- are taken in tablet form, without the need for injections (in most cases).
In contrast, the previously available treatments were less effective, frequently had severe side effects and injections were required for 6 to 12 months.
Hepatitis C treatment improves people’s liver health by stopping liver damage caused by the hepatitis C virus. Following treatment some of the damage that has already occurred may repair. Successful treatment clears the virus so that the person can no longer transmit hepatitis C virus to another person.
People living with hepatitis C virus should see their general practitioner (GP) about getting treated. A liver biopsy is not required before starting treatment.
To reduce the risk of further liver damage, people with hepatitis C should limit or avoid alcohol and get vaccinated against hepatitis A and hepatitis B.
Eating a healthy diet and regular physical exercise can also contribute to improved liver health.
If you have been diagnosed with hepatitis C it is important to tell people who may also have been exposed so they can be tested. Your doctor can help you to decide who may be at risk and help you to contact them. If you wish, your doctor can make the contact for you, while also keeping your identity confidential.
If you are a health care worker you should ensure that you do not pass hepatitis C on to patients. Speak to your doctor, professional body or your employer. Further information is available in the Australian National Guidelines for the Management of Health Care Workers known to be Infected with Blood-Borne Viruses.
What is the public health response?
Doctors, hospitals and laboratories must notify new cases of hepatitis C to the local public health unit. This information is kept confidential and is used to better understand who is at risk of the disease and to help control further spread.