Hepatitis C

What is this?

Hepatitis C is a viral infection which is passed on by blood-to-blood contact.  Blood-to-blood contact is when the blood from a person with Hep C enters another person’s bloodstream. This is usually through sharing injecting drug equipment.

Approximately 30% of people who get Hep C clear the virus from their body during the first year of infection without any treatment.

For those who do not clear the virus, Hep C becomes a chronic condition. People can have Hep C many years without experiencing any symptoms.  However, the virus is present in their blood and can be spread by blood-to-blood contact.

Currently there is no vaccine for Hep C but treatment is available and can be very effective. 

How do you get it?

Hep C is passed on through blood-to-blood contact. The most common transmission method in Australia is by sharing drug-injecting equipment, such as needles, spoons and syringes and tourniquets.

Given Hep C is spread through blood, it is only transmitted through sexual contact if the blood of one sexual partner gets into an open cut of the other. Condoms should be used if there is fresh blood (including menstrual blood). This risk for acquiring Hep C through sex is significantly increased if a person has HIV infection.  So people living with HIV are regularly tested for Hep C.

Less common, but potential sources for Hep C infection include:

• unsterile or unclean tattoo or body piercing equipment
• surgical procedures - some people in Australia have acquired Hep C from surgical procedures, but this is now very rare
• blood transfusions - the risk of getting Hep C from a blood transfusion in Australia reduced since 1990. Since 1990, all blood donations are screened for Hep C.
• needle stick injury - particularly for healthcare workers
• sharing toothbrushes, razor blades or other personal items - where these items have come in contact with Hep C infected blood. These are rare but possible Hep C risks.
• pregnancy or childbirth - carries a very small risk
• breastfeeding - is considered safe.  However bleeding or cracked nipples can carry a very small risk so feeding should be avoided during these times

What are the symptoms?

Many people do not feel unwell when first infected with Hep C  

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 gone.

While many people do not have any symptoms, others may experience a variety of symptoms, including:

• tiredness and fatigue, which may be severe
• general feeling of being unwell
• pain or discomfort in the upper right side of the abdomen
• nausea, vomiting and diarrhoea
• muscle aches

Chronic Hep C

A Hep C infection which lasts more than six months is called chronic Hep C. Most people with chronic Hep C will have some liver inflammation.  Sometimes, liver function remains normal or only mildly affected. 

When the liver is inflamed over a long period of time it can develop scar tissue, known as fibrosis. Extensive scarring of the liver is called cirrhosis.

Studies show that without treatment, 25% of people with chronic Hep C will:

• develop cirrhosis over an average period of 18 years
• have a higher risk of developing liver cancer over the next decade.

How do you test for it?

An antibody blood test can tell you whether or not you have ever been infected with Hep C.

We recommend you have a Hep C test at least 8-12 weeks from the time you may have been infected. In people who are immunocompromised (such as HIV positive), a repeat test may be recommended at 6 months. 

If your Hep C antibody blood test is positive, an additional test called hepatitis C PCR can find if the virus is still in your blood or liver. This is an important test to have as it will tell you whether you have naturally cleared the virus or not. If you have not naturally cleared the virus, then treatment is available.

How is it treated?

Direct acting antivirals will cure Hep C in about 95% of people. You should talk to your GP or liver specialist who can advise you about when is best to treat your infection.

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

• avoid drinking alcohol and using drugs
• eat a well-balanced, low fat diet
• exercise regularly

Are there any complications if not treated?

Studies show that without treatment, 25% of people with chronic Hep C will:

• develop cirrhosis over an average period of 18 years
• have a higher risk of developing liver cancer over the next decade

People who have Hep C that is untreated or has failed to respond to treatment are monitored carefully by liver specialists.  Liver specialists look for signs of disease progression.

Is it likely to come back after treatment?

If you have had Hep C and cleared the virus, you can get Hep C again.

There are also six different types of Hep C. If you are infected with one type, you can still get the other types through taking risks, such as sharing drug equipment.

Having more than one type of Hep C makes treatment more difficult. 

How can I protect myself?

There is no vaccine for Hep C. 

Ways to avoid Hep C include:

• If you use drugs, never share needles, syringes or any other equipment such as tourniquets, spoons, swabs or water. 
• Avoid sharing personal items such as toothbrushes, razors, nail files or nail clippers and scissors.  These items can puncture the skin and have small amounts of blood on them.
• Practitioners of body piercing, tattooing, electrolysis or acupuncture should always ensure that any instrument which pierces the skin is sterile.
• Health care workers should follow infection control guidelines at all times.
• If you give someone first aid or clean up blood or body fluids, wear single-use gloves.

Although Hep C is not considered a sexually transmissible infection in Australia, always practice safe sex if blood is going to be present.

New needles and syringes are available from some chemists and Needle and Syringe Program outlets.

Contact DirectLine on 1800 888 236 to find out where you can obtain new needles and syringes.

Where can I get help?

• Visit your local doctor
• Visit your local community health centre