Hepatitis C

Hepatitis means inflammation of the liver. Hepatitis C results from infection with the hepatitis C virus. It is a contagious liver disease that ranges in severity from a mild illness lasting a few weeks to a serious, lifelong illness. Hepatitis C can be either acute or chronic.

Acute hepatitis C virus infection is a short-term illness that occurs within the first 6 months after someone is exposed to the hepatitis C virus. Some people manage to clear the virus naturally from their body, but for most people, acute infection becomes a long term “chronic” infection.

Chronic hepatitis C virus infection occurs when the hepatitis C virus remains in a person’s body for longer than six months. Hepatitis C infection can last a lifetime and if left untreated can lead to serious liver problems and death.

Hepatitis C is usually passed from person to person through blood. Common routes of transmission include:

• Injecting drugs and sharing injecting equipment (needles, syringes, spoons), or equipment used for snorting or smoking drugs, used by someone who has hep C.
• Receiving contaminated blood (transfusion) or blood products. This is now rare since widespread screening of donated blood was introduced.
• Unprotected penetrative anal or vaginal sex with a hepatitis C infected partner, particularly amongst persons already infected with another STI, and/or HIV or those engaging in rough sex, fisting, chemsex, group sex or multiple sex partners.
• It can be passed on from fingers to genitals or anus.
• Needlestick injuries in health care settings.
• Unsterilized tattoo or piercing equipment.
• An infected mother to her baby.
• Sharing personal care items that may have come in contact with a hep C infected person’s blood, such as razors or toothbrushes.

Most people with hepatitis C don’t have noticeable symptoms when they first get the virus.

Around 1 in 5 people may get flu-like symptoms within the first 6 months. This is easily mistaken for flu or another illness

Some people’s bodies clear the hepatitis C virus in a few weeks or months, but most people will have it for longer.

About 8 in 10 adults who get hepatitis C get it for more than 6 months. This is called chronic hepatitis C.

It’s possible to have chronic hepatitis C for many years with no symptoms, but you can still pass it on to others.

Symptoms may come and go and can include:

• Flu-like illness.
• Feeling really tired.
• Feeling or being sick.
• Appetite loss.
• Pain in the tummy.
• Itchy skin.
• Jaundice (yellowing of skin and whites of eyes; you may have dark wee and pale poo).
• Feeling confused, forgetful, or unable to focus (brain fog).
• Feeling depressed.

If it’s not treated, hepatitis C can be very serious and cause life-threatening liver damage.

If a person has been infected for many years, his or her liver may become damaged. Most people with chronic hepatitis C do not have any symptoms up until the point where the liver is significantly damaged. Thus, chronic hepatitis C is often first detected during routine blood tests to measure liver function.

Chronic hepatitis C, if left untreated, can result in long-term health problems: liver cirrhosis, liver failure, liver cancer, or even death. It is the leading cause of cirrhosis and liver cancer and the most common reason for liver transplantation.

Of every 100 people infected with the hepatitis C virus, about 75–85 people will develop chronic hepatitis C virus infection; of those:

• 60–70 people will go on to develop chronic liver disease.
• 5–20 people will go on to develop cirrhosis over a period of 20–30 years.
• 1–5 people will die from cirrhosis or liver cancer.

A simple blood test is done to check for hepatitis C.

Your hepatitis C test shows whether you have antibodies to the hepatitis C virus.

Testing positive for antibodies means that you have had contact with hepatitis C at some point.

The test can’t tell whether your body has cleared the virus, or you still have active hepatitis C infection.

If you test positive for hepatitis C, visit your health care provider for a test to confirm whether you have an active hepatitis C infection.

If the test shows you do have hepatitis C, you can start treatment.

It can take up to 3 months before hepatitis C shows up on a test. This is called the window period. If you test negative for hepatitis C during the window period, you may be advised to take another test later.

If you have HIV, it can sometimes be harder for an antibody test to detect hepatitis C and you may need a different type of test.

CDC recommends that everyone over the age of 18 should be tested for Hepatitis C.

You should take a test if you have been exposed to any of the transmission routes indicated above.

Hepatitis C can be treated with antiviral tablets, which are taken for 12 weeks. Greater than 90% of people will be cured after taking the treatment. There is no vaccine for hepatitis C.

People with active hepatitis C should be monitored and reviewed regularly by a Hepatitis specialist. If you test positive for hepatitis C our Health Adviser team will refer you to a clinic or service with expertise in hepatitis. They will confirm if you are actively infected and if so, provide ongoing care and management of your infection.

Acute infection can clear on its own without treatment in up to 25% of people. Treatment is available that reduces the risk of an infection becoming chronic. There are several medications available to treat chronic hepatitis C, including new treatments that appear to be more effective and have fewer side effects than previous ones.

As well as taking treatment, it can help to:

• Avoid alcohol and recreational drugs to help your liver get better.
• Avoid smoking.
• Eat a healthy, balanced diet.

If your hepatitis C is not cured straight away, you may be advised to try different treatments and will be given help and advice to manage the virus and look after your liver.

If you are diagnosed with hepatitis C you will need to inform previous sexual partners, or partners whom you shared injectable equipment with, as they may also be infected and will need to get tested for hepatitis C.

Telling sexual partners you have hepatitis C means you can both take steps to lower the chance of passing on the virus.

Once you have cleared hepatitis C (naturally or by taking hepatitis C treatment) you can be infected again. To prevent hepatitis C transmission use condoms for penetrative sex and do not share injecting equipment.

If you are infected with hepatitis C you should avoid alcohol because it can cause additional liver damage. You should also check before taking any prescription pills, supplements, or over-the-counter medications, as these can potentially damage the liver as well. You should be given Hepatitis A and Hepatitis B vaccinations, have regular sexual health check-ups and avoid donation of semen, organs, or blood.

If you have been infected with hepatitis C it is possible you may also have picked up another infection: this being any other STI if you were infected by sex and/or Hep B and HIV if you were infected from sharing injecting equipment. Therefore, we advise you to have a full sexual health including chlamydia, gonorrhea, LGV, syphilis, hepatitis B and HIV.

There is no hepatitis C vaccine. Vaccines for other types of hepatitis won’t protect you from hepatitis C.

You can lower your chance of getting hepatitis C by:

• Not sharing drug injecting equipment or anything else used for taking drugs.
• Not sharing things like razors or toothbrushes.
• Using condoms for anal or vaginal/frontal sex.
• Using latex gloves for fisting.
• Covering sex toys, fingers, or anything inserted in more than one person with a new condom or latex glove for each person or washing thoroughly before each person uses them.
• Not sharing enema/rectal douching equipment.
• Not sharing pots of lube (so the virus is not passed from fingers to lube to genitals).