Hepatitis C (HCV)
What is it?
Hepatitis C (HCV) is a virus that causes inflammation (swelling) of the liver and may result in liver disease.
How do you get it?
Hepatitis C is passed on by blood-to-blood contact. Infected blood from one person must enter another person’s blood stream. A small amount of blood can carry enough of the virus to cause infection.
Transmission can occur through sharing injecting equipment, toothbrushes and razors, un-sterile tattoo and piercing equipment and needle stick and sharps injuries in occupational settings. Hepatitis C is not considered an STI, however there is a risk of sexual transmission if there is blood present (e.g. when using sex toys, during rough anal (bum) sex or fisting or when there are other STIs present that cause lesions (sores) or inflammation (swelling).
What are the symptoms or signs?
Many people infected with hepatitis C do not experience any symptoms. Others may experience flu-like symptoms, nausea and abdominal pain in the early stages of infection.
During the first two to six months some people are able to clear the virus naturally; for others they will go on to develop chronic hepatitis C infection. Chronic infection can lead to cirrhosis and liver cancer in some people. About 16,000 Aboriginal and Torres Strait Islander people have chronic hepatitis C.
There are two blood tests for hepatitis C. One blood test tests for antibodies to the hepatitis C virus; however, despite developing antibodies, you do not develop immunity to hepatitis C. This means even if you clear the virus from your first infection, you can be infected again. The other blood tests, test for the presence of the hepatitis C virus itself.
Can it be treated?
The current treatment for hepatitis C is a combination of two drugs, pegylated interferon and ribavirin. As of 2010, lots of new treatments are currently being developed or in clinical trials. The current treatment aims to clear the virus from your body and also to prevent the progression of the infection to cirrhosis and liver cancer or liver failure. Treatment is not available to all people with hepatitis C and can have side effects which range from mild to very severe. Ask your doctor about currents treatments for hepatitis C. Other people manage their symptoms successfully with complementary therapies and lifestyle changes.
How can it be prevented?
At present there is no vaccine available to prevent a person from being infected with hepatitis C.
To reduce the risk of transmission of hepatitis C:
- avoid sharing injecting equipment including needles, syringes, swabs, spoons, filters, water and tourniquets
- always use new injecting equipment
- always wash your hands before and after injecting
- avoid sharing personal items such as toothbrushes, razors and nail scissors / clippers
- make sure body artists use new, sterile equipment for tattooing, body piercing and other body art
- use condoms, gloves and water-based lube during sex (especially if there is blood or an STI present) and latex gloves for fisting
- wear disposal gloves if you give someone first aid or are cleaning up blood or body fluids
If you already have hepatitis C:
- wipe up any blood spills carefully with cold water and household bleach, using disposable paper towels, and wearing disposable gloves
- keep cuts, wounds and abrasions covered with sterile waterproof dressing
- place blood-stained tissues, sanitary towels or other blood-stained dressings in a plastic bag before disposal
- blood-stained clothing can be washed on a regular cycle in a washing machine after it has been rinsed separately
- use condoms and water-based lubricant during sex
Hepatitis C and pregnant women
Hepatitis C is not commonly passed from mother to baby. Perhaps 5% of babies born to women with hepatitis C will be infected. Many of these babies will then get rid of the virus by themselves without the need for any treatment at all.
Hepatitis C & HIV
Studies have found a higher prevalence of hepatitis C in people who are also HIV positive. This might be because a number of risk factors for HIV are also risks for hepatitis C. HCV in a person who is already HIV positive can lead to a higher concentration of hepatitis C virus in bodily fluids than other people with HCV.
Having HIV may lead to an increase in false-negative and indeterminate test results for HCV. Evidence also shows that a person who is co-infected (i.e. has both HIV and HCV) can have an increased HIV viral load.
No relationship has been found between HCV and the acceleration of HIV-related disease.
HIV and HCV can be safely treated in people with both infections. However, HIV is usually the first priority, because untreated HIV may cause HCV viral load to rise. Some people do need to be treated for both infections, especially if there are HCV-related liver problems.
Some anti-HIV drugs can cause liver inflammation and other problems, which can be life threatening. Starting treatment for both HIV and HCV at the same time is not generally recommended, since it may increase the likelihood of side effects.
Starting on combination HIV antivirals may cause brief symptomatic reactivation of HCV.
There are a number of common drugs, many of them HIV treatments, which carry a risk of liver inflammation or damage. People with both HIV and HCV are advised to regularly and carefully monitor their liver enzyme levels, and avoid HIV antivirals most strongly associated with liver problems.