Hepatitis C

What is it?

Hepatitis C is a virus that causes inflammation of the liver and may result in liver disease.

How do you get it?

Hepatitis C is passed on by blood-to-blood contact so 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, unsterile tattoo and piercing equipment and needlestick and sharps injuries in occupational settings. Hepatitis C is not an STI however there is a risk of sexual transmission if there is blood present when sharing toys, during rough anal sex or fisting or there are other STIs present.

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 2 - 6 months some people are able to clear the virus naturally, for others they will go on to develop chronic infection. Chronic infection can lead to cirrhosis and liver cancer after many years in some people.

Testing

Hepatitis C is diagnosed with a blood test (HCV antibody test). Once you have or have had hepatitis C anti-bodies will be detectable in your blood. Unlike hepatitis A and B if your body clears the hepatitis C virus you can become infected again if you are exposed. You do not develop immunity to the hepatitis C virus. The hepatitis C virus can be detected with a PCR test. This test actually looks for the virus in your blood. Among people who do not clear the virus hepatitis C, it can be monitored with blood tests called liver function tests.

Can it be treated?

The current treatment for hepatitis C is a combination of two drugs, pegylated interferon and ribavirin. The 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 ranging from mild to very severe. Ask your doctor about current 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 and sterile equipment for tattooing, body piercing and other body art. Use condoms, gloves and water-based lube during anal sex and fisting or if there is blood or STIs present. Wear disposable gloves if you give someone first aid or are cleaning up blood or body fluids. If you are living with hepatitis C: Wipe up any blood spills carefully with household bleach and disposable paper towels, wearing disposable gloves. Use cold water. Keep cuts, wounds and abrasions covered with sterile waterproof dressing. Place bloodstained tissues, sanitary towels or other bloodstained dressings in a plastic bag before disposal. Blood stained clothing can be washed on a regular cycle in a washing machine once rinsed. Use condoms and water-based lubricant during sex.

Hepatitis C & HIV

Studies have found a higher prevalence of HCV in people who are also HIV-positive. This might be because a number of risk factors for HIV are also risks for HCV. HCV in a person who is already HIV-positive can lead to a higher concentration of HCV in bodily fluids than other people with HCV.
However a high HCV viral load does not necessarily mean a high HIV viral load, nor does it correlate to a low CD4 count.
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 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.