What is Hepatitis C

"Hepatitis" is a word used to describe disease or inflammation of the liver. Hepatitis can be caused by alcohol, some drugs and chemicals, and by infection. Hepatitis C is one form of hepatitis and it is caused by the hepatitis C virus.

Hepatitis C is one of the most serious types of hepatitis. When a person is first infected with hepatitis C they have what is known as an acute infection. After the acute infection, most people do not get rid of the virus from their body. The virus stays in their body and may cause ongoing disease in the liver. This is called chronic infection. Chronic infection refers to the duration of infection, not to the severity of the disease. People who have chronic infection can pass the infection on to other people. They are carriers of hepatitis C.

Chronic hepatitis C infection causes progressive scarring of the liver. This is usually a very slow process, occurring over 20 to 50 years. About one in ten people with chronic hepatitis C develop severe scarring and shrinking of the liver called cirrhosis. These people can become very ill and have an increased risk of liver cancer.

 

 

How do you get Hepatitis C?

Hepatitis C is spread by blood from an infected person entering the bloodstream of another person. Every drop of blood from an infected person will contain the virus. However, for transmission to occur, the virus must be concentrated (viral load) to pose a threat of infection.

 

You can get hepatitis C through:

• re-using or sharing needles or any equipment when injecting drugs. Hepatitis C spreads very easily through sharing injecting drug equipment. Sharing once can be enough to become infected.

• having received an infected blood transfusion. Until February 1990, there was no way to test for hepatitis C. Since then however, all donated blood in Australia has been screened and is regarded as safe.

• sharing personal hygiene equipment, such as razors or toothbrushes with an infected person. Hepatitis C is not transmitted by social contact or sharing items such as crockery, cutlery, shower and toilet facilities.

• poorly sterilised equipment and poor infection control used by doctors, nurses, dentists, tattooists, acupuncturists, hairdressers, body piercers, beauty therapists and others.

• sharing tattooing or piercing equipment at home or in a custodial setting.

• occupational risks that may include any procedure which could lead to penetration, involving the transfer of blood between two people. This could include health workers performing invasive procedures and dental practitioners.

• women with hepatitis C can pass the virus to their baby before or during birth, (however the risk is less than six per cent. This risk is higher if the mother also has a sexually transmissible infection such as herpes or HIV). Hepatitis C has been detected in breast milk, but levels of the virus are not thought to be high enough to pose a risk of transmission.

• transmission through sexual contact is uncommon as transmission occurs only through blood and not is thought to be through semen or vaginal secretions. Condoms and lubricant are recommended for anyone with a new sexual partner, during anal sex, if a partner is menstruating or when blood exposure is possible. Condoms and lubrication are also recommended for the use of sex toys.

 

Hepatitis C is not transmitted through:

• kissing, sneezing, coughing, hugging or other social contact

• sharing food or drinks

• sharing eating or cooking utensils

• toilet or shower facilities

• there is no risk of contracting hepatitis C from a mosquito or other blood-sucking insects.

 

How common is Hepatitis C?

It is estimated that just over one per cent of the population has hepatitis C. This means that, for approximately every hundred people, one of them may carry the virus. Hepatitis C is one of the most common reason for liver transplant.

 

How would you know if you had Hepatitis C?

You can only tell you have hepatitis C (HCV) by having an HCV antibody test.

Hepatitis C is usually a long-term (chronic) illness and often there are no symptoms. Only a small number of people experience short-term (acute) illness with hepatitis C.

However, some symptoms that might be experienced with acute hepatitis C include:

• yellow skin and eyeballs (jaundice), and dark orange or tea coloured urine

• nausea

• tiredness

• swollen and painful liver (right-hand side of abdomen).

It usually takes one to five months after contact with hepatitis C for infection to develop. This time is called the incubation period. Hepatitis C is very infectious during this period, as well as when symptoms occur.

Most people with acute hepatitis C go on to have chronic hepatitis C infection. These people usually feel well and may never develop symptoms. However, they remain infectious to others for the rest of their lives.

 

How can you test for Hepatitis C?

Having a blood test is the only way to tell if you are infected with the hepatitis C virus. Blood tests can also show if there is any damage to the liver.

If you have ever injected drugs, you may have been exposed to hepatitis C, see your doctor and have a test.

If you are currently injecting drugs, no matter how infrequently, you should never share any equipment. If you have shared equipment, you could have hepatitis C. See your doctor and have a test.

If you find out you have hepatitis C, people you have shared injecting equipment with or sexual partners where there was a possible exchange of blood, should be tested if possible. This is to see if they are infected and to prevent further spread of the infection. If you feel uncomfortable or embarrassed about telling your friends, partner or partners, the doctor, nurse or health worker can contact them. This is a confidential process and your name will not be mentioned.

 

How can you be treated for Hepatitis C?

Your doctor will monitor your health in relation to your hepatitis C status. They may suggest at some stage you undergo treatment. Treatment outcomes for people with hepatitis C are encouraging. Meanwhile, people with hepatitis C are advised to:

• limit or avoid alcohol. People with chronic hepatitis C should seriously think about not drinking alcohol at all. Alcohol can increase the injury to the liver.

• maintain a healthy well-balanced diet

• get adequate rest.

There are treatments available for chronic hepatitis C. People with chronic hepatitis C may be referred by their doctor to specialist liver clinics located in the larger hospitals in Queensland to discuss treatment choices. Treatments may be made available for people with hepatitis C who meet certain conditions, depending on the type of hepatitis C and how serious it is. Antiviral treatment may be given by regular injection or orally, and this type of treatment fights the hepatitis C virus in the body. These drugs cannot be used during pregnancy, in people with depressive illness and people with conditions called auto immune disorders.

Treatment is ongoing and can last between 6 to 12 months, and involves regular blood tests (liver function tests) to check on progress of the disease. A liver biopsy may also be needed. This means that a small sample of your liver is taken for testing.

 

How do you avoid getting Hepatitis C?

Because hepatitis C is a blood borne virus there are certain settings where transmission is more likely to occur. There are a number of precautions to take which will reduce the risk of transmission.

 

Injecting drug users

People who inject drugs are most at risk and should always practise the following:

• wash hands thoroughly before and after injecting

• always use sterile needles, syringes and equipment

• clear and cover the area to mix and prepare

• never share any injecting equipment, including the mix, water, tourniquets, swabs, syringes, needles, etc.

• dispose of equipment in rigid-walled, puncture-resistant, sealable containers to reduce risk of needle stick injury to others. Use NSP disposal bins instead of household waste bins where possible.

• never recap needles.

If caught unprepared consider the option of waiting until you can obtain sterile equipment. However if this is not possible and as a last resort, there is no alternative to sharing, use the following procedures:

1. Rinse the needle and syringe with cold water to remove any blood. Do not use hot water, as this will cause the blood to clot.

2. Rinse the needle and syringe with undiluted bleach (use fresh high strength bleach, at least 5.25% sodium hypochlorite). The bleach needs to be in contact with the needle and syringe for at least two minutes. Repeat this process twice.

3. Rinse with clean cold water repeatedly (at lease six times).

Cleaning a used needle and syringe is NOT guaranteed to kill HIV, hepatitis B or hepatitis C. It is strongly recommended that sterile equipment is always used.

 

Workplaces and health care settings

• In these settings always follow standard infection control procedures; always comply with first aid guidelines and always comply with occupational health and safety procedures

 

 

In the home

• Do not share any sharp grooming implements, such as razors or tooth brushes

• It is advisable to seek professional practitioners for body piercing or tattooing. However, if attempting any of these activities at home, use sterile equipment and do not share any equipment, inks or jewellery

 

 

Tattoos, beauty therapy and acupuncture

• when getting tattoos, go to a registered tattooist who uses sterilised equipment and disposable dye tubes

• if you receive acupuncture therapy, make sure the provider uses disposable needles

• for body piercing, make sure the operator uses a spring loaded gun with pre-sterilised disposable fittings

• ensure beauty therapists, hairdressers, etc use sterile equipment.

 

 

 

Sexual activity

• Hepatitis C is not considered to be a high risk for transmission during sex as it is a blood borne virus. However safe sex is still recommended particularly with casual partners or in circumstances where blood contact is more likely, such as during menstruation or in the presence of genital ulceration Always using condoms when you have vaginal or anal sex and using water-based lubricant with condoms is recommended. Oil-based lubricants (such as Vaseline) should not be used. They weaken the condom and may cause it to break.

• If sharing sex aids, use condoms to cover the toy, changing the condom after use by each partner

• If you or your partner have more than one sexual partner and do not use condoms, have regular sexual health checkups.

 

When dealing with blood

There may be instances where a person comes into contact with blood. In this instance the following steps should be taken:

• Always use gloves when handling blood or body fluids. Supplies of clean gloves should be available in all households, childcare centres, schools and sporting venues

• Cover cuts and wounds with waterproof adhesive dressing

• Dispose of blood stained tissues, tampons, sanitary napkins and other dressings in a sealed plastic bag or an approved collecting bin
• Wipe up blood spills using gloves and newly opened hospital strength bleach (one part bleach to nine parts water).

People with hepatitis C

In the interest of maximising their health care, people with hepatitis C may choose to inform their doctor, dentist and other relevant health workers of their hepatitis C status. This is to ensure that all factors are taken into account to ensure the best quality of care is provided. However, a person is not obliged to divulge their hepatitis C status.

 

Source: Queensland Government

 

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