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 by

  • Injecting drugs and sharing injecting equipment (needles, syringes, spoons) 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, group sex or multiple sex partners.
  • Needlestick injuries in health care settings.
  • 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.

How does it affect you?

Approximately 70%–80% of people with acute hepatitis C do not have any symptoms. Some people, however, can have mild to severe symptoms, including fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, clay-coloured stools, joint pain, jaundice (yellow colour in the skin or eyes). If symptoms occur, the average time to appear is 6–7 weeks after exposure, but this can range from 2 weeks to 6 months.

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

Diagnosis

A simple screening blood test shows whether you have ever been exposed to hepatitis C. The screening test looks for antibodies to the virus. Testing positive for the antibody test means that you have been exposed to the virus at some point in your life and you have either cleared this and are no longer infected or you are still infected with it. You will need to attend a clinic for a second test (commonly hepatitis C antigen or hepatitis C RNA) to confirm whether the virus is still present and you are actively infected with the infection.

Treatment

People with active hepatitis C should be monitored and reviewed regularly by a Hepatitis specialist. If you test positive for hepatitis C at SHL 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/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 becoming a chronic infection. 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.

Contacting partners

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. If you feel unable to inform previous partners one of our Health Advisers will be able to notify them on your behalf.

Maintain good sexual Health and preventing re-infection

If you are infected with hepatitis  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 have a full sexual health including chlamydia, gonorrhoea, LGV, syphilis, hepatitis B and HIV.

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