Hepatitis C, sometimes called hep C or HCV, is a virus that is carried in the blood which infects and damages the liver.  Hepatitis simply means “inflammation of the liver”.   The liver is a big organ in the upper right side of the belly.

The hepatitis C virus infects the cells in your liver, causing inflammation (swelling and tenderness) and fibrosis. In people with chronic (long-term) hepatitis C infection, inflammation and fibrosis continue to spread. Over time, usually many years, this can lead to scarring of the liver known as ‘cirrhosis’.

In the UK, 1 in 150 people is estimated to have chronic hepatitis C infection

There is no vaccine for hepatitis C.

Many people with hepatitis c never have any symptoms and, as people may not know they are infected, they can pass on the virus to others without realising.  The absence of symptoms does not mean the virus is under control.  Symptoms can come and go and be very vague.  They include

• mild to serious tiredness (fatigue)
• anxiety
• weight loss
• loss of appetite
• inability to tolerate alcohol
• discomfort in the liver area (place your right hand over your lower right ribs and it will just about cover the area of your liver)
• problems concentrating
• feeling sick
• flu-like symptoms such as fever, chills, night sweats and headaches
• yellow skin or eyes, called jaundice (this is very rare and is a sign of advanced disease or acute infection).

Unfortunately, the liver does not start to complain until it is seriously damaged – often only then do people realise that there is anything wrong.

Hepatitis C is known as a ‘blood-borne virus’ and can be spread by blood to blood contact.

While blood is not the only body fluid that can contain the hepatitis C virus, it is in the blood that the highest concentrations of virus are found and as a consequence only a small trace of blood may have sufficient virus present to cause infection. This can also apply to dried blood on objects and surfaces, as the hepatitis C virus can survive for up to two weeks in dried blood.

1)       

Drug use 

— Injecting drugs, including steroids or sharing any needles, syringes, or other drugs ‘works’ is high risk for hepatitis c transmission.  Hep C can also be passed through needles used for tattooing, acupuncture or ear piercing if these procedures are performed with contaminated instruments. Other forms of drug use, in particular the sharing of rolled bank notes or straws to snort powders through pose a risk of transmission. This is because the lining of the nose is very thin and fed with a rich supply of blood. A drug such as Cocaine is very corrosive to this lining. As a result traces of infected blood, often too small for the eye to see, can lurk on banknotes and straws. While there have been no properly documented cases, in theory the risk is significant.

2)       

Blood products 

-Nowadays, it is extremely rare for hepatitis c to be spread through blood transfusion or organ transplantation. Blood and organ donors are carefully screened for markers of hepatitis infection.   People who received blood products in the UK before September 1991 or people who have received medical treatment or blood products in a country where hepatitis C is common may be at risk.

3)       

Sex without a condom –

The risk of sexual transmission of hepatitis C is considered low. However, this risk increases for sexual activities where there is potential exposure to blood. This includes vaginal sex during menstruation or anal sex with the associated risk of bleeding. Sex toys used during these activities are also potential source of infection.  Sex with someone who is infected with both HIV and hep C carries an increased risk of hep C transmission.

Pregnant women can rarely spread the virus to their fetus.

• Kissing or hugging
• Sneezing or coughing
• Casual contact or other contact that does not involve blood
• Sharing food, water, eating utensils, or drinking glasses

There are different types (genotypes) of hepatitis C each with different subtypes. Knowing what type of hepatitis C virus you have is important as the types respond differently to treatment, with genotype 1 needing the longest course of treatment.

The most common types in the UK, Europe and USA are 1, 2 and 3. Subtypes are labelled a, b and c.

It is possible to be infected again with a different type of hepatitis C, or be infected with two types at the same time. Because each type responds to treatment differently you will be given a test to find out which type you have.

What is the difference between Acute and Chronic Hepatitis C?

When people are first infected with the hepatitis C virus, they develop what is called an acute infection. Some people are able to fight off the infection at this stage and become cured. But most people – 60 to 80 percent of those infected—go on to develop a chronic infection. That means the virus remains active in their body, even if they do not know they have it.

If you have a positive test for hepatitis C you will be asked to see a specialist doctor.  You will need some further tests to assess for liver damage.  It is also important to test for other infections which can be transmitted the same way as hepatitis C, like hepatitis B and HIV.  Your doctor will assess whether you need treatment and discuss this with you.

Treatment

Effective treatment for hepatitis C is available and can permanently clear hepatitis C from the blood and prevent further liver damage. Once you are diagnosed with hepatitis C it is important to get a prompt referral to a liver specialist. They can give you information about the risks and benefits of treatment. Treatment can be prolonged and have side effects, so it is important you know that treatment is right for you before starting on it.

Treatment will usually last for between 6 to or 12 months, depending on the strain of hepatitis C you have and will consist of at least two different drugs taken in combination for some or the whole of this time.

If you are having any other medical treatment, visiting the dentist, having a tattoo, body piercing or acupuncture; you should let the practitioner know that you have hepatitis C so they can take precautions to protect themselves and others.

Using a condom will help protect your sexual partners from hepatitis c.

You have no legal obligation to inform your employer. However, you do have a legal duty to ensure your own health and safety and that of others while at work. The type of work that you do will influence the level of risk to others. Working with your employer means you can prevent others being infected. If you do decide to tell your employer they are obliged to keep this information confidential and cannot pass it on without your consent.

Taking a test will allow you to look after yourself and others.