Hepatitis C, also called hep C is an infection caused by a virus that attacks the liver and leads to inflammation. The virus is spread by contact with contaminated blood for example from sharing needles or from unsterile tattoo equipment.
What is it?
- Sexual transmission is rare but can occur in men who have sex with men (MSM), particularly those with HIV
- Hepatitis C can cause acute Hepatitis (uncommon), chronic Hepatitis C (longer than 6 months, 75%) or spontaneously clear (25%)
- Disease progression is usually slow but may cause cirrhosis, liver failure and hepatocellular carcinoma
- Disease progression can be affected by age at infection, duration of infection, heavy alcohol intake, coinfection with HIV or HBV, male gender, stage of fibrosis and higher ALT levels
- Almost all patients can be successfully treated with DAA (directly acting antiviral) therapy
Signs and Symptoms
- Asymptomatic infection: common
- Acute Hepatitis: uncommon. Symptoms such as lethargy, nausea, fever, anorexia for a few days then jaundice, pale stools and dark urine
- Chronic Hepatitis: infection lasting over 6 months, can be life-long, may cause extra-hepatic manifestations such as skin or joint symptoms
- You should see your GP if you think you might have hepatitis C. Blood tests can show if you have a current infection
- About 75% will progress to chronic hepatitis
- Past cleared hepatitis C infection does not provide immunity to reinfection
- Medicare Benefits Schedule (MBS) allows 1 HCV RNA qualitative test annually for patients who are Hep C Ab positive or where the results are indeterminate, the patient is immunosuppressed or before seroconversion if necessary for clinical management. A maximum of 4 HCV RNA quantitative RNA tests are allowed on the MBS for patients undertaking treatment.
There are some very effective options for the treatment of hepatitis C infection. Newer treatments differ from those available previously:
- They cure around 95% - or more of people who have them (even if they have cirrhosis)
- Their side effects are minimal
- Treatments last just 12 weeks (in most cases)
- They involve just a few pills each day, with no injections required
Curing hepatitis C means clearing the virus from the body. It helps reduce liver inflammation and can also help reverse scarring and cirrhosis. You can be re-treated if your treatment does not work the first time. Check with your GP before taking any other medication or supplements and whether you need vaccinations against hepatitis A and hepatitis B. You should also avoid alcohol if you have hepatitis. If you have liver damage, you may also need to see a liver specialist.
- Patient with chronic hepatitis C should be assessed with other causes of hepatitis for example alcohol or fatty liver and should be counselled to reduce these factors if relevant
- Test of Cure (TOC): Following successful treatment or natural clearance of hepatitis C, HCV RNA will be negative although hepatitis C antibody will still remain positive
- Re-testing: Clearance of hepatitis C does not provide immunity from reinfection. Re-testing is required if there is a continued risk of re-exposure
- Low risk for sexual exposure (except for HIV positive men) so contact tracing not generally performed for sexual partners
- Contacts via parenteral exposure (shared needles, injecting equipment) should be tested if possible
- Children of mothers who are hepatitis C positive should be tested
For more information
- Health Direct – Hepatitis C
- Australian STI Management Guidelines – Hepatitis C
- Hepatitis Australia
- Contact Tracing: You can now contact trace via SMS, email or send a letter to “Let Them Know” anonymously.