Hepatitis C

Overview

Hepatitis C is a viral infection that is carried in the blood and which can cause severe damage to the liver. The World Health Organization estimates that up to 3% of the world's population is infected with hepatitis C virus (HCV) including more than 250000 Canadians. However because many people have no symptoms only 1 in 4 are aware they are infected. While there is no vaccine to protect against the virus and no cure hepatitis C can be treated.

Causes

Hepatitis C is caused by the hepatitis C virus (HCV) which is spread by direct contact with the blood of an infected person. Prior to routine blood screening for HCV the virus was usually contracted through blood transfusions. This is now rare. Currently the most common means of transmission is through sharing contaminated needles or other drug-related equipment.

Major high-risk groups include:

  • Injection drug users including those who used drugs briefly many years ago.
  • People who had blood transfusions before June 1992 when sensitive tests for anti-HCV were introduced for blood screening.
  • People who have frequent exposure to blood products. These include patients with hemophilia solid-organ transplants chronic renal failure or cancer requiring chemotherapy.
  • Infants born to HCV-infected mothers.
  • Health care workers who suffer needle-stick accidents.

Other groups who appear to be at slightly increased risk for hepatitis C include:

  • People with high-risk sexual behavior multiple partners and sexually transmitted diseases
  • People who use cocaine particularly with intranasal administration using shared equipment

The Hepatitis C virus is very resilient and will change repeatedly in order to thwart the body's immune system. It is also very insidious inflaming and slowly damaging the liver over a period of 10 to 20 years often without an individual ever being aware that the virus is inside their body. Because there are often no symptoms over 80 per cent of acute HCV infections progress to chronic hepatitis C a long-term progressive condition that can lead to liver disease including cirrhosis and in some cases cancer.

Symptoms

Although some people may experience symptoms following initial infection many others have no symptoms at all. However because the disease progresses slowly in the body symptoms can appear many years later. They could include:

  • Jaundice (skin or eyes turn yellow)
  • Abdominal pain (right upper abdomen)
  • Fatigue
  • Loss of appetite
  • Nausea and vomiting
  • Low-grade fever
  • Pale stools
  • Dark urine
  • Generalized itching

See your doctor if symptoms of hepatitis develop or if you believe you have been exposed to the hepatitis C virus.

Treatment

Hepatitis C is often detected during blood tests for a routine physical or other medical procedure. If the results are positive your doctor may order a second test to confirm that the virus is really in your blood. If you are infected there is no cure. The virus will almost certainly be with you for the rest of your life.

To prevent further damage to your liver your doctor may advise you to be vaccinated against hepatitis A and hepatitis B. You may also benefit from treatment with drugs such as interferon alpha or a combination of interferon alpha and ribavirin. Unfortunately both have significant side effects in some people including headaches fever fatigue loss of appetite nausea vomiting depression and thinning of hair. Treatment with interferon alpha may also interfere with the production of white blood cells and platelets. Ribavirin may cause severe anemia and birth defects.

Your doctor will advise you to get plenty of rest and to avoid alcohol. Even moderate amounts of alcohol will speed up the progression of hepatitis C and reduce the effectiveness of drugs you may be taking to combat the disease.

You will also need to take precautions so that you do not infect others:

  • Do not donate blood organs for transplants or semen for artificial insemination.
  • Do not share razors or toothbrushes
  • If you use drugs do not share needles or other drug-related equipment
  • Always tell healthcare professionals who may be exposed to your blood that you have hepatitis C
  • Although sexual transmission is rare inform your sexual partner(s) that you have hepatitis C and take appropriate precautions

Prevention

To prevent hepatitis C avoid the risks:

  • Do not share drug needles or drug-related equipment
  • Wear latex gloves if you are likely to be in contact with someone's blood
  • If you have sex with more than one partner use a condom
  • If you are getting a tattoo body piercing or acupuncture choose a reputable service and ensure that only fresh single-use disposable needles are used and all equipment is disinfected and sterile.

Additional Resources