You've Got What? Hepatitis C
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Infection with the hepatitis C virus causes inflammation of the liver.
In Australia, many people became infected with hepatitis C from the late 1950s, but the hepatitis C virus was only identified in 1989 and a hepatitis C antibody test available from 1990. While the number of people known to be infected with hepatitis C virus has reduced over the past 15 years, the number of people with hepatitis C-related liver disease is increasing.
Hepatitis C is a notifiable condition1
Hepatitis C is spread by blood-to-blood contact through needle puncture, broken skin or a break in mucous membranes (the thin moist lining of many parts of the body such as the nose, mouth, throat and genitals).
In Australia, most infections are associated with sharing injecting equipment. This accounts for 90% of new cases of hepatitis C each year.
Other ways hepatitis C can spread are:
Hepatitis C is much more common in prisons due to multiple risk factors.
The risk of transmission (spreading of the infection) is low in the following situations:
People do not appear to develop immunity to hepatitis C virus infection and can be re-infected with the same or different strains of the virus.
Acute infection is followed by chronic (lifelong) infection in 50 to 80% of cases. The majority of people exposed to hepatitis C are unable to eliminate the virus from their body following initial (acute) infection and remain infected for life (chronic infection) if not successfully treated.
Less than 25% of people with acute infection develop symptoms. These may include:
Image Courtesy Public Health Image Library (PHIL), Department of Health and Human Services, Centers for Disease Control and Prevention (CDC-USA) CDC, Dr. Thomas F. Sellers / Emory University
Liver function remains normal or only mildly affected in some people with chronic infection, though most will have some liver inflammation. When the liver is inflamed over a long period of time the liver can develop scar tissue, known as fibrosis. Extensive scarring of the liver is called cirrhosis. It is believed without treatment, 25% of people with chronic hepatitis C will develop cirrhosis over an average period of 18 years and will have a higher risk of developing liver cancer over the next decade. While many people do not have any symptoms, others may experience a variety of symptoms, including:
Hepatitis C is diagnosed by blood tests. There are two types of tests to confirm hepatitis C infection
This detects antibodies against hepatitis C virus (anti-HCV) and is the most commonly used test. Antibodies are proteins in the blood which the body produces to try to destroy the virus, although with hepatitis C virus this is usually not successful. It may take 3 to 6 months for these tests to become positive after infection occurs. Anti-HCV antibodies can be detected in 50 to 70% of patients at the onset of symptoms and in about 90% of patients 3 months after the onset of infection; therefore a negative antibody result may not exclude acute hepatitis C infection. If the antibody test is positive it means that the person has been exposed to the hepatitis C virus at some point in his or her life.
Also known as Hepatitis C RNA test or viral RNA test (a test for genetic material of the virus)
A PCR (polymerase chain reaction) test in a pathology laboratory is necessary to see if the virus is still present and whether the person is still likely to be infectious. Hepatitis C viral RNA can be detected within 1 to 2 weeks of exposure.
Persistence of hepatitis C virus RNA in the blood, even when symptoms start to settle, indicates chronic infection. The levels of viral RNA vary over time and may be undetectable even in the presence of active hepatitis C infection. However, repeatedly negative PCR tests are likely to indicate clearance of the virus.
(time between becoming infected and developing symptoms)
6 to 9 weeks, but can range from 2 weeks to 6 months. The majority of infected people do not develop symptoms of acute hepatitis.
(time during which an infected person can infect others)
One or more weeks before symptoms develop in the acute stage; lifelong in chronic infection.
Improved antiviral therapy is available and new treatments have increased the number of people who have been able to clear the virus (are cured of hepatitis C) and avoid ongoing symptoms and liver damage.
People who are infected with hepatitis C should seek advice about minimising further damage to their liver from alcohol and drug use, and preventing co-infection with blood borne viruses, including immunisation against hepatitis A and hepatitis B.
Lifelong monitoring of chronic hepatitis C infection by a general practitioner and liver specialist can assist in preventing the progression to severe liver disease including liver cancer.
Exclusion from childcare, preschool, school and work is not necessary.
There is no evidence that giving immunoglobulin (a solution containing human antibodies that is made from blood products) after exposure to hepatitis C will prevent infection.
Infected health care workers must comply with the requirements of their professional boards.
Everyone has a responsibility to help prevent the spread of hepatitis C and to take care of themselves and others. This means:
For more information about Hepatitis C read the Get tested, get treated, eliminate Hepatitis C infographic.
There is a cure for hepatitis C.
Get Tested. Get Treated. For Yourself. For Your Family.
For more information contact your local Aboriginal health service or call the Hepatitis SA Helpline 1800 437 222.
1 – In South Australia the law requires doctors and laboratories to report some infections or diseases to SA Health. These infections or diseases are commonly referred to as 'notifiable conditions'.