Hepatits C (HCV)

Hepatitis C is a blood borne virus; this means that for transmission to occur, hepatitis C positive blood must directly enter the bloodstream of another person.  Hepatitis C is a slow-acting virus and for the majority of people affected by hep C, it will not result in serious disease or death.  Around 75% of people who contract hepatitis C will develop chronic symptoms.  There is no vaccine for hepatitis C.

The other 25% of people exposed to hepatitis C will clear the virus naturally within two to six (2-6) months after exposure; however they will continue to have antibodies in their blood.  Antibodies are completely harmless and cannot be transmitted to other people (you can be hep C antibody positive, but not have the hep C virus).  It is important to remember that, unlike some antibodies your body makes for other viruses; hepatitis C antibodies do not protect you from getting the virus in the future if you are ever exposed to hepatitis C again.

An estimated 284,000 people living in Australia have been exposed to the hepatitis C virus. Of these:

• 72,100 people were estimated to have cleared the virus
• 211,700 people developed chronic hepatitis C
• 162,000 have early liver disease (stage F0/F1)
• 44,000 have moderate liver disease (F2/F3) and
• 5,700 have hepatitis C-related cirrhosis

Australian snapshot

• There are around 12,500 new hepatitis C diagnoses each year
•  An estimated 3,562 people with chronic hepatitis C were prescribed antiviral treatments in 2008 (pegylated interferon and ribavirin combination or pegylated interferon only);
• An estimated 83% of hepatitis C infections were acquired through injecting drug use; 12% due to other transmission routes (e.g. vertical transmission (mother to baby); non-sterile body piercing; tattooing; and medical procedures in countries of birth with high hepatitis C background prevalence); and 5% due to receipt of blood
• In Queensland approximately 39,000 people have been exposed to hepatitis C, with 2,877 new notifications in 2006

How do you get hep C?

• Blood-to-blood contact
• From a mother with chronic hepatitis C to her newborn baby (approximately 1-5% risk of transmission – low risk)
• Sexual transmission is unlikely unless there is blood-to-blood contact

For example…

• Skin penetration (e.g. tattooing and piercing) with unsterile equipment
• Use of contaminated injecting equipment when injecting drugs
• Receiving blood products prior to February 1990 in Australia

Symptoms

• General aches and pains
• Yellowing of the eyes and skin
• Nausea
• Abdominal pain and discomfort
• Loss of appetite
• Light coloured faeces and dark urine

Prevention

• Avoid blood-to-blood contact
• Avoid sharing personal items (e.g. toothbrushes and razors) which may allow the transfer of blood from one person to another
• Use gloves when giving someone first aid or cleaning up blood and bodily fluids
• Seek medical advice for any accidental exposure

Treatment

Treatment currently available for people with hepatitis C is Pegylated Interferon and Ribavirin; commonly called ‘combination therapy’ when both drugs are used together. Using combination therapy involves injecting Pegylated Interferon into the fatty tissue under the skin once a week and taking Ribavirin tablets daily, for either six or 12 months.

Pegylated Interferon monotherapy is also available for people who cannot tolerate Ribavirin (i.e. if you have an allergic reaction to it), although this has a lower success rate in clearing the virus.

Combination therapy is highly effective:

• About 80% of people with genotype 2 or 3; and
• 50% of people with genotype 1, who finish treatment will clear the virus.