Hepatitis C

Hepatitis C is a virus that is transmitted sexually and through blood or body fluids. The virus infects the liver and can cause acute hepatitis that could lead to chronic liver disease. About 15-25% of individuals infected by HCV will clear the virus during the acute phase. The other 75-85% will become a chronic carrier and will carry the virus for life. Some of these chronic carriers will develop cirrhosis or liver cancer.

Most people who develop acute hepatitis C have no symptoms and do not know they are infected. If symptoms develop, they usually appear six to seven weeks after exposure to the virus. During this period, people can have symptoms such as jaundice (skin and eyes turn yellow), fatigue, loss of appetite, nausea, dark urine, pale stools, joint pain and pain in the stomach area. It is important to note that you can pass the virus on to others even if you have no symptoms. 

HCV is mostly spread through contact with infected blood. The virus can live outside of the body for several days to several weeks.

In Canada, HCV is mainly spread through:

• sharing equipment for preparing or consuming drugs (such as syringes, pipes, straws, spoons, cookers)
• sharing personal care articles such as razors, nail clippers, or toothbrushes with an infected person
• tattoo equipment that was not properly sterilized
• from an infected birthing parent to a newborn infant at the time of birth

Hepatitis C is rarely spread through sex, but it may happen if people engage in high-risk behaviour and where there is a chance of exposure to HCV infected blood.

*HCV is not spread by casual contact such as hugging, sharing eating utensils, sneezing, coughing, or holding hands or using toilets.

Testing for HCV can be done using a blood test to determine if you have been exposed to the virus. Most people who get the virus do not know they are infected. If you think you are at risk for HCV or if you are pregnant, you should get tested. 

Any patient known to have hepatitis C should be referred to a health-care provider for further assessment and treatment. 

When a person is diagnosed it’s best to reduce the risk of further damage to the liver by:

• being immunized against Hepatitis A and B
• minimizing alcohol intake
• checking with a health-care provider before taking prescription or over-the-counter drugs

Having HCV once does not prevent someone from getting infected again. When someone who has HCV is cured whether by getting treated or clearing the virus on their own, they can still get HCV again.

The following persons are known to be at increased risk for an HCV infection: 

• people who do not use new equipment for drug use and/or who share equipment with others
• recipients of blood transfusions or organ transplants before 1992, when better testing of donors became available
• people engaging in in sexual activity where there is a risk of exposure to infected blood (i.e., rough, or anal sex) 
• people with an HIV infection
• children born to a HCV-positive birthing parent
• a person having a procedure where unsterilized equipment is used (i.e., tattoo or piercing)

There is no vaccine to prevent HCV infection. The best way to protect you is to take the following precautions.

Individuals who are sexually active should:

• limit the number of sexual partners and avoid sex with people whose sexual history is unknown
• always use condoms when having sex (vaginal, oral, or anal) - a dental dam (a sheet of latex) or a male condom cut open should be used for oral sex
• avoid the use of alcohol and other drugs that might cloud thinking and lead to high-risk behaviour

Individuals who inject drugs should:

• not share needles or injection drug equipment with others (cleaning with bleach may not kill the virus)
• use only clean needles and equipment

Be cautious about body piercings, tattoos and acupuncture. Make sure single-use, disposable needles are used, and that all other equipment is disinfected and sterile. If you are likely to be in contact with blood or other bodily fluids in your work, take appropriate precautions, such as wearing latex gloves. 

If you have hepatitis C:

• do not donate blood, semen, tissue or organs unless recommended otherwise
• be very careful to make sure that other people are not exposed to your blood
• cover any wounds with a waterproof bandage

If you have been diagnosed with hepatitis C, your health-care provider will treat you and give you information about sexually transmitted and blood-borne infections (STBBI). A Public Health nurse may contact you to help you notify your partners

Contact your local sexual health clinic, or your primary care provider with any questions, for testing, or for further education about hepatitis C. Public Health recommends that all sexually active New Brunswickers have testing for all sexually transmitted diseases at the same time and on a regular basis. When you “test for one, test for all” you will be tested for gonorrhea, chlamydia, hepatitis, syphilis, Human Papillomavirus (HPV) and HIV/AIDS.

For more information, contact your health-care provider, Tele-Care 811, your local Public Health office or visit Testing and treatment for STBBIs.

To find hepatitis C services near you, visit the HIV411.ca website.