Sexual Health Advice - Patient Information Leaflets

Hepatitis C

What is hepatitis and hepatitis C?

Hepatitis is an inflammation / infection of the liver with many causes such as alcohol excess and several types of viruses. One such virus that causes hepatitis is called the hepatitis C virus. In this leaflet we shall only discuss the hepatitis C virus.

How can you get hepatitis C?

Hepatitis C is a blood-borne infection which comes from blood from an infected person. Examples include:

Hepatitis C is usually caused by using contaminated needles to inject drugs (‘sharing needles'). A very small amount of blood left on a needle from an infected person is enough to cause spread to others.

Although all blood donated in the UK is checked for the hepatitis C virus (and for certain other infections) there is a very very small risk of getting hepatitis C from a blood transfusion.

There is a small risk of getting hepatitis C from needlestick injuries, or other injuries involving blood spillage from infected people.

There is a small risk of getting hepatitis C virus from sharing razors, toothbrushes and equipment which is not sterile for body piercing, tattooing and other such items which may be contaminated with blood.

There is a small risk that an infected mother can pass on the infection to her baby during childbirth.

There is a small risk that an infected person can pass on the hepatitis C virus during sexual intercourse.

It is not possible to pass on the hepatitis C virus during normal social contact such as hugging, holding hands, sharing cups or plates.

What are the symptoms and how does hepatitis C progress?

It occurs in two phases i.e. an acute phase when you are first infected and a chronic phase when the virus remains over long-term.

Acute phase

Most people have no symptoms or only mild ‘flu-like' symptoms in the acute phase.

If symptoms do occur they develop about 7 – 8 weeks after being exposed to the virus, symptoms may include:

Flu-like illness (fever, feeling generally unwell, tiredness)
Abdominal pain
Nausea and vomiting
Itchy skin
Jaundice (yellow tinge of skin and whites of eyes, dark urine and pale faeces)

Following the initial infection:

In about 20% of cases the hepatitis C virus is cleared from the body by the immune system, usually within 2 – 6 months.

In about 4 in 5 cases, the virus remains active in the bloodstream and liver long-term. This is called chronic infection with hepatitis C.

Chronic phase

Of those people who develop chronic infection:

Some people remain well throughout life. They develop no problems to the liver. However, despite having no symptoms you can still pass on the hepatitis C virus to others.

Some people develop some symptoms due to persistent inflammation of the liver such as: tiredness, muscle aches, lack of appetite, feeling sick, intolerance of alcohol, jaundice, depression, pain in the upper abdomen.

About 1 in 5 people with chronic hepatitis C infection develop cirrhosis. This can occur over a period of about 20 – 30 years. Cirrhosis is a ‘scarring' of the liver. Some people with chronic hepatitis C have no symptoms for many years until they develop cirrhosis. Only when the liver starts to fail with cirrhosis do symptoms appear.

How is hepatitis C diagnosed?

A simple blood test can detect antibodies in your blood to hepatitis C virus, which usually takes about 3 days.

However, this test remains positive even in people who have cleared the virus from their body i.e. the antibodies remain in the blood even after the hepatitis C virus has gone. Likewise, it can take up to six months for the antibody test to become positive after first being infected as the body's immune system can take up to 6 months to make these antibodies. Therefore, a negative blood test does not necessarily rule out a recent infection. A repeat test in a few weeks may be advised in some people who have recently been at risk of getting hepatitis C.

If the antibody test is positive, then a further blood test is usually needed to see if the virus is still present (chronic infection). Also, there are several different strains (types) of the hepatitis C virus. Tests may be done to find exactly which strain you are infected with. Some strains are more resistant to treatment than others.

How can I prevent passing on the hepatitis C virus to others?

If you have a current hepatitis C infection you should:

Use condoms when having sex.
Not donate blood, semen, or carry a donor card.
Not share any needles or syringes.
Cover cuts or wounds with a dressing.
Not share toothbrushes, razors or other items that may be contaminated with blood.
If any of your blood spills make sure it is cleaned away with bleach.
There is no vaccine against the hepatitis C virus (unlike hepatitis B).

What is the treatment of hepatitis C?

The main aim of treatment is to prevent severe liver damage leading to cirrhosis. If you have chronic hepatitis C with little or no damage to the liver, you are then at low risk of developing cirrhosis. No treatment is therefore needed.

If you have persistent inflammation of the liver then you are at risk of developing cirrhosis and treatment is therefore advisable.

The usual treatment is a combination of interferon and ribavirin. This treatment can clear the virus (‘cure') in up to 50% of cases. Even if the treatment does not clear the virus, it may still slow down the progression of inflammation and liver damage.

Diet and alcohol

People with current hepatitis C infection should not drink alcohol as alcohol can increase the risk of developing liver cirrhosis.

Hepatitis C PDF file pdf document or Text-only Version

The Lambda Clinic, 22 Somerset Road, Edgbaston, Birmingham, B15 2QQ, Tel: 0121 452 2815