Sexual Health Advice - Patient Information Leaflets
Hepatitis C
What is hepatitis and hepatitis C?
Hepatitis means inflammation of the liver. There are many causes of hepatitis. For example, alcohol excess and various infections. Several different viruses can infect the liver and cause hepatitis. One type of virus which causes hepatitis is called the hepatitis C virus. This leaflet is only about hepatitis C.
How can you get hepatitis C?
Hepatitis C is a blood-borne infection. The main source of infection is from blood from an infected person.
Most cases of hepatitis C are caused by using contaminated needles to inject drugs (‘sharing needles'). Even a tiny amount of blood left on a needle from an infected person is enough to cause spread to others.
Some people who received blood transfusions and blood products several years ago were infected with hepatitis C from some donor blood. In recent years, all blood donated in the UK is checked for the hepatitis C virus. Therefore, the risk of contracting hepatitis C from a blood transfusion is now very small.
There is also a risk of contracting hepatitis C from needlestick accidents, or other injuries involving blood spillage from infected people.
There is a small risk of contracting the virus from sharing toothbrushes, razors, equipment which is not sterile for tattooing, body piercing, 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.
There is a small risk that an infected person can pass on the virus whilst having sex.
You cannot pass on the virus during normal social contact such as holding hands, hugging, sharing cups or plates.
What are the symptoms and how does hepatitis C progress?
There are two phases of infection with hepatitis C virus. An acute phase is when you first become infected and a chronic (persistent) phase where the virus remains 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:
Feeling sick and vomiting
Flu-like illness (fever, feeling generally unwell)
Jaundice (yellow tinge of skin and whites of the eyes, dark urine and pale faeces)
Itchy skin
Following the initial infection:
In about 1 in 5 cases the virus is cleared from the body by the immune system within 2 – 6 months.
In about 4 in 5 cases, the virus remains active in the liver and bloodstream 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 damage or problems to the liver. However, even if you have no symptoms, if you have chronic infection you can still pass on the virus to others who may develop problems.
Some people develop some symptoms due to persistent inflammation of the liver such as: muscle aches, tiredness, feeling sick, lack of appetite, intolerance of alcohol, pains over the liver, jaundice and depression. Symptoms vary in severity and some people have liver inflammation without feeling any symptoms.
About 1 in 5 people with chronic hepatitis C infection develop cirrhosis over a period of about 20 – 30 years. Cirrhosis is like 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 blood test can detect antibodies in your blood to hepatitis C. (Antibodies are proteins made by the immune system to attack viruses and bacteria). The specific antibody against hepatitis C can be detected by a simple routine blood test. The result is usually known within 3 days. A positive test means that you have at some stage been infected with hepatitis C.
However, this test remains positive even in people who have cleared the virus from their body i.e. the antibodies remain even if the virus has gone. Also, it can take up to six months for the antibody test to become positive after first being infected as the body may take a while to make these antibodies. So, a negative test does not necessarily rule out a recently acquired infection. A repeat test in a few weeks may be advised in some people who have recently been at exposure risk of hepatitis C.
If the antibody test is positive, then a further blood test is needed to see if the virus is still present (chronic infection). This is a more specialised test which detects particles of the virus. 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:
Not share any injecting equipment such as needles, syringes
Not donate blood or carry a donor card
Not share razors, toothbrushes or anything else that may possibly be contaminated with blood
Use condoms when having sex. The risk of passing on the hepatitis C virus during sex is small, but is reduced even further by using condoms. However, your partner in a regular faithful relationship may accept the small risk of having sex without condoms.
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 but have little or no damage to the liver, you are at low risk of developing cirrhosis. No treatment may then be needed.
If you have persistent inflammation of the liver then you are at risk of developing cirrhosis and so treatment is often advised.
The usual treatment is a combination of medicines called interferon and ribavirin. This treatment can clear the virus (‘cure') in up to half 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
Most people with current hepatitis C infection should not drink alcohol (or only drink small amounts) as drinking alcohol can greatly increase the risk of developing liver cirrhosis.
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