Hepatitis C

What is Hepatitis C?

The hepatitis C virus is one of several viruses that can cause inflammation of the liver.

Hepatitis C infection involves an initial acute phase of infection that may not be noticeable, because in most cases people do not feel sick.

This phase can last up to six months, levels of the virus in the blood rise dramatically until the body’s immune system starts to produce antibodies. Antibodies are made in response to the presence of the hepatitis C virus.

For most people, hepatitis C is a slow acting virus and is a chronic illness that can be managed with a variety of strategies. The impact of hepatitis C and how severe it is will vary over time and will be different for each person.

Generally, the statistics show that the damage caused by the virus will increase as time goes on and will have a matching impact on the liver. However, this will not apply to everyone.

It is estimated that approximately 48,000 Victorians and around 227,306 people Australia-wide have been infected with the hepatitis C virus. Of these, many have developed chronic hepatitis C.

Within Australia’s Indigenous community, around 22,000 have been exposed to the virus while 16,000 have developed chronic hepatitis C.

Chronic Hepatitis

Of 100 people with chronic hepatitis C who have remained untreated after 20 years, 45 people may not develop any liver damage, 31 may develop mild to moderate liver damage, 7 may develop cirrhosis of the liver and 1 may develop liver failure.

After 40 years, 45 people may not develop any liver damage, 31 may develop mild to moderate liver damage, 20 may develop cirrhosis of the liver and 4 may develop liver failure.

When the virus is multiplying in the liver, it can mutate and change its outer protein coat so that antibodies don’t recognise it easily. This may explain why the antibody response does not eliminate the virus in most cases.

By the time antibodies are ready to attack the virus, it has already changed and the antibodies have no effect.

Some people may never experience any symptoms. The virus is slow acting and it can take many years from infection before any permanent damage to the liver (such as scarring) occurs.

There is no way to predict how the virus will affect each individual or over what period of time liver damage may develop.

For most people, hepatitis C does not result in serious disease or death. However, factors such as the person’s gender, genetics, health history, diet, life situation, age when they were infected, stress levels, alcohol and drug intake (whether legal, prescribed or illicit), will all have an impact on how each person experiences hepatitis C.

Immunity

Unlike antibodies to other diseases, such as hepatitis A, hepatitis C antibodies do not provide any immunity to hepatitis C.

Even in those people who have been infected with hepatitis C once and cleared the virus, re-infection can still occur.

Genotypes

There are several different strains of the hepatitis C virus called ‘genotypes.’ These strains are slightly different in their genetic make-up, but similar enough to still be labelled hepatitis C.

It is currently believed that there are at least 6 different genotypes of hepatitis C here in Australia, which are numbered 1, 2, 3, and so on.

There are also subgroups within each genotype, which are further differentiated 1a, 1b, etc. The most common genotypes found in Australia are 1 and 3. Studies have shown that it is possible to be infected with multiple hepatitis C genotypes.

To prevent re-infection with a different genotype, it is important to practise the same blood awareness precautions as for preventing an initial infection.

Treatments are evolving and as of September 2020 all genotypes respond well to available treatments. The use of pan genotype treatments is now widespread.

Common Myths

Common myths and misconceptions related to hepatitis C.

Symptoms

Each person will experience hepatitis C differently, having some, many, or no symptoms at all. Symptoms vary and their severity and intensity may rise and fall over time.

It is therefore important to have an ongoing relationship with a qualified health practitioner who is knowledgeable about hepatitis C.

Transmission

Hepatitis C is a blood-borne virus. Transmission of hepatitis C may only occur when the blood of an infected person enters the bloodstream of another person.

The point of entry for infected blood can be a fresh cut or broken or punctured skin.

The hepatitis C virus cannot penetrate unbroken skin and is killed by the digestive juices in the stomach if it is swallowed.

Testing

Any blood-to-blood contact can expose you to a risk of hepatitis C. If you think you may have been exposed at any time you should get tested.

Prevention

There is no effective vaccine against the hepatitis C virus.

Prevention of hepatitis C infection depends upon reducing the risk of exposure to the virus.

Treatment

New revolutionary treatments for hepatitis C are now available for all adolescents and adults in Australia who hold Medicare cards.

Health Professionals

General practitioners as well as Nurse Practitioners are able to treat hepatitis C in consultation with specialists.

For all other health professionals, there is a range of information that can assist you in providing advice and support to clients who are concerned about, or may have been diagnosed with hepatitis C.

Hepatitis C FAQs

Can Hepatitis C be cured?

Yes, treatment therapies, which have a 95% or higher success rate in eliminating hepatitis C have been listed on the Pharmaceutical Benefits Scheme (PBS) and are available for all people living with hepatitis C over the age of 15 and who have a Medicare Card, in Australia.

However, the particular combination of medicines used will depend on a range of individual factors.

Currently Direct Acting Antiviral medications for all genotypes are available. These are 8 or 12 week regimes and may be longer if the liver is damaged.

Learn more: www.befreefromhepc.org.au

Can Hepatitis C be transmitted through sex?

Transmission of hepatitis C occurs through blood-to-blood contact. While hepatitis C is not normally classified as a sexually transmissible infection (STI), and while exposure through sex is not common, it can occur if sexual activity includes any direct blood-to-blood contact.

You should talk to your GP or health specialist about risk factors and how to minimise them. Or you can call the Hepatitis Infoline to speak with a hepatitis educator.

Can I get reinfected with Hepatitis C?

Yes. Having had hepatitis C in the past does not provide you with immunity from being infected again, so it is possible to be reinfected with Hepatitis C even if you have previously cleared it, with or without treatment.

Some studies have shown that reinfection is more likely to occur for people who are also HIV positive.

Reinfection can be avoided by reducing risky activities that have the potential to expose one to the hepatitis C virus, such as, sharing needles or any of the injecting equipment, including spoons and tourniquets, or any activities, which have the potential for blood-to-blood contact.

Can someone with Hepatitis C still have children?

Yes. The virus does not impact on fertility or function. Transmission to baby from a mother with hepatitis C is extremely low, and there are ways to reduce this risk even further.

Speak to your doctor is you have Hepatitis C and are planning a family, you can be cured with treatment in as little as 8 weeks. The current treatments cannot be taken during pregnancy.

Can I pass on Hepatitis C to my family or household contact/s?

While household transmission of hepatitis C is extremely rare, there are a number of possible ways by which hepatitis C could be transmitted from one person to another in a household setting.

Because the virus is carried in the blood, it could be transmitted between household members were to come in contact with blood containing hepatitis C.

Be careful to avoid sharing razors, toothbrushes, toothpicks or any personal grooming items that may break the skin and cause bleeding, this form of transmission is rare, but be blood aware.

If an item was contaminated with hepatitis C-infected blood from one person, the virus could be passed to a second person if it were to tear the lining of the mouth or break through the skin.

You should speak with your GP if you have any concerns. For peace of mind they can arrange for your family or household members to be tested.

Stigma & Discrimination

People who live with a liver condition such as hepatitis B or hepatitis C, have reported been discriminated against.

LiverLine
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LiverWELL, trading as Hepatitis Victoria is the peak community organisation working across the state for people affected by, or at risk of, liver disease and viral hepatitis.

We acknowledge and pay respect to the past, present and future Traditional Custodians and Elders of this nation and the continuation of cultural, spiritual and educational practices of Aboriginal and Torres Strait Islander peoples.

We welcome people from all cultures, nationalities and religions. Being inclusive and providing equitable services is our commitment.