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Hepatitis C

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What is hepatitis C?

Hepatitis C is a disease that affects the liver and is caused by the hepatitis C virus (HCV). The word hepatitis means “inflammation of the liver”. Hepatitis C (formerly known as non-A, non-B hepatitis) is found in the blood of infected people. It is different from the other viruses that cause hepatitis A and hepatitis B and was first discovered in 1989.

How do I know if I have hepatitis C?

The only way to find out for sure is by having a blood test. The test for hepatitis C is based on the detection of antibodies to the virus, not the virus itself. Antibodies are substances produced by the body in response to infection and are found in the blood. A positive hepatitis C antibody test indicates you have been infected with the hepatitis C virus at some time in your life. You are then considered “hepatitis C positive.”

Who should be tested for hepatitis C?

  • People who had blood/blood product transfusions in Canada before 1990.
  • Anyone who has ever shared needles, spoons, straws and other drug-related equipment for drug use.
  • Anyone who has had tattooing, ear and/or body piercing or acupuncture done with “shared” or “improperly cleaned” needles.
  • People who share personal items (e.g., razor or toothbrush) with someone who has hepatitis C.
  • People exposed to needle stick injuries (e.g., health care workers).
  • Hemodialysis patients.

How is hepatitis C spread?

Hepatitis C virus is present in the blood of infected people. This virus is not easily spread but it can be passed on through blood-to-blood contact with an infected person such as, by sharing needles. The Canadian Red Cross began testing the blood supply for hepatitis C virus in 1990, so the possibility of becoming infected from the blood supply is very small. Unfortunately, prior to testing in 1990 and the improved testing in 1993, some people were infected with the virus from getting blood or blood product transfusions. Because hepatitis C takes years to develop, people are being diagnosed with it many years after having had a blood transfusion.

Getting a tattoo done is another way that hepatitis C is spread. Even though the needles are new, there may be a risk if the artist re-uses ink from a container that has been used to tattoo others.

Acupuncture (a form of body piercing) is also a way that hepatitis C can be spread, if the needles are reused without proper sterilization.

Can hepatitis C be transmitted by sexual intercourse?

The risk of spreading the hepatitis C virus by sexual means, either heterosexual (straights) or homosexual (gays), is very low. Studies have shown that long-term sexual partners (for 20 years or more) of those infected with hepatitis C are at risk of becoming infected themselves. Although the risk is low, it is not absent.

Any long-term sexual partners (10 years or more) of a hepatitis C-infected individual should be tested for hepatitis C virus. In a long-term relationship, the choice to use condoms to prevent spreading this virus is up to the individuals involved. This decision should be based on careful consideration of the risk. A discussion with a family doctor or other health care provider may be helpful. The risk of getting the virus during sexual activity may be increased when open sores are present and during a woman’s menstrual period. Barrier methods such as condoms should be used in these situations.

Can babies get hepatitis C from their mothers?

Yes, there is a small chance that the hepatitis C virus can be passed to the newborn either before OR at the time of birth. Potential, expectant and/or new parents should be advised that there is about a 6% risk of hepatitis C-infected pregnant women passing this virus to their newborns.

Although data available on the safety of breastfeeding is limited, studies show it does NOT pass the virus from mother to baby. However, if the nipples are bleeding or cracked, it is recommended that breastfeeding be stopped until they are healed.

What do I do if I test positive for hepatitis C?

If you find out you have hepatitis C, you will be one of tens of thousands of Canadians who have the virus, with more than 5,000 or so becoming infected each year. Your family doctor may refer you to a specialist to determine whether or not you need treatment.

Learn more about hepatitis C and how it may affect you. Be monitored by your doctor and ask questions. Finally, learn what steps to take to prevent the spread of infection.

What are the signs and symptoms of hepatitis C infection/disease?

When some people are first infected with hepatitis C virus, they often experience no symptoms and may feel quite well. Others may feel unusually tired and/or nauseated and may develop jaundice (yellowing of the eyes and skin).

Scientists are still studying the long-term health risks for persons infected with the virus. Early diagnosis and lifestyle changes can prevent further damage to the liver. People who get hepatitis C as adults and do not regularly drink alcohol are less likely to develop life-threatening problems from this disease. At most, 20 people out of 100 with chronic hepatitis C develop cirrhosis (scarring) of the liver over 10 to 30 years.

Chronic hepatitis C liver infection may persist for many years with no symptoms at all, although it may be damaging liver cells at a very low level. Some hepatitis C-infected people do not have symptoms because the liver has a large reserve and can function normally even when damaged. The severity of liver disease caused by the virus varies from person to person for unknown reasons.

How will I know if my liver is okay?

Blood tests may be performed every so often by your doctor to monitor the health and functioning of your liver. Other tests such as liver biopsy may also be performed. A liver biopsy is a medical procedure in which a small sample of liver is removed for analysis. Your doctor or liver specialist (hepatologist) will advise you if a liver biopsy is necessary.

Is there treatment for hepatitis C infection?

Your doctor or liver specialist will advise you if you are a candidate for treatment. In the past the only treatment, was with a drug called interferon. Because interferon does not have a direct anti-viral effect, most people had a very poor response to this treatment. Studies show that only 6% of people were able to get rid of hepatitis C virus after six months of continuous treatment with this medication.

Another drug, ribavirin, has been used recently with interferon, and has improved the success rate of treatment. Studies show that about 40 percent of people using this combination therapy completely get rid of the virus from their body. Success ranges from 20-80% and depends on the amount of liver scarring, the amount of virus in the body and the type of hepatitis C virus. The combination treatment therapy is taken anywhere between six to 12 months. Other treatment options are being developed.

While taking both drugs (the combination therapy), and for six months following the completion of the medication, it is extremely important that both you and your partner use birth control methods. If you become pregnant while taking this treatment, serious birth defects may occur.

How can I prevent the spread of hepatitis C?

Hepatitis C is spread through blood-to-blood contact. The risk of spreading the virus to people within the home is unknown but probably very low.

Hepatitis C virus-positive people should:

  • Avoid alcohol (including spirits, wine, beer) as this is harmful to the liver.
  • Avoid sharing razors, toothbrushes, nail files and other personally used items such as these, as there can be small amounts of blood on these items.
  • Cover all open sores or breaks in the skin.
  • Clean up blood spills with soap and water, then disinfect with bleach.
  • Throw out all bloodstained items in a plastic bag.
  • Never use a needle (syringe) or any drug-related equipment that has been used by someone else.
  • Never donate blood, body organs, other tissue or semen.
  • Persons with hemophilia and related bleeding disorders on self-infusion programs should follow all instructions carefully.
  • Advise the doctor, nurse, dentist and hospital staff that you have hepatitis C.
  • Get vaccinated against hepatitis B. This series of three vaccinations is provided free of charge and can be given to you by your doctor or at the Health Unit.
  • Get vaccinated against hepatitis A. This vaccine is provided free of charge and can be given to you by your doctor or at the Health Unit.
  • Before you have sex, tell your partner that you have hepatitis C.
  • Practice safer sex by using a condom.

How do I live with hepatitis C?

You will need to make some changes in your life to keep healthy and to prevent further damage to your liver.

You will have to:

  • Stop drinking alcohol – no beer, wine, or spirits.
  • Eat foods that will keep you healthy, as in lots of fresh fruits and vegetables. Eat foods that are reduced in fat, cholesterol, sugar and fewer processed foods.
  • Get shots (vaccinations) to make sure you never get hepatitis A or hepatitis B.
  • Exercise regularly, as this helps to improve your sleeping pattern.
  • Avoid taking medications and/or pain killers such as acetaminophen (Tylenol) and sleeping pills that can damage your liver.

Where can I get more help?

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