Treatments For Hepatitis C
Hepatitis C can be treated with medicines that stop the virus multiplying inside the body. These usually need to be taken for several weeks.
Until recently, most people would have taken 2 main medicines called pegylated interferon and ribavirin .
Tablet-only treatments are now available.
These new hepatitis C medicines have been found to make treatment more effective, are easier to tolerate, and have shorter treatment courses.
They include sofosbuvir and daclatasvir.
Using the latest medications, more than 90% of people with hepatitis C may be cured.
But it’s important to be aware that you will not be immune to the infection and should take steps to reduce your risk of becoming infected again.
How Are Hepatitis C And Hiv Connected
People living with HIV are at higher risk for hepatitis C. Of the 1.2 million people living with HIV in the U.S., about 1 in 4 also have hepatitis C.
Having both HIV and hepatitis C means increased risk for liver disease, liver failure and liver-related death from hepatitis C. Because hepatitis is often serious in people living with HIV and may lead to liver damage more quickly, the CDC recommends people living with, or at risk for HIV, also get tested for hepatitis C.
Reactive Or Positive Hepatitis C Antibody Test
- A reactive or positive antibody test means that Hepatitis C antibodies were found in the blood and a person has been infected with the Hepatitis C virus at some point in time.
- Once people have been infected, they will always have antibodies in their blood. This is true even if they have cleared the Hepatitis C virus.
- A reactive antibody test does not necessarily mean that you have Hepatitis C. A person will need an additional, follow-up test.
Persons for Whom HCV Testing Is Recommended
- Adults born from 1945 through 1965 should be tested once
- Those who:
- Ever injected drugs, including those who injected once or a few times many years ago
- Have certain medical conditions, including persons:
- who received clotting factor concentrates produced before 1987
- who were ever on long-term hemodialysis
- with persistently abnormal alanine aminotransferase levels
- who have HIV infection
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Who Is More Likely To Get Hepatitis C
People more likely to get hepatitis C are those who
- have injected drugs
- had a blood transfusion or organ transplant before July 1992
- have hemophilia and received clotting factor before 1987
- have been on kidney dialysis
- have been in contact with blood or infected needles at work
- have had tattoos or body piercings
- have worked or lived in a prison
- were born to a mother with hepatitis C
- are infected with HIV
- have had more than one sex partner in the last 6 months or have a history of sexually transmitted disease
- are men who have or had sex with men
In the United States, injecting drugs is the most common way that people get hepatitis C.13
How Is Hepatitis C Spread
The hepatitis C virus is spread through contact with infected blood and bodily fluids, such as semen and vaginal fluid. You will only be infected if the virus enters your bloodstream.
In Canada, most people are infected by:
- using or sharing drug paraphernalia contaminated with infected blood, including:
If you have hepatitis C, you can pass the virus to your baby during:
- breastfeeding if your nipples are cracked and bleeding, and your baby also has bleeding in or on the mouth
- it can be hard to tell if a baby has bleeding in or on the mouth
- cracked nipples may not be bleeding but may begin to during breastfeeding
You can also be infected if you receive contaminated:
- blood products
Although rare, hepatitis C can also be spread through unprotected sex especially if it involves blood contact, such as:
- contact with:
- open sores, cuts or wounds
- semen or vaginal fluid if blood is present
Unprotected sex means having sex without using a condom or other barrier safely.
Hepatitis C is not spread through:
- breast milk
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Treatment Of Hepatitis C
Hepatitis C is treated with antiviral medications that aim to clear the virus from your body.
New all-tablet treatments have greatly improved the outcomes for people with hepatitis C. These treatments can cure more than 95% of individuals with chronic hepatitis C. There are several new tablets that are used in combination to treat all hepatitis C strains . They are effective for people with no liver damage and those who have more advanced liver damage or cirrhosis.
These new tablet medications are available and subsidised on the Pharmaceutical Benefits Scheme, and can be prescribed by specialists, general practitioners and specialised nurse practitioners.
There are no restrictions on accessing treatment it is available for all adults with a Medicare card. People under 18 are able to access treatment and it is recommended they are referred to a pediatrician experienced in the treatment of hepatitis C.
For more information on the new medications for the treatment of hepatitis C, see our video: Hepatitis C Cure what it means for Victorians.
If your doctor does not know about the new treatments, you can call the LiverLine on for information, and to find a GP who can help you.
Talk with your doctor about treatment options and the potential for interactions with other medications, herbal preparations and other drugs. If you take prescribed medication this will be managed so you can access treatment.
In general, if you have hepatitis C you will feel better if you:
How Do People Get Hepatitis C
Hepatitis C is spread when the blood of a person who is infected with hepatitis C gets into the body of a person who does not have hepatitis C.
Hepatitis C infection happens the most in people who:
- Are being treated in a health care setting where needles or other medical tools are not sterilized in the right way
Much less often, hepatitis C can happen:
- When a child is born to a mother who has hepatitis C
- From having sexual contact with a person who has hepatitis C
- From sharing items like a toothbrush or a razor with a person who has hepatitis C
In the past, hepatitis C would happen from:
- Medical procedures involving donated blood
- Before this time, the screening process for blood diseases within donated blood was not well controlled.
- Medical equipment contaminated with hepatitis C, before strict infection control was required.
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What Causes Hepatitis C
The hepatitis C virus causes hepatitis C. The hepatitis C virus spreads through contact with an infected persons blood. Contact can occur by
- sharing drug needles or other drug materials with an infected person
- getting an accidental stick with a needle that was used on an infected person
- being tattooed or pierced with tools or inks that were not kept sterilefree from all viruses and other microorganismsand were used on an infected person before they were used on you
- having contact with the blood or open sores of an infected person
- using an infected persons razor, toothbrush, or nail clippers
- being born to a mother with hepatitis C
- having unprotected sex with an infected person
You cant get hepatitis C from
- being coughed or sneezed on by an infected person
- drinking water or eating food
- hugging an infected person
- shaking hands or holding hands with an infected person
- sharing spoons, forks, and other eating utensils
- sitting next to an infected person
A baby cant get hepatitis C from breast milk.18
Who Is Most At Risk Of Contracting Hepatitis C
You have a high risk of contracting hepatitis C if you:
- use or have used injection drugs even if it was just once or many years ago
- have received blood or blood products or an organ transplant before July 1990 in Canada
- have been in jail or
- have been injected or scratched during vaccination, surgery, blood transfusion or a religious/ceremonial ritual in regions where hepatitis C is common.
You have a high moderate risk of contracting hepatitis C if you:
- have tattoos or body piercing
- have multiple sexual partners
- have a sexually transmitted infection , including HIV or lymphogranuloma venereum
- have experienced traumatic sex or rough sex or have used sex toys or fisting that can tear body tissue
- have vaginal sex during menstruation
- have received a kidney treatment
- have received an accidental injury from a needle or syringe
- have another infectious disease
- were born to a hepatitis C infected mother or
- have a sexual partner infected with hepatitis C.
Hepatitis C is NOT passed from person to person by:
- coughing, sneezing
- breastfeeding unless your nipples are cracked and bleeding or
- oral sex, unless blood is present.
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Why Getting Tested Is Important
A blood test is one of the only ways to confirm a diagnosis of hepatitis C. Additionally, hepatitis C often has no visible symptoms for many years.
Because of this, its important to be tested if you believe youve been exposed to the virus. Getting a timely diagnosis can help ensure you receive treatment before permanent liver damage occurs.
Hepatitis C And Blood Spills
When cleaning and removing blood spills, use standard infection control precautions at all times:
- Cover any cuts or wounds with a waterproof dressing.
- Wear single-use gloves and use paper towel to mop up blood spills.
- Clean the area with warm water and detergent, then rinse and dry.
- Place used gloves and paper towels into a plastic bag, then seal and dispose of them in a rubbish bin.
- Wash your hands in warm, soapy water then dry them thoroughly.
- Put bloodstained tissues, sanitary towels or dressings in a plastic bag before throwing them away.
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Preventing The Spread Of Hepatitis C
There is no vaccine available to prevent a person from being infected with hepatitis C. Recommended behaviours to prevent the spread of the virus include:
- Always use sterile injecting equipment. This can be accessed from your local needle and syringe program service.
- Avoid sharing personal items such as toothbrushes, razors, nail files or nail scissors, which can draw blood.
- If you are involved in body piercing, tattooing, electrolysis or acupuncture, always ensure that any instrument that pierces the skin is either single use or has been cleaned, disinfected and sterilised since it was last used.
- If you are a healthcare worker, follow standard precautions at all times.
- Wherever possible, wear single-use gloves if you give someone first aid or clean up blood or body fluids.
- Although hepatitis C is not generally considered to be a sexually transmissible infection in Australia, you may wish to consider safe sex practices if blood is going to be present, or if your partner has HIV infection. You may wish to further discuss this issue and personal risks with your doctor.
How Do I Know If I Have Hepatitis C Virus
Diagnosis of hepatitis C virus requires a blood test your doctor can order. Other blood tests can determine which subtype of HCV you have to better target your drug treatment, if needed. Your doctor will also want to know your viral load . In some patients, a liver biopsy is required to determine the level of damage.
Symptoms of chronic HCV may not appear for 2 to 3 decades after infection, so the disease may develop silently in your body for many years. This is the reason you should be tested for HCV infection, to start treatment if needed and to help protect your liver from damage.
The US Centers for Disease Control and Prevention recommends anyone 18 years or older be tested for hepatitis C virus at least once in their lifetime. Women should be tested for hepatitis C testing during each pregnancy. Some high risk groups may need more frequent testing, such as people who share drug preparation equipment and those on hemodialysis.
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Spread Of Hepatitis C
Hepatitis C is spread through blood-to-blood contact when blood from a person with hepatitis C enters another persons bloodstream.
The most common way people become infected with hepatitis C in Australia is by sharing injecting equipment such as needles, syringes, spoons and tourniquets. It is possible to be infected with hepatitis C after only one risk event.
Hepatitis C may also be spread through:
- tattooing and body piercing with equipment that has not been properly cleaned, disinfected or sterilised such as backyard tattoos’. Registered parlours with appropriate infection control procedures are not a risk
- needlestick injuries in a healthcare setting
- receiving blood transfusions in Australia prior to 1990 before hepatitis C virus testing of blood donations was introduced
- medical procedures, blood transfusions or blood products and mass immunisation programs provided in a country other than Australia
- pregnancy or childbirth there is a 5% chance of a mother with chronic hepatitis C infection passing on the virus to her baby during pregnancy or childbirth.
Breastfeeding is safe, however if nipples are cracked or bleeding cease breastfeeding until they have healed.
Less likely possible routes of transmission of hepatitis C include:
Hepatitis C cannot be transmitted by:
- sharing food, cups or cutlery
- shaking hands or day-to-day physical contact.
Living With Hepatitis C Infection
Many people are living with hepatitis C. If you have hepatitis C, there are several important things that you can do to help yourself and others such as:
- Eat a healthy diet and get plenty of rest.
- To avoid further liver damage:
- Do not drink alcohol.
- Do not take medicine that can cause liver damage .
- Get vaccinated against hepatitis A & B if you are not already immune.
- Do not to pass the infection to anyone else by taking the following precautions, such as:
- Do not share toothbrushes or razors with others.
- Do not to let anyone else come into contact with your blood, urine or feces.
- Use condoms during sexual activity.
- Limit the number of sex partners you have.
- If you use injection drugs, do not share needles or syringes with anyone else.
- It is best to not get tattoos or body piercings.
Although often uncomfortable, you should notify your partner of your hepatitis C prior to having sex. You also must notify all your health care professionals of your infection, so they can take precautions.
How Can I Protect Myself And Others
- Never share injecting drug equipment or things that may have blood on them such as toothbrushes and razors. Also avoid sharing straws or rolled up banknotes if snorting drugs with others.
- Use condoms for anal and vaginal sex and latex gloves for fisting.
- During group sex, cover anything which goes from one partner to another with a fresh condom or fresh latex glove for each new person it enters. Clean objects with warm water and anti-bacterial soap before using on a new partner.
- Dont share enema equipment or pots of lubricant.
If you have hepatitis C you may want to tell a partner and explain that youre infectious. They can then decide if they’re happy to take any risks and whether they want to take precautions. That way they cannot accuse you of infecting them without them knowing that the risk was there.
Encouraging Others To Get Tested For Hepatitis C
While the odds of passing on the hepatitis C virus are low, you should still tell anyone at risk that you have hepatitis C. You should tell sexual partners, spouses, and family members. Your infection may be difficult to discuss, but anyone at potential risk must know. That way, they can get tested and treated if needed. Read more on why you should get tested for hepatitis C.
Paul Berk, MD, professor of medicine and emeritus chief of the division of liver disease, Mount Sinai School of Medicine, New York City chairman of the board, American Liver Foundation.
Alan Franciscus, executive director, Hepatitis C Support Project and editor-in-chief of HCV Advocate, San Francisco.
Thelma King Thiel, chair and CEO, Hepatitis Foundation International.
David Thomas, MD, professor of medicine, Johns Hopkins School of Medicine, Baltimore.
Howard J. Worman, MD, associate professor of medicine and anatomy and cell biology, College of Physicians and Surgeons, Columbia University, New York City.
The American Gastroenterological Association.
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Why Should I Get Treated
Hepatitis C can be fatal when left untreated.
Untreated hepatitis C can lead to scarring of the liver known as cirrhosis.
A small number of people with cirrhosis will go on to get liver failure, the only treatment for which is a liver transplant. A small proportion of people with cirrhosis develop liver cancer.
Keep Personal Items Personal
Any tools or implements that may have a bit of blood on them from infected people are potential sources of hepatitis B or C transmission. Toothbrushes, nail clippers, razors, needles, and washcloths may all contain trace amounts of blood that can transmit infection. Keep personal items such as these to yourself and never use personal items that belong to others.
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