General Information

What is hepatitis C?

Hepatitis means swelling or inflammation of the liver. The most common causes of hepatitis are viral infections. Hepatitis C infection (also known as Hep C or HCV) is one such virus that can cause long-lasting infection and can lead to liver disease.

What are the symptoms of hepatitis C?

Hepatitis C infection affects different people in different ways; many experience no symptoms at all while others experience extreme tiredness and can feel very unwell. Reported symptoms include fatigue, weight loss, nausea, 'flu like symptoms, problems concentrating, abdominal pain and jaundice.

It is estimated that around 15-20% of infected people clear their infections naturally within the first 6 months of infection. For the remainder, hepatitis C is a chronic infection that can span several decades and can be life-long.

How common is hepatitis C?

The World Health Organisation estimates that there are 170 million carriers of hepatitis C worldwide. On a global scale, the United Kingdom is considered to be a relatively low prevalence country. The prevalence of chronic hepatitis C infection in England is estimated be around 0.4%.

How do you catch hepatitis C?

Hepatitis C is a blood borne virus infection. The virus is spread when blood from an infected person gets into the bloodstream of another.

Today, injecting drug use is the most common way to acquire hepatitis C virus infection. Individuals who inject drugs acquire their infections when they share contaminated injecting equipment with other infected individuals.

In the United Kingdom blood donations have been screened for hepatitis C since September 1991. Consequently, it is now very difficult to acquire hepatitis C virus infection by blood transfusion. However, some people who received blood or blood products before this date could be infected if they received blood from a donor who was carrying the hepatitis C virus. It is also possible to acquire hepatitis C virus infections by blood transfusion from transfusion in a country that does not screen its blood for the virus.

Unlike many other blood borne viruses, sexual transmission is thought to be relatively rare. Nevertheless, it may occur and people with new or casual sexual partners are advised to use condoms to protect them against all sexually transmitted infections.

Infection is not acquired through normal social contact, but it can occur in situations where blood can be transferred from one person to another, for example by sharing razors or toothbrushes. It is also possible to acquire hepatitis C infection during body piercing (like tattooing or acupuncture) if sterile needles are not used.

The risk of a mother infecting her newborn baby with hepatitis C is estimated to be less than 10%. This risk is highest in mothers who are also infected with HIV and in those who have particularly high levels of virus circulating in their blood. Current regulations do not advise HCV-infected women against breast-feeding as there is insufficient evidence to assess the risk of transmission via breast milk.

How long can you have the infection before developing symptoms?

In the 80-85% of individuals who fail to clear their infections naturally, the outcome of infection is extremely variable. Many people never develop any signs or symptoms of liver disease in their lifetime and consequently may not even know that they have been infected. Other people go on to develop serious liver disease. It is not currently possible to work out who will progress to serious liver disease and who will have only very mild, if any, disease.

In most cases the infection will not be apparent for many years. This is partly because the liver has a remarkable capacity to 'cope' with the infection. Symptoms do not often develop until the liver has been quite extensively damaged. Alcohol consumption, acquiring the infection at an older age, and being male, have all been shown to be associated with more progressive disease.

How can hepatitis C be prevented or treated?

Prevention is centred on stopping the blood from infected individuals from coming into contact with others. Injecting drug users are at high risk of infection and when injecting cannot be avoided, sterile injecting equipment should always be used; injecting equipment should never be shared. Similarly, individuals who undergo body piercing should ensure that disposable sterile needles are used. In the home, sharing of personal items, like toothbrushes and razors, should be avoided and all wounds and cuts should be cleaned and covered with waterproof dressings; blood spills should be cleaned-up with undiluted bleach. In a health care setting, universal precautions should be adhered to; all blood, body fluids and body tissues should be treated as potentially infectious at all times.

The treatment of choice for individuals with chronic hepatitis C infection is a combination of two drugs: interferon and ribavirin. This combination therapy is successful in clearing virus from the blood of around 40% of those treated. However, not everybody is suitable for treatment or can tolerate it. Factors such as age, sex, duration of infection, the strain of the virus, and the degree of existing liver damage determine the effectiveness of treatment. New more effective treatments are likely to become available in the near future.