Hepatitis C FAQ
1. What is hepatitis C anyway?
Hepatitis means inflammation of the liver. The liver is a vital part of the body. If it does not work properly it can cause serious illness or sometimes even death. The liver breaks down waste products in your blood. When the liver is inflamed, it doesn't do a good job of getting rid of waste products. A visible sign of the build up of waste products is jaundice, or going yellow.
Hepatitis can be caused by many things: drinking too much alcohol or taking certain medicines, for example. Many viruses can cause hepatitis, too. Hepatitis C is a blood-borne virus — that is it lives and spreads in blood.
Hepatitis C is the most prevalent liver disease in the world. It is often called the ‘silent’ epidemic because someone can be infected for decades before the infection is discovered. Hepatitis C emerged at the beginning of the 1960s and since then has been associated with blood transfusions and injecting drug use. The extent of the problem only became clear after 1990 when reliable hepatitis C blood tests first became available.
Hepatitis C is the most common life threatening infection in Australia. Over the last 30 years, an estimated 250,000 people have been infected, with an estimated 10,000 new infections annually. Of those infected, 80-85% develop chronic liver disease. Of those, 10-20% will develop cirrhosis within 20 years, and of those with cirrhosis, 5% will develop liver cancer.
2. Can you get hepatitis C through sex?
Possibly, but unlikely. Many couples live together for years where one is positive and the other is negative without transmitting the virus from one to the other.
Although hepatitis C is unlikely to be sexually transmitted, transmission can occur during unprotected sexual contact if the sexual activity involves blood-to-blood contact. The sexual spread of hepatitis C is due to blood-to-blood contact rather than the presence of the virus in vaginal fluid or semen.
3. Is sharing syringes the only way to get hepatitis C?
Though sharing syringes is the most likely way to spread hepatitis C it isn’t the only way. There are lots of ways to transmit infected blood when injecting with someone else, for example blood on fingers, spoons, tourniquets and so on.
Because hepatitis C is a blood-borne virus, anytime blood, even tiny amounts, is spread round there is a risk. The standard advice is not to share toothbrushes, nail scissors and clippers, or combs and hairbrushes because these things might transmit blood. However, many people are skeptical about the extent of the risk that these activities pose. Obviously you need to use common sense: for example if you’ve got bleeding gums, don’t share your toothbrush.
4. “I’ve had it and don’t have it anymore.” Is this possible?
There seems to be a lot of people with hepatitis C who believe they don’t have the virus anymore. It’s true that up to one in four people will spontaneously clear the virus but you’ll only know if you’re one of the lucky ones if you get a particular blood test. This test detects the presence of the virus, and you’ll need to get the test repeated six months later to make sure.
Some people who were tested in the early ‘90s, when not much was known about hepatitis C, were told after testing positive to an antibody test that they’d had the virus but don’t have it anymore.
5. Is it worth going onto treatment?
Hepatitis C treatment has improved dramatically over recent years. In the old days, when only interferon was available, success rates were pretty dismal. About 25% of people who went on it succeeded.
Today the interferon used is far better than before and has been combined with ribavirin (called combination therapy). Ribavirin stimulates the T cells in the body to fight the virus. Interferon attacks the virus by interfering with its ability to copy itself and spread throughout the body. The combination of ribavirin and interferon works by containing the virus and strengthening the body’s immune system.
The success of treatment is significantly influenced by the type of hepatitis C being treated. The common types in Australia are types 1a, 1b and 3. Types 1a and 1b are less responsive to treatment. About half the people who go onto treatment with types 1a and 1b succeed. The rate of success goes up to about 70% for people with type 3.
The other thing you would need to factor in when considering treatment is that the course of combination therapy is twice as long (48 weeks) for people with types 1a and 1b.