About hepatitis C

Prevention first! Drug users knit new livers with sterile needles.

Hepatitis C is a blood borne virus that affects the liver. The word hepatitis means inflammation or swelling of the liver. A blood borne virus is a virus that lives in blood and is passed on by sharing blood.

Hepatitis C transmission occurs when infected blood from one person enters another person’s bloodstream. The liver’s job is to cleanse the blood in the body and to help it absorb nutrients, so having an impaired liver can severely affect your general health and wellbeing.

Hepatitis C has had a huge impact on the injecting drug user community —it’s estimated that we make up about 90% of all people in Australia with the virus. With around 284,000 people in Australia who are currently hepatitis C positive (as at 2010) and around 10,000 new infections each year, the risk of contracting it through injecting drug use is high. About 89% of new infections occur through injecting drug use.

Unlike the HIV/AIDS virus, hepatitis C is relatively easy to contract and any particle of blood that gets on a spoon, swab, tourniquet or filter (and, of course, in used needles and syringes) that is transmitted to another person’s bloodstream puts that person at risk of contracting the virus. Not being able to see blood doesn’t mean it’s not there — transmission can occur through the tiniest of blood particles that are impossible for the eye to see.

Even when all the injecting equipment is new and sterile it is still possible to transmit hepatitis C to another user through, for example, making a filter with blood on the fingers or hands or putting a finger over another person’s injection site after holding their own first. Washing hands and arms really thoroughly before every shot can help, but the only way to be completely safe is to have your own injecting equipment and space and to mix up and inject for yourself. But in the real world, deals get split and often the fairest way to do it is in a spoon, so taking things slowly and following every step carefully and with new equipment can really reduce the risks of transmission.

While about 25% of people with hepatitis C will clear the virus within about two to six months, they will continue to carry antibodies which do not provide immunity against re-infection. The remaining 75% who do not clear the virus will have an ongoing or chronic infection which after 20 years will result in approximately 7% of those people developing cirrhosis of the liver. After 40 years, this figure jumps to 20% with cirrhosis of the liver, which means the liver is severely and irreversibly scarred.

There are a few different strains (genotypes) of the hepatitis C virus and some are harder to treat than others. A person with one strain of the virus can be infected with other strains. This means if you’re sharing with partners or friends, even if you both have the virus, you still risk being re-infected with another strain. This can add to your problems as each strain changes character slightly once it’s in the body and this makes it difficult for the body to fight it. Also, if you have more than one strain of the virus your liver comes under even more stress.

Because hep C doesn't always make people feel ill they often don't consider it a serious illness and may not address it, but because hep C can advance to cancer of the liver it is important that you are tested and that your doctor helps you to assess whether you might benefit from treatment and keep an eye on the progress of the virus. Testing is also important so that you do not pass on the virus to someone else unknowingly and can take precautions to prevent others being infected with hep C from contact with your blood.

A series of videos made by NUAA interviewing Prof Greg Dore, taking about current hepatitis C treatments in Pt 1, hep C treatment and drug use in Pt 2 and the future of hep C treatment in Pt 3.

Annie Madden, Executive Officer of AIVL, gave evidence to the House of Representatives Health Committee in April 2015. Here is her testimony and an interview with her about hep C and people who inject drugs.

Resources

Websites you might find useful

The Albion Centre provides multi-disciplinary clinical services for people living with HCV and HBV. (NOT confined to HIV positive clients). Albion has all the essential services on site to provide hepatitis care. Their website is now updated with relevant information.

Research and conference papers