Hepatitis C (HCV)

Hepatitis is an inflammation of the liver. This can be caused by alcohol and some drugs, but usually it is the result of a viral infection. There are many types of the virus which can cause hepatitis. Each of these viruses acts differently.

The virus can be spread in the following ways:

• By sharing contaminated needles or other drug-injecting equipment. If you have ever shared drug-injecting equipment, you may want to be tested for Hepatitis C virus (HCV).
• By using non-sterilised equipment for tattooing, acupuncture or body piercing.
• By unprotected penetrative sex with someone who is infected. Also by sex which draws blood with someone who is infected. This is not a common way of becoming infected with HCV.
• On very rare occasions, from an infected mother to her baby during birth. The risk may also be greater if the mother is also HIV positive.
• Through a blood transfusion in a country where blood is not tested for HCV.

Signs and symptoms – what to look out for

People may have no symptoms at all, but they can still pass on the virus to others. Symptoms may include:

• A short, mild flu-like illness.
• Nausea and vomiting.
• Diarrhoea.
• Loss of appetite.
• Weight loss.
• Jaundice – yellow skin and whites of eyes, darker yellow urine and pale faeces (poo).
• Itchy skin.
• Some people may need to be admitted to hospital.

Current evidence suggests that only about 20% of people infected with HCV will clear the virus whilst about 80% will remain infected and can pass the virus on. If a person continues to be infected over a number of years with HCV, they could develop the following complications:

• Chronic hepatitis.
• Liver cirrhosis.
• Liver cancer.

The tests for HCV

Your GP or medical specialist at the GUM/sexual health clinic can diagnose HCV by carrying out blood tests. You will be asked questions to try to discover the source of infection.

What does a POSITIVE result mean?

It means that you may be a carrier of HCV and can pass it on to others.

The first test will be a test for antibodies to HCV if this test is positive; it means you have been exposed to HCV. This test does not indicate whether or not you are still infected, you will need a second blood test to find this out.

What does a NEGATIVE result mean?

This result means you have never come into contact with HCV. The tests only rely on detection of antibodies to HCV, and the antibodies can take up to 9 months to develop.
There is no vaccine against HCV.

Follow-up

• If you are diagnosed as having an active infection you will be advised to have regular blood tests and check-ups.
• If you are infected with HCV, you should limit the amount of alcohol you drink. You may also be given some dietary advice.
• Transmission of HCV by penetrative sex does occur, although not common.
• If you are infected it is advisable to use a condom for penetrative sex to ensure that you do not pass on the virus to your partner(s).
• If you have Hepatitis C, you should use a condom for penetrative sex to prevent passing on the virus.
• If you have partner they should also be immunised.

Remember, using condoms can reduce your risk of getting or passing on sexually transmitted infections.

What next?

• Your own GP.
• Your local NHS GUM/Sexual Health Clinic – you will get free confidential advice and treatment here.
• A hospital A&E Department.