Hepatitis C

What is it?

  • Hepatitis C is a virus that causes inflammation of the liver.
  • Hepatitis C can lead to cirrhosis and liver cancer in chronic illness

How is it transmitted?

  • Most common form of transmission is blood to blood contact
  • Less common is vertical transmission – mother to baby

Activities which place people at risk

  • Sharing injecting and auxiliary injecting equipment
  • Tattooing and skin piercing with contaminated equipment
  • Sharing toothbrushes,   razors, and even combs

Short term effects

  • May present as mild, flu-like illness
  • Rare to experience an acute illness

Long term effects

  • 75% of people develop long-term illness and remain infectious to others

and if untreated can develop

  • Symptoms may be mild to severe and include fatigue, nausea, muscle pain, abdominal discomfort, and low mood

Prevention

  • No sharing of all injecting and auxiliary equipment
  • Ensure sterile equipment for tattooing and skin piercing
  • Follow Universal Precautions when managing body fluids
  • Avoid sharing toothbrushes, razors, and combs

Testing

  • Antibody test – This is the most common test. It checks if you have you ever been exposed to hepatitis C. It can take 6 weeks to 3 months before hepatitis C antibodies show up in a test after exposure. This test does not tell you if you have active virus.
  • PCR/RNA Test – There are 3 types.
  • Checks if you have active virus
  • Checks your viral load, and
  • Checks your genotype
  • Fibroscan – checks the stiffness of your liver, which provides indications of fibrosis and cirrhosis of the liver
  • Other less common tests include ultrasound, ALT levels and rarely these days, biopsy

Monitoring

  • Getting a periodic Fibroscan and/or ultrasound will allow you to monitor you liver health
  • If your liver health shows significant damage you may need to consider treatment

New treatments

New treatments for hep C, called DAAs (direct acting antiviral’s) became available from the 1 March 2016. The actual medicines are free but you will be charged the usual co-payment paid for a prescription.  From January 1, 2019, consumers pay up to $40.30 for most PBS medicines or $6.50 if you have a concession card. The Australian Government pays the remaining cost.  See the government’s PBS page for more information.

They are different to previous treatment in several ways:

  • Higher cure rate  95%, or more, for people who take them (even if you have cirrhosis)
  • Have minimal side-effects
  • Treatment only lasts 12 weeks (in most cases)
  • From one/two pills a day (no injections required).

Clearing hep C reduces liver inflammation and can help reverse fibrosis and even cirrhosis. Knowing that you are no longer hep C positive means you no longer have to worry about passing on the virus to someone else.

The easiest way to get onto treatment is to simply visit your GP or Prescriber and be  assessed for treatment. Being assessed involves full blood tests and assessment of liver damage (Fibroscan)

Those people who have advanced liver damage, such as cirrhosis, will be referred for treatment by a specialist (Liver Clinic)(this is because people who have cirrhosis also need long term monitoring for liver cancer even when they clear their hep C).

If you see your GP for treatment all you have to do is  take your prescription to a pharmacy. Not all Pharmacies will carry the drugs and will need to order them in for you after they ask for the prescription first .

New treatment for Hepatitis C

The new cures for hep C are different to the previous treatments that were available before 2016. Now around 95%, or more, of people who take them are cured, even if your hep C has resulted in liver cirrhosis.

The new cures for hep C include:

    • Epclusa (all genotypes and for 12 weeks)
    • Harvoni (genotype 1 and for 8 or 12 weeks)
    • Maviret (all genotypes and for 8 weeks)
    • Zepatier (genotypes 1 & 4 and for 12 weeks)

You can read more about the latest in treatment for hep C at Hepatitis NSW.

Information on Hepatitis C

Further reading

http://www.health.nsw.gov.au/hepatitis/Publications/HepatitisCStrategy.pdf

http://www.cdc.gov/hepatitis/hcv/index.htm

http://www.ashm.org.au/HCV

http://www.mhahs.org.au/

https://www.hepatitisaustralia.com/how-do-you-get-hep-c/

Hepatisis NSW

AIVL Be Blood Aware fact sheet

AIVL Liver First resource

AIVL Needs of People Living With HCV After leaving Custodial Settings