Hepatitis C is a bloodborne infection that causes inflammation and damage to the liver and is a leading cause of liver cancer. It's caused by the hepatitis C virus (HCV) (WHO 2022; Hepatitis Australia 2020a).
Prior to March 2016, hepatitis C treatment in Australia involved weekly injections and oral medications that were known to bring on unwanted side effects and health complications. Today, however, chronic hepatitis C is curable with oral medications known as direct acting antivirals (DAAs), which have limited side effects and in most cases, only need to be taken for eight weeks (Mayo Clinic 2021; Health NSW 2019).
Prevalence of Hepatitis C
In 2020, over 115,000 people were estimated to be living with chronic hepatitis C in Australia (Hepatitis Australia 2022).
Globally, that number is close to 58,000,000 people (WHO 2022)
Rates of hepatitis C are disproportionately high in Aboriginal and Torres Strait Islander communities. Aboriginal and Torres Strait Islader Peoples make up 3% of the Australian population, yet, in 2015, they accounted for 16% of cases of chronic hepatitis C. This is related to a variety of social and cultural determinants of health, many of which are due to the ongoing effects of colonisation - in particular, over-incarceration, which places Aboriginal and Torres Strait Islander Peoples in prison environments where injecting equipment is commonly shared (Kirby Institute 2021; Hepatitis NSW 2019)
How is Hepatitis C Transmitted?
It’s a common misconception that hepatitis C can be transmitted by social contact such as kissing, hugging or sharing food. This is not the cause of hepatitis C transmission (Hepatitis Australia 2020a).
Transmission of hepatitis C in Australia occurs as a result of:
Coming into contact with non-sterile tattooing, body piercing and acupuncture instruments
During childbirth, from mother to infant, if the mother has high levels of the hepatitis C virus in her blood (there is about a 5% chance of this occuring)
Needle stick injuries and accidental exposure to infected blood or blood products in occupational settings
Through transfusion of infected blood or blood products in Australia before screening was introduced in 1990
Sharing personal items that have traces of blood on them such as razors, toothbrushes or floss
Through non-sterile medical and dental procedures, particularly in countries where hepatitis C is more common.
(Better Health Channel 2021; Hepatitis Australia 2020)
People can contract hepatitis C by coming into contact with non-sterile tattooing, body piercing and acupuncture instruments.
Types of Hepatitis C
Acute Hepatitis C
A person with acute hepatitis C will spontaneously recover without treatment
‘Acute’ in this context is defined as a period of hepatitis C that lasts for less than six months
Acute hepatitis C is usually asymptomatic
Between 15 and 45% of people with a HCV infection will experience acute hepatitis C.
(WHO 2022)
Chronic Hepatitis C
Chronic hepatitis means at the virus will stay in the liver indefinitely until cured
Without appropriate treatment, this may result in liver failure or liver cancer
Between 55 and 85% of people with hepatitis C will develop a chronic infection.
(WHO 2022)
Who is at Risk of Hepatitis C?
People who:
Work in healthcare and may be exposed to infected blood
Have injected drugs recently or in the past
Have spent time in prison
Had a blood transfusion or organ transplant prior to 1992
Have a mother with a hepatitis infection
Have HIV
Have a sexual partner who is HIV positive or lives with hepatitis C
Have been born, or have undergone medical procedures, in a country with high rates of hepatitis C
Have received a tattoo or piercing in unsafe, unclean circumstances
Have had blood-to-blood contact with another person.
(Health NSW 2019; Mayo Clinic 2021)
Hepatitis C Symptoms
Most cases of hepatitis C are asymptomatic.
Darkened urine
Pale or grey faeces
Yellowing of eyes and skin (jaundice)
Flu-like symptoms (fever, joint pain, general malaise, tiredness, soreness under ribs)
Abdominal pain
Decreased appetite
Nausea, possibly with vomiting.
(Health NSW 2019; WHO 2022)
Symptoms may appear between two weeks and six months following exposure to the virus, but most cases are asymptomatic (WHO 2022).
Unfortunately, people with chronic hepatitis C often do not experience symptoms until their liver is damaged, which in some cases takes years. For this reason, it’s vital that patients get tested for hepatitis C if they think they may have been exposed to the virus (Hepatitis Australia 2020b).
Hepatitis C Diagnosis
There are two different blood tests that can be used to diagnose hepatitis C. They are:
Hepatitis C antibody test: Can determine whether a person has ever had hepatitis C
Hepatitis C PCR (RNA) test: Can determine whether a person currently has hepatitis C, as well as their viral load.
(Better Health Channel 2021; Hepatitis Australia 2020c)
Hepatitis C Treatment
As of 1 March 2016, new medications have been introduced to treat chronic hepatitis C in Australia. These medications are called direct acting antivirals (DAAs). They:
Have a cure rate of over 95%
Have no or few side effects
Usually only need to be taken for 8 weeks (in most people), or for 24 weeks in certain instances
Safely disposing of found or used needles and syringes is a method of hepatitis C prevention.
Use sterile equipment
Avoid sharing any personal equipment that could draw blood (e.g. toothbrushes, razors, nail files or nail scissors)
Ensure that piercing instruments are clean (e.g. body piercing, tattooing, acupuncture or electrolysis instruments)
Practice safe-sex (using condoms, dental dams), as unprotected sex involving blood or damaged skin poses the highest risk
As a healthcare worker, follow infection control guidelines strictly, particularly when blood or body fluids are being handled
Safely dispose of found or used needles and syringes
Cover sores or open wounds with appropriate bandaids/bandages
Wear single-use gloves.
(Better Health Channel 2021; SA Health 2022; WHO 2022)
Conclusion
While there is no current vaccine for hepatitis C, new hepatitis C treatments are simple, safe and highly-effective with a cure rate of more than 95%. Treatment also has the added benefit of preventing transmission to others (Better Health Channel 2021).
New 