Hepatitis C is a chronic liver disease caused by the hepatitis C virus (HCV). An estimated 242,500 people in Canada are infected with HCV.
While not identified until 1989, the hepatitis C virus has been around for a very long time. Many infected people do not know they have the virus because for most, there will be no symptoms and for others, the symptoms may not show up for decades. During this time, they can spread the infection to others. You may not know you have this infection until damage has already been done to your liver. That's why you need to know if you're at risk.
It's important to keep your liver healthy because it does a lot of things for you. It helps digest food and also stores vitamins and minerals. But most important, the liver acts as a filter for chemicals and other substances that enter the body. It is also important in the manufacturing of your blood and many proteins.
If you think you may be at risk for hepatitis C, you should consult your health care provider who may recommend that you take a simple blood test to determine if you have the virus.
If you have a confirmed positive result, this means you have been infected with the virus at some point in time. It does not show whether your infection is new, how long you have had it, or if the infection is still present. Your health care provider may order a second blood test to confirm if you still have the virus and to find out how much of it is in your blood. Another test may also be done to determine the type of HCV you have.
A small number of people are able to get rid of the disease within six months. But when these people have a blood test, antibodies to HCV can show up. A second test is needed to find out if the virus is really there. In most cases, people with HCV infection do NOT get rid of it. They will have HCV infection for the rest of their lives. If you have hepatitis C, your health care provider may suggest you see a specialist who knows a lot about liver infections. He or she will discuss your options for treatment with you.
Because hepatitis C progresses slowly, most infected people experience no symptoms at all for many years after being infected. Therefore, they are unaware of their infection. This means that they may unknowingly spread HCV to others.
For those who experience symptoms, the most commonly reported include fatigue, lethargy, reduced appetite, sore muscles and joints, nausea, abdominal pain or jaundice.
In the majority of cases, hepatitis C progresses to a "chronic" stage which lasts for a long time. This can lead to “cirrhosis”, which causes severe damage to the liver. A small number of people may get liver cancer.
Most people infected with HCV show no symptoms. As such, they are unaware of their infection and may spread the hepatitis C virus unknowingly.
For those who experience symptoms, the most commonly reported ones include fatigue, lethargy, reduced appetite, sore muscles and joints, nausea and abdominal pain. Some people have a yellow look to the whites of their eyes and skin. This yellow look is called jaundice.
Currently, there is no licensed vaccine for the prevention of HCV infection.
The hepatitis C virus (HCV) is spread through contact with infected blood. This can happen if you:
Hepatitis C is NOT spread by casual contact, such as hugging, kissing or shaking hands, or by being around someone who is sneezing or coughing. The virus is not found in food or water.
The best way to keep yourself safe from hepatitis C infection is to take the following precautions:
If you live or work with someone who has hepatitis C, you will NOT get the disease from day-to-day contact. To get hepatitis C, you must share blood with a person who is infected with HCV.
Although HCV is not a sexually transmitted infection (STI), transmission can occur during unprotected sexual contact if the sexual activity involves blood to blood contact. In general, longstanding sexual partners need to be informed that although the risk of HCV transmission sexually is very low, it is not absent. Long-term monogamous couples should decide for themselves about routine condom/dental dam use.
People with multiple sexual partners should always practice safer sex, not only to protect themselves against HCV infection but to prevent getting STIs. Studies show that having multiple sex partners and being infected with HIV may increase the risk of hepatitis C infection.
Hepatitis C virus has not been shown to be transmitted by mosquitoes or any arthropods.
Recent studies suggest that HCV may survive on environmental surfaces at room temperature at least 16 hours, but no longer than 4 days.
There is no risk of transmission from sharing a hot tub with an infected person. Transmission of hepatitis C virus occurs through blood-to-blood contact. Both the infected person and the person sharing the hot tub would have to have open, bleeding wounds in order to allow for the possibility of transmission.
That being said, people infected with the virus should not share hot tubs if they have open wounds.
There is still a theoretical risk of transmission through manicure/pedicure equipment- essentially any item which might have infected blood on it. To date, there have been no reported cases of transmission from sharing pedicure or manicure equipment.
Still, all instruments used for foot and/or hand care should be cleaned followed by sterilization with steam under pressure, or dry heat, 6-25 percent hydrogen peroxide, peracetic acid, chlorine dioxide, or 6-8 percent formaldehyde. All items in contact with the blood stream, non-intact skin or membranes must be sterilized.
There is no risk of transmission from sharing exercise equipment, unless infected blood is on the equipment. If there is blood on the equipment, it should be cleaned off using proper infection control procedures. The hepatitis C virus is not transmitted through sweat.
The risk of hepatitis C infection can be significantly reduced by implementing infection control guidelines suitable for the specific workplace.
Infection control precautions are the first line of defense to protect workers from this virus and other blood-borne infections.
Originally developed for hospitals, universal precautions have been adapted to a wide range of workplaces. They apply to all situations where workers have risk of exposure to blood or certain body fluids.
Also, please refer to :Canadian Centre for Occupational Health and Safety (External link)
Avoid or limit alcohol consumption
There is no licensed vaccine to prevent infection with the hepatitis C virus. However, effective treatment involving a combination of medications is available. The effectiveness of the treatment depends on a variety of factors. Talk to your health care provider to see if treatment is right for you.
To prevent further damage to your liver, your health care provider may advise you to be vaccinated against hepatitis A and hepatitis B. Many provinces and territories provide these vaccinations at no direct cost to you.
If you have hepatitis C, you may infect others. To prevent spreading the virus:
Follow safer sex practices. In non-monogamous sexual relationships and for new sexual partners - use condoms/dental dams to protect yourself against potential exposure to blood. The risk of sexual transmission of HCV is low but not absent, particularly for those with more than one sex partner, if there is a concurrent sexually transmitted infection with open sores present or, during menstruation. Â In general, couples who only have sex with each other should be informed that the risk of hepatitis C being sexually transmitted is minimal but not absent.
There does not appear to be an increased risk of complications in pregnancy when a woman is infected with hepatitis C virus. Routine obstetrical care is recommended.
Yes, they can. Some studies show that, in general, between four to seven women out of 100 who have HCV might pass it to their babies at the time of birth. The risk of transmission from mother to child may reach 36 percent in mothers who have a larger quantity of the hepatitis C virus in their blood and in those who are also infected with HIV
Despite the fact that hepatitis C antibodies have been detected in colostrum and breastmilk, no case of transmission through breastmilk has been reported, and as such, breastfeeding is not considered a risk. Studies show that the chance of passing HCV from mother to baby during breastfeeding is highly unlikely. However, if the nipples are bleeding or cracked, it is recommended that breastfeeding be suspended until they have healed, since transmission can occur through blood.
You may need to make some changes in your life. You should:
The hepatitis C virus is NOT spread by casual contact, such as hugging, kissing or shaking hands, or by being around someone who is sneezing or coughing. HCV is not transmitted through food or water. If household members have shared items such as toothbrushes or razors, which pose a risk of blood contamination, then HCV testing of other members in the household should be considered. It is important to avoid sharing personal hygiene items
For those whose hepatitis C infection is more advanced, drug treatment may be appropriate and must be administered after careful assessment by your health care provider. Currently, the available treatment is a combination of antiviral medications. The effectiveness of treatment depends on a variety of factors.
New medications are being developed. Herbal treatments may not be particularly helpful for treatment of hepatitis C. Research is urgently required in this area
The popularity of natural health products has been on the rise in recent years, as people take a more active role in their own health.
Although some products have been touted as possible treatments for the hepatitis C virus, many other products have proven detrimental or harmful to those with any liver disease. Other natural health products interact with conventional medications, and can decrease or change the effectiveness of the drug. As such, persons infected with HCV should consult with their health care provider before using any natural health product. To date, no natural health product has been proven safe and effective for treating hepatitis C infection.
A liver transplant is not considered until the person experiences liver failure. The success rate of transplantation is at least 80 percent, but infection to the liver with hepatitis C will recur. Having a liver transplant also means that you will likely need to take medication for the rest of your life to prevent your body from rejecting the transplanted liver. A health care provider who specializes in liver diseases can provide you with more information.
It is difficult to predict as each individual is different. Approximately 15 to 25 percent of people infected with HCV appear to clear or resolve their infection without treatment. The majority (75 to 85 percent) progress to chronic infection. The course of the chronic disease is generally slow, without symptoms for two or more decades after infection. However, once symptoms develop, the quality of life generally decreases, with chronic fatigue, abdominal pain, and nausea being the main symptoms.
The hepatitis C virus attacks the liver, which causes inflammation. This inflammation causes scarring of the liver (called fibrosis), which in turn affects how the liver functions. The scarring caused to the liver can progress into cirrhosis, and makes the liver more susceptible to cancer. Approximately 10 to 20 percent of infected persons may develop cirrhosis after 20 years. It is difficult to predict when and how quickly the damage will occur in each person, and several factors can compound the damage, such as HIV co-infection, alcohol use, and infection after the age of 40 years.
When a health care provider prescribes treatment for a person infected with the hepatitis C virus, one of the goals is to reduce the person’s viral load (the amount of the virus present in the blood) to undetectable. If there is no measurable virus repeatedly in these people, they are considered to be “sustained viral responders”. Should treated individuals continue to be virus-free after repeat blood tests after two, three, five, and eight or more years, then specialists consider these people to be cured of hepatitis C virus.