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Hepatitis C: Your Questions Answered

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Contents

What is hepatitis C?
How could I get hepatitis C?
What are the symptoms?
How might the virus affect me in the long term?
How do I know if I have the virus?
Where can I get a test?
What if the test result is positive?
Is treatment available?
How can I help myself?
What if the test result is negative?
How can I avoid becoming infected or passing on the virus to others?
Information and support

What is hepatitis C?

HEPATITIS C IS A VIRUS THAT CAN DAMAGE THE LIVER. UNLIKE HEPATITIS A AND B, THERE IS NO VACCINE TO PROTECT AGAINST HEPATITIS C.

How could I get hepatitis C?

HEPATITIS C VIRUS IS CARRIED IN THE BLOOD AND HAS BEEN DETECTED IN OTHER BODY FLUIDS. BUT BLOOD IS THE MAIN SOURCE OF INFECTION. THE VIRUS IS MAINLY SPREAD THROUGH CONTACT WITH THE BLOOD OF A PERSON WHO HAS HEPATITIS C. YOU CAN'T CATCH IT THROUGH EVERYDAY CONTACT SUCH AS HOLDING HANDS, HUGGING OR KISSING, OR THROUGH SHARING TOILETS, CROCKERY AND KITCHEN UTENSILS.

Hepatitis C is passed on by:

• Sharing equipment for injecting drugs, even if you did this only once or twice or a long time ago. Needles and syringes are the greatest risk but spoons, water and filters could also carry infection.

• Blood or blood products prior to September 1991. Prior to the introduction of screening of all blood donations in September 1999, there was a risk to recipients of blood. A heat treatment process to protect blood clotting factors (used in the treatment of haemophilia) against hepatitis C and other viruses was introduced in the mid-1980s (treated Factor IX available in 1985 and Factor VIII in 1987). There is a high prevalence of hepatitis C in people with haemophilia who received untreated clotting factors before these dates.

LESS COMMONLY, HEPATITIS C CAN BE PASSED ON BY:

• a hepatitis C positive mother to her baby, before or during birth;

• unprotected sex (without a condom) with someone who has the virus;

• medical and dental treatment abroad where unsterile equipment may be used;

• tattooing, ear piercing, body piercing or acupuncture with unsterile equipment;

• sharing razors or toothbrushes contaminated with blood from someone who has the virus.

See your doctor or nurse if you think you could have been in contact with the virus in any of these ways.

What are the symptoms?

MANY PEOPLE WHO HAVE THE HEPATITIS C VIRUS HAVE NO SIGNS OR SYMPTOMS AT ALL - FOR YEARS OR EVEN DECADES. BUT EVEN WITHOUT SYMPTOMS YOU CAN STILL PASS THE VIRUS ON TO OTHERS.

Symptoms, though not common, may include:

• muscle aches and a high temperature

• mild to severe fatigue

• nausea

• loss of appetite

• weight loss

• depression or anxiety

• pain or discomfort in the area of the liver (right side of the stomach)

• mild jaundice (yellowing of the skin and whites of eyes)

• poor memory or concentration

• alcohol intolerance.

How might the virus affect me in the long term?

AROUND ONE IN FIVE PEOPLE WHO BECOME INFECTED WITH HEPATITIS C WILL CLEAR THE VIRUS NATURALLY. HOWEVER, MOST PEOPLE WHO BECOME INFECTED REMAIN SO FOR A VERY LONG TIME. THIS MAY AFFECT THEM IN DIFFERENT WAYS:

• Some people can remain well throughout their life.

• Some people experience a range of symptoms (see What are the symptoms? Previous page).

• About one in five people will develop severe liver damage (cirrhosis) after about 20 years.

• In some people, cirrhosis can lead to liver cancer or complete liver failure.

How do I know if I have the virus?

If you think you could have been in contact with the hepatitis C virus at any time in the past, you can have a simple blood test to find out if you may have been infected.

Where can I get a test?

Your doctor will be able to carry out tests for hepatitis C. Local drug agencies and sexual health/GUM (genito urinary medicine) clinics may also offer testing. (See information and support at the end of this booklet for details on how to contact these services.)

What if the test result is positive?

An initial blood test (an antibody test) will tell you whether you have been infected with the virus at any stage in the past. Some people will clear the virus but will still have a positive antibody test. However, this test will not tell you if you still have the virus. You can have a test (the PCR Test) to see if you still have the virus and be referred to a specialist to see how it is affecting your liver.

Is treatment available?

Treatments for hepatitis C are improving all the time. A form of drug therapy is available that can clear the virus in about half of those treated. Your doctor and specialist will discuss with you whether treatment is appropriate.

How can I help myself?

If you are infected with hepatitis C, the most important thing you can do to minimise damage to your liver is to limit the amount of alcohol you drink to less than 21 units per week, or to cut out alcohol altogether.

What if the test result is negative?

This probably means that you have never been in contact with the hepatitis C virus. However, it can take up to six months for your body to react to the virus, so the test may not be positive if you have been infected recently. Your doctor may advise you to have a second test.

How can I avoid becoming infected or passing on the virus to others?

• If you inject drugs, NEVER share or pass on drug injecting equipment. This includes needles, syringes, spoons, water, filters or anything else that might be contaminated with blood. Contact the Executive's 'Know the Score' drugs website - www.knowthescore.info - for details of drugs services in your area and safer injecting advice or its telephone helpline on - 0800 587 5879.

• If you are considering having ear piercing, body piercing, a tattoo or acupuncture, check that equipment such as needles and ink pots are not being re-used and are sterile.

• If your sexual partner has hepatitis C, there is a small risk that it could be passed on to you during sex. Condoms minimise the risk. Using condoms will also help to protect you against unwanted pregnancy, HIV and many other sexually transmitted infections.

• Avoid sharing any toiletry equipment that could have been contaminated with blood, for example razors, toothbrushes, nail scissors, tweezers.

Information and support

If you have any worries or questions, you can talk to your doctor or nurse.

• The British Liver Trust (BLT) provides information on all forms of liver disease. Hepatitis C and Hepatitis C and injecting drug use, are leaflets available free from the BLT by sending a stamped, self-addressed envelope to: The British Liver Trust, Ransomes Europark, Ipswich IP3 9QG or they can be downloaded from their website: www.britishlivertrust.org.uk Tel: 01473 276 326 E-mail: info@britishlivertrust.org.uk
  The Trust will also be able to refer you to local support organisations in your area.

• The Children's Liver Disease Foundation specialises in supporting children with liver disease. Children's Liver Foundation,
  36 Great Charles Street, Birmingham B3 3YJ Tel: 0121 212 3839
  E-mail: info@childliverdisease.org
  Website: www.childliverdisease.org

• The Haemophilia Society provides information and support for young people living with or affected by haemophilia who are concerned about hepatitis C.
  Freephone helpline: 0800 018 6068
  Mon to Fri, 9am to 5pm Fax: 020 7387 8220
  E-mail: info@haemophilia.org.uk
  Website: www.haemophilia.org.uk

• The NHSScotland leaflet - Hepatitis C Your Questions Answered - is available free from your doctor or local Public Health Department or direct from the Executive's Public Health Division (by faxing 0131 244 2157).

• The 'Know the Score' Drugs Helpline provides confidential information and advice to drug users and anyone concerned about drugs - 0800 587 5879

• You can also contact your local Public Health Department who will be able to direct you to the right services in your area.

• Drinkline provides confidential information and advice about sensible drinking - 0800 917 82 82. They can put you in touch with your local alcohol advice centre where help is available on a one-to-one basis.

Information is also available by calling the NHS helpline on freephone 0800 22 44 88 (minicom 0800 31 71 60)
Lines open 7 days, 8am to 10pm