What is hepatitis C virus infection?
Hepatitis C is a disease of the liver caused by the hepatitis C virus (HCV).
What are the symptoms?
Most people who have HCV infection feel well, have no symptoms, and do not know they have the disease. Some people may have a brief illness with symptoms usually appearing 6 to 12 weeks after being exposed to the virus.
Symptoms of acute HCV infection may include:
- jaundice (yellow skin or eyes);
- stomach pain;
- joint pain;
- dark urine;
- pale stool;
- loss of appetite; and
- nausea and vomiting.
Approximately 75% of people infected with HCV will develop a chronic (long-term) infection. Most people will have no symptoms but those that do may experience tiredness, lack of energy, depression or digestive problems.
How common is hepatitis C virus infection?
In Canada, about 1 in every 100 people are living with HCV. The rate in B.C. is slightly higher.
Because HCV infection is often not symptomatic for a period of time, some people are living with the virus but do not know. There are about 2,500 new cases of HCV infection identified in B.C. each year.
People who are more vulnerable to HCV include:
- People who have used injection drugs or shared drug use equipment.
- People who have resided in correctional facilities.
- People who were born or lived in countries from regions where the hepatitis C virus is common (such as Eastern Europe, Asia, Sub-Saharan Africa, North Africa, the Middle East, Australasia and Oceania).
- First Nations and Indigenous people
- People born between 1950-1970
- People who received a blood transfusion or blood product before May 1992.
- People who received blood-derived coagulation products before July 1988, or intravenous immunoglobulin products prior to 1997.
- People who received an organ or tissue transplant before 1990.
All blood products and donors in Canada are now screened for HCV. The risk of infection from a blood transfusion or blood products is now very low, estimated at less than 1 in 500,000 units of blood donated.
There is a risk of getting HCV infection in countries where unsafe medical equipment is used, or in countries where blood is not screened for the virus.
How can I tell if I have hepatitis C virus infection?
After you are exposed to HCV, antibodies to the virus appear in your blood, which can be detected by a blood test. A positive antibody test means that you have been exposed to the virus at some point in time. Another blood test will then be done to determine if you are still living with the virus and are infectious to others.
About 1 in 4 people infected will naturally clear the virus from their body and recover, with the other 75% of people going on to live with a chronic infection. Approximately 15-25% of those who go on to have a chronic infection may develop significant liver disease.
How is the hepatitis C virus spread?
HCV infection is usually spread by blood-to-blood contact with blood containing the virus. Transmission may occur through the following:
- Sharing equipment for drug snorting, smoking or injection, such as needles and syringes, straws and pipes, with someone living with HCV.
- Exposure to blood and/or blood products, including receiving a transfusion of blood or a blood product in a country where the blood supply is not tested for HCV. In Canada, this applies to blood and blood products received before 1992.
- An accidental poke with a needle or syringe used by someone living with hepatitis C.
- From a mother to her baby before or during birth (about 5 per cent of the time).
- Skin-piercing events such as tattoos, body piercing, acupuncture or electrolysis, if the equipment is contaminated with the virus.
Other, less common ways HCV is spread is through:
- Sexual intercourse, especially if blood or open sores are present.
- Sharing toothbrushes, dental floss, razors, nail files or other items, which could have tiny amounts of blood on them.
There is a very low risk of spreading the virus through other body fluids, such as semen or vaginal secretions. The risk increases if blood is mixed in with these secretions.
At this time, there is no vaccine to prevent people from getting HCV infection.
How is hepatitis C virus not spread?
HCV is not known to be spread by the following:
- casual contact, such as in an office setting;
- coughing or sneezing;
- physical contact such as hugging and kissing;
- using the same dishes or cutlery;
- swimming in a chlorinated pool when you have cuts or scrapes or when you are menstruating;
- being bitten or stung by an insect, which then bites or stings someone else; or
- healthy skin of others coming into contact with your body fluids such as saliva, urine, feces or vomit.
Breastfeeding is not considered to be a risk for the spread of HCV. However, if a breastfeeding mother living with HCV has cracked or bleeding nipples (and/or surrounding areola), she should express and discard her breast milk until after they have healed, since the virus could be spread through blood.
Once a mother’s nipples are no longer cracked or bleeding, she may fully breastfeed her baby.
What should I do if I prick myself with a dirty needle?
If you prick yourself with a dirty needle, you can take these steps:
- If possible, keep the wounded area lower than your heart to promote bleeding.
- Wash the area well with soap and water.
- Go to the nearest hospital emergency department immediately for care.
What can I do if I have chronic hepatitis C infection?
People with chronic HCV infection should see their health care provider regularly, and they should have their blood tested to see how their liver is functioning. They may also be referred to a specialist for further testing and liver assessment. Assessment can prevent progression to very serious liver disease, including liver transplant or liver cancer. Reducing alcohol use can also prevent disease progression.
New drugs to treat HCV have recently been covered by BC PharmaCare with certain criteria. These drugs are less toxic, have fewer side effects and are easier to take than older treatments for HCV, and are highly effective. HCV treatments clear the virus from the body in about 12 weeks in most patients. Speak with your health care provider regarding treatment.
If I have hepatitis C, can I be protected against other diseases?
Yes. Vaccines that protect you from hepatitis A, hepatitis B, pneumococcal disease, and influenza are provided free to people living with HCV. You can get these vaccines from your local public health unit or health care provider.
For More Information
See the following HealthLinkBC Files for more information:
- HealthLinkBC File #12d Inactivated Influenza (Flu) Vaccine
- HealthLinkBC File #25a Hepatitis B Vaccine
- HealthLinkBC File #33 Hepatitis A Vaccine
- HealthLinkBC File #40b Living Well with Hepatitis C Virus Infection
- HealthLinkBC File #62b Pneumococcal Polysaccharide Vaccine
For more information on hepatitis C, visit:
- Hepatitis Education Canada hepatitiseducation.med.ubc.ca