Hepatitis C Virus Infection
What is hepatitis C virus infection?
Hepatitis C is a disease of the liver caused by the hepatitis C virus (HCV). HCV infection is curable.
What are the symptoms?
Most people who have HCV infection feel well, have no symptoms, and may not know they have the disease. Some people may have a brief illness with symptoms around 6 weeks after being infected with HCV.
Symptoms of acute HCV infection may include:
- Loss of appetite
- Stomach pain
- Joint pain
- Dark urine
- Pale stools
- Nausea and vomiting
- Jaundice (yellow skin or eyes)
Most people will have no symptoms and may not know that they have the virus. People with HCV infection may feel tired, have a low mood or stomach pains. About 75% of people living with HCV infection will develop a chronic (lifelong) infection.
How common is hepatitis C virus infection?
In Canada, about 1 in every 100 people is living with HCV. The rate in B.C. is slightly higher.
There are about 2,300 new cases of HCV infection identified in B.C. each year. Most people will have had the infection for many years, but are just now being tested and newly diagnosed.
People who experience more HCV infection include:
- People who have ever injected drugs or shared drug use equipment
- People who have been in correctional facilities
- People who were born or lived in countries where HCV is common. It is common in Eastern Europe, Asia, Sub-Saharan Africa, North Africa, the Middle East, Australasia and Oceania
- People born between 1945 to 1975
- Indigenous people (First Nations, Métis and Inuit) have higher rates of HCV infection
- People who have received healthcare in a country where unsafe medical practices were used
- Received a blood transfusion, blood product or organ transplant before 1992 in Canada
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. The risk is estimated at less than 1 in 6.7 million donations for HCV.
How can I tell if I have hepatitis C virus infection?
After exposure to HCV, antibodies to the virus appear in your blood around 5-10 weeks later. You need a blood test to detect the antibodies. A positive HCV antibody test means that you have been infected with the virus at some point. You should get another blood test to determine if you still have the virus and are infectious to others.
About 1 in 4 people infected will naturally clear the virus from their body and recover; the other 75% will develop chronic infection. Over decades, around 15 to 25% of those with chronic HCV infection will develop significant liver disease including liver failure and liver cancer, and may need a liver transplant.
How is the hepatitis C virus spread?
Blood-to-blood contact with blood containing the virus spreads HCV infection. The infection may spread in the following ways:
- Sharing equipment for snorting, smoking or injection of drugs, 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 like semen or vaginal secretions. This risk increases if blood is present in these secretions.
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
- Healthy skin of others coming into contact with your body fluids such as saliva, urine, feces or vomit
If you have HCV infection, breast/chestfeeding is safe, unless your nipples and/or areola are cracked/bleeding. During this time, milk should be expressed and discarded. When your nipples are no longer cracked or bleeding, you can resume breast/chestfeeding your baby.
What should I do if I prick myself with a used needle?
If you prick yourself with a used 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
Is hepatitis C infection curable?
Yes. Hepatitis C infection is curable. BC PharmaCare covers newer, highly effective drugs to treat HCV. These drugs have few side effects and are easier to take than older medications (no injections). In 8 to 12 weeks, most patients are cured of their HCV infection.
If you have chronic HCV infection, you should see your health care provider regularly. During these visits, you may have physical exams and other tests (e.g. blood tests, Fibroscan® or ultrasound) to help see how your liver is functioning. You may also be referred to a specialist for further testing. Early treatment can prevent the infection from becoming a very serious liver disease.
To further prevent liver disease, you should stop alcohol use and take steps to avoid getting other infections that could affect the liver (e.g., human immunodeficiency virus (HIV), hepatitis B and hepatitis A).
If I have hepatitis C, can I be protected against other diseases?
Yes. You can get vaccines that protect you from hepatitis A, hepatitis B, pneumococcal disease and influenza. If you have HCV infection, you receive these vaccines for free. 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
- HealthLinkBC File #102a Understanding Harm Reduction: Substance Use
- HealthLinkBC File #102b Harm Reduction for Families and Caregivers
- HealthLinkBC File #118 Naloxone: Treating Opioid Overdose
For more information on hepatitis C, visit Hepatitis Education Canada https://hepatitiseducation.med.ubc.ca/