Hepatitis C

Facts on the Condition

General description including
types, causes, prevalence, signs and symptoms

It is estimated that over 250,000 Australians currently live with the hepatitis C virus.

Hepatitis C is a blood borne virus. It is one of several viruses that can cause inflammation of the liver. The virus was identified in 1989. Before that time it was called non-A/ non-B hepatitis It is a very slow-acting virus. Hepatitis C involves an initial acute phase of infection that may not be noticeable, because in many cases people do not feel sick. A large percentage of people infected with the virus will experience impaired quality of life. The variety and intensity of the symptoms vary widely. Many people will have symptoms that are uncomfortable and significantly affect the quality of life, while a smaller percentage of other people may not be as seriously affected. According to current estimates, only 3-5% of people infected may die through liver cancer or failure due to its complications.

The virus is transmitted through infected blood being entering into another person’s blood stream. Risk transmission factors are related to activities that involve this type of contact such as: sharing injecting equipment, transfusion of blood products before 1990, previous mass vaccination programmes in Europe and Asia, non-sterile medical or dental procedures, non-sterile tattooing and body-piercing, needlestick injuries and other accidental exposures where infected blood can transfer from the bloodstream of one person to another. The risk of transmission from mother to baby is relatively low (8%).

Symptoms can appear a long time after exposure to the virus (average of 15-20 years). Most common symptoms are bouts of extreme fatigue, pain in the liver region, flu-like symptoms, night sweats, nausea/indigestion, depression/mood swings, loss of appetite, itching and joint pain. Some people will present no symptoms, others will present some of the above symptoms but not necessarily all of them. It is important to note that the experience of the infection varies widely and people who are diagnosed with the infection face much uncertainty about its impact.

Treatments, including role of specialists,
effects of treatments, use of devices, daily routines

An antibody test has been available since 1990. A confirmatory PCR test is currently used to determine the presence or absence of the virus in the blood and the genotype of the virus. There are 10 different types of hepatitis C called genotypes
Currently there is no vaccine for hepatitis C nor is there one expected in the near future.

Since November 2003 the approved treatment for hepatitis C is a course of two drugs - called pegylated interferon and ribavirin. Treatment requires regular monitoring by a gastroenterologist and involves daily administration of tablets and a weekly injection. Its aim is to reduce the virus to a nondetectable level in the blood of the patient. Treatment success depends on the genotype. Genotype 2 and 3 have an 80 - 88 % SVR ( sustained viral response) and others have a 48 - 52% SVR. It is useful to be aware that the treatment is associated with some serious side effects for some individuals. Criteria need to be met in order to access this form of treatment free of charge under the Pharmaceutical Benefit Scheme. Some people prefer to choose complementary or alternative therapies, such as Traditional Chinese and Western Herbal Medicine to assist with managing the symptoms. Research on the effectiveness of these treatments is increasing with some specific herbs being identified with helpful properties.

While the role of general practitioners (GPs) is increasing in the management of hepatitis C, a referral from a GP to a gastroenterologist is usually required for specialist assessment. Complementary and/or alternative medicine practitioners also provide advice and support to people who choose to explore these forms of treatment. Counsellors have an important role in supporting people with the many issues that may arise at various stages of the infection.

Disclosure of hepatitis C is only legally required in a small number of situations:

• when giving blood to the blood bank
• when PCR+ and working as a health care worker who conducts “exposure prone procedures”
• when applying for some insurance policies which require the disclosure of any infections .