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Hepatitis C

Facts on the Condition

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

It is estimated that around 210,000 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 others may not be as seriously affected. According to current estimates, only 3-5% of people infected may die through liver cancer or failure after 20 to 40+ years of infection.

The virus is transmitted through infected blood 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 in Australia,  unsterile mass vaccination programmes in  many countries, non-sterile medical or dental procedures, non-sterile tattooing and body-piercing, 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 (5%) while infection from a community needlestick injury is extremely rare.

Symptoms may appear a long time after  infection to the virus (average of 10-20 years). Most common symptoms are bouts of extreme fatigue,  flu-like symptoms, night sweats, nausea/indigestion, depression/mood swings, loss of appetite, itching, joint pain and pain in the liver region. 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. Severity of symptoms are not necessarily related to the extent of liver damage.

Complementary or alternative therapies, such as Traditional Chinese and Western Herbal Medicine are used by many people to assist with managing the symptoms of hepatitis C. Research on the effectiveness of these therapies is increasing with some specific herbs being identified as having helpful properties.

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 of a person as around 25% of people will clear the virus spontaneously within the first 6 to 12 months. A PCR test will also test for the genotype of the virus. As 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 health worker and involves daily administration of tablets and a weekly injection. Its aim is to reduce the virus to a non detectable level in the blood of the patient. Treatment success depends on the genotype. Genotype 2 and 3 have around 80% SVR ( sustained viral response) while genotypes 1 & 4  have a 48 – 52% SVR. It is useful to be aware that the treatment may be 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.

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
  • When applying to join the defense force or the secret service.

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