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Module 3 - Hepatitis C

Hepatitis C (knows as HCV) is usually spread when a person comes into contact with blood from an infected person.

HCV can be transmitted through:

  • Sharing needles and injecting equipment
  • Tattooing, body piercing or medical procedures with unsterilised equipment
  • Sharing toothbrushes, razors or nail files
  • Childbirth – there is a 5% chance that a baby can contract hep C from their mum during childbirth.

What happens if someone contracts hepatitis C?

Hepatitis C can lead to chronic illness in 75% of people exposed.

People with hep C often do not have any symptoms and often dismiss symptoms as just part of getting older.

If someone does contract hepatitis C, the body’s immune system will try and fight the virus. There are 2 possible outcomes: people can either get an acute or chronic illness.

  • Acute hepatitis C means the virus might make people sick for a short time but they will improve. About 25% of people only get acute hepatitis C because their body manages to clear the virus. However, if the virus stays in the liver for more than 6 months, then it will develop into chronic hepatitis C.
  • Chronic hepatitis C means the virus stays in the liver for the whole of a person’s life unless they get cured. People may not always feel sick, but the virus will continue to cause problems for the liver.

There is no vaccine for hep C; however, people with chronic hepatitis C can be cured with direct-acting antiviral (DAA) medicines.

Without treatment, hep C can cause liver disease and cancer.

New medicines provide a 97% chance of cure. Other genotypes (strains of the virus) can be more difficult to treat and can require combinations of medicine.

Please note, cure is defined as having no presence of the virus immediately after therapy and for 12 weeks afterwards.

Blood tests to diagnose hepatitis C

The only way to know if someone has hep C is to have a blood test.

Tests for hepatitis C are not part of regular blood tests – people have to ask, but they are free for people with a Medicare card.

2 types of blood tests for hepatitis C:

  • Hepatitis C antibody test – This test shows if a person has been exposed to the hep C virus. If the test comes back positive for hep C, the person has previously been exposed, or currently has, hep C.
  • Hepatitis C RNA test – This test shows if a person currently has hep C. If the test comes back positive for hep C, the person will need to speak with their GP about getting cured.

Treatment and Cure

If 100 people are infected with hepatitis C, about 25% will clear the virus completely in 2 to 6 months, but will continue to have hep C antibodies in their blood.

The remaining 75 people, who do not clear the virus, will develop an ongoing or chronic hepatitis C infection and are at risk of developing cirrhosis of the liver.

 

Where can people get treatment?

GPs can now prescribe medications but they may ask for advice from a specialist if they do not have a lot of experience treating hepatitis C.

In some cases, people will need to see a specialist to get treatment because of other health problems.

GPs may refer to a specialist if people:

  • Also have another blood borne virus, such as hepatitis B or HIV
  • Have previously had failed DAA treatment for hep C
  • Have end stage renal (kidney) disease
  • Have cirrhosis (severe liver scarring).
Who can get cured?

Anyone over the age of 15 with a Medicare card can get the medicines at low cost.

 

How will people know if they have been cured?

Treatment is now more than 97% effective at curing hepatitis C.

Being cured of hepatitis C means that treatment has worked, and people no longer have the hepatitis C virus. To check this, a doctor will order an RNA test 12 weeks after treatment and if the results show ‘virus undetectable’ (no virus) this means that it has been cured. It is important to have this final test and not assume people are cured until the results confirm it.

If the hep C is not cured, the doctor may recommend a second course of treatment, usually with different medicines.

Please note, people can contract hepatitis C again, but they can also be cured again.

How to treat hepatitis C

Full disclosure

People are required by law to disclose they have hep C ONLY in the following circumstances:

  • When giving blood, donating organs or bodily fluids
  • Healthcare workers conducting exposure-prone procedures, you may be required to notify your employer
  • Some insurance policies require disclosure
  • If joining the Australian Defence Force.

Viral hepatitis still causes deaths

  • In 2019, there were 1,023 deaths attributed to hep B and 1,078 attributed to hep C.
  • Hepatitis viruses cause more deaths than HIV/AIDS or tuberculosis.
These deaths are preventable now there is a cure available for hep C and treatment available for hep B.

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