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Living > Public Health, Safety

Hepatitis C

What is Hepatitis C

Hepatitis C virus is a blood borne virus and one of several viruses that cause Hepatitis (inflammation of the liver). More than 110,000 people in Ontario are infected with the hepatitis C virus. Symptoms often do not appear for many years, and about 35,000 Ontarians do not realize they are infected. Research has shown that an average of 25% of individuals infected with Hepatitis C will clear the virus within 6 months of becoming infected. Those who do not clear the virus are at risk of developing cirrhosis (scarring of the liver) and liver cancer. This slow and silent virus can take 20-30 years to cause liver damage.

What are the symptoms?

Most people who become infected do not have symptoms. Six to seven weeks after exposure, some will develop fatigue, nausea, loss of appetite, jaundice (yellow skin and eyes) and dark urine. It is not unusual to experience ongoing fatigue. Symptoms may also develop very late in the course of the disease when liver damage has occurred.

How is it spread?

Hepatitis C is spread through direct contact with the blood of an infected person. Ten percent have no known risk factors. Sources of infection can include the following:

  • through drug-using equipment, including equipment used for injecting, snorting and smoking drugs
  • blood transfusions/products prior to 1992
    NOTE: Currently, all blood and blood products are carefully screened for Hepatitis C.

Less common ways in which hepatitis C can be transmitted:

  • From infected mother to baby, before or during birth
  • Sexual activity that includes contact with blood or the exchange of blood
  • Medical and dental treatment where non-sterile equipment is used
  • Tattooing, piercing or acupuncture with non-sterile equipment
  • Sharing razors, toothbrushes, tweezers, manicure or pedicure equipment such as nail clippers, which may be contaminated with infected blood

Reducing risk of transmission to others

  • Share information with health care workers, sexual contacts and household members so they can avoid contact with your blood. Testing household members is not considered necessary unless there was possible exposure
  • Do not share toothbrushes, razors, needles/drug paraphernalia and personal care items
  • Cover open wounds or cuts
  • Testing sexual partners is not considered necessary. Condoms should be used during the menstrual period of a woman who has Hepatitis C or with multiple sexual partners
  • Do not donate blood. Inform the Public Health Department if you donated blood or received blood products prior to 1992

If you had a blood transfusion or were treated with a blood product before 1992, you may have been infected by the hepatitis C virus. If so, you may be eligible for assistance. For more information, visit http://www.hepcontario.ca/en/blood.html for more detailed information.

How long is a person infectious?

Those individuals who do not clear the Hepatitis C virus (chronic form) are infectious for their lifetime.

How is it diagnosed?

The main test for Hepatitis C is an anti-HCV test. It detects the Hepatitis C virus (HCV) antibodies in the blood. These antibodies are produced in response to infection by the Hepatitis C virus. To determine if the virus has been cleared, another type of blood test called PCR RNA qualitative test can be ordered.

What is the treatment?

Some people may clear the virus with antiviral therapy. Those with persistently high liver ALT enzymes (sign of liver inflammation) should be referred to a specialist for possible treatment. A combination therapy of Interferon (by injection) and Ribavirin (in pill form), has a higher response rate than Interferon treatment alone. Length of treatment can vary from 6-12 months. The Trillium Drug Plan (application at local pharmacy) is available to defer cost. Liver transplant may be the treatment of choice if Hepatitis C is life threatening.

Protecting the liver from further harm

  • Seek ongoing medical care with blood work every 6-12 months to assess liver function
  • Avoid alcohol and smoking as it can accelerate liver damage
  • Maintain good nutrition and exercise
  • Consult your physician or pharmacist before taking over the counter medication as some remedies may be harmful to your liver (e.g.: high doses of Tylenol)
  • Determine Hepatitis A or B immunity. Hepatitis A and B vaccine can be obtained free of charge from your physician through the Public Health Department. (This does not apply to the Hepatitis A and B combination vaccine Twinrix)
  • Pneumococcal and Influenza vaccines are recommended for anyone with a chronic illness

Where can I go for help?

For further education, counselling and support, there are two organizations you can access to help manage your daily life effectively:

  • HEPATITIS C SOCIETY OF CANADA (Monthly meetings in Niagara) 1-800-652-4372
  • CANADIAN LIVER FOUNDATION 1-800-563-5483

For more information, contact the Public Health Department, Infectious Diseases Program, 905-688-8248 ext. 7330 or 1-888-505-6074 or visit Ontario's Hepatitis C site.

This information is intended to provide general health-related information about Hepatitis C. It is not intended to replace medical consultation by your physician and/or other health care professionals.

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