Hepatitis C

What is hepatitis C?
Hepatitis C is a viral infection, which causes inflammation of the liver. It is a major cause of serious liver disease, including cirrhosis and liver cancer.

How is hepatitis C spread?
Hepatitis C is spread by contact with the blood of an infected person. This may happen in different ways:

  • Sharing injecting needles and equipment (‘works’) with someone who is infected is the most likely way to get hepatitis C. Most injecting drug users in Ireland have been infected with hepatitis C.
  • Hepatitis C can also be spread by snorting cocaine
  • In the past, some people got hepatitis C from transfusions of blood and blood products. Since 1991, blood donations in Ireland are checked for hepatitis C. So you can’t get infected in this way any more.
  • There is a small risk that infected mothers can pass hepatitis C on to their babies before or during birth. There is a 1 in 20 chance of this happening. This is more likely to happen if the mother is also infected with HIV.
  • There is also a small risk of getting hepatitis C by having sex. This is more likely to happen if the person with hepatitis C also has HIV.

Other less common ways of getting hepatitis C include:

  • Tattooing and body piercing without proper sterilisation
  • Needle-stick injuries in health-care workers
  • Sharing personal items such as toothbrushes and razors with an infected person
  • Kidney dialysis and some surgical and dental treatments can lead to infection but this is very rare.

What is the incubation period for hepatitis C?
The incubation period (the time from infection to the onset of symptoms) is 2 weeks to 6 months, the average being 6-9 weeks.

What are the symptoms of hepatitis C?
Most people have no symptoms when they first get hepatitis C. A minority of people may lose their appetite, get a pain in their stomach, feel sick, vomit and get jaundice (yellow skin and eyes).

About one in four people with hepatitis C get fully better without any treatment. However, most people will carry the virus for many years, or even for the rest of their lives if they are not treated. This is known as ‘chronic’ hepatitis C infection. People with chronic infection may feel well for many years. Without treatment for hepatitis C, about one in five people with chronic infection develop cirrhosis (scarring) of the liver after 20-30 years. They may then suffer liver failure or cancer of the liver.

Where is hepatitis C a problem?
The World Health Organization estimates that 130-150 million people are chronically infected with hepatitis C worldwide. Ireland is considered a low prevalence country (0.5%-0.7% of the population infected). Many countries in Africa, Eastern Europe and East and South-East Asia have a high prevalence of hepatitis C.

How is an infection diagnosed?
Hepatitis C is diagnosed by a blood test. This test is usually done in two stages:
First, blood is tested for hepatitis C antibodies. If this is positive, then the person has had hepatitis C at some time.
A second test is then needed to see if they are still infected (that is, that the virus is still present).

  • If this is negative, then the person has had hepatitis C infection in the past but may no longer be infected
  • If the test is positive, the person still has hepatitis C.

Can hepatitis C be treated?
Yes. Treatment for hepatitis C has advanced significantly in recent years. Highly effective all-oral treatment with direct-acting antivirals is now available in Ireland. This treatment eradicates the hepatitis C virus in over 90% of cases and cures the infection. The HSE National Hepatitis C Treatment Programme has been established to ensure that persons living with hepatitis C in Ireland are given access to appropriate treatment options.

How can a person with hepatitis C infection protect others?
If you have hepatitis C, you can pass the infection onto someone else. To prevent this, you need to make sure that your blood is not in contact with other people.

  • Never share drug injecting equipment such as needles or syringes.
  • Never let anybody else use your razors, toothbrushes or any personal items that might have your blood on them.
  • There is a small risk that you can pass on hepatitis C during sex. Condoms reduce this risk. For more advice, talk to your doctor.
  • If you are female, don’t have sex during or straight after your period.
  • Cover open cuts and sores with a sticking plaster or bandage.
  • Clean all blood spills with paper towels. Then disinfect the area with a solution made up of 10 parts water and 1 part bleach. Dry the area with a clean paper towel.
  • Put blood-stained items such as tampons in a plastic bag, tie it at the top and put it in an outside rubbish bin.
  • Put used razors and needles in a special sharps bin. Keep it away from children.
  • Tell your family doctor and dentist that you have hepatitis C.

Hepatitis C cannot be spread by:
• Sneezing or coughing
• Kissing or hugging
• Breastfeeding
• Food or water
• Sharing dishes or glasses
• Casual contact (such as work).

Is hepatitis C a notifiable disease?
Hepatitis C is a notifiable disease under the Infectious Disease Regulations. All cases should be notified to the Medical Officer of Health, including those identified by laboratories and through STI screening programmes and GUM clinics. HPSC reports describing hepatitis C notifications are available here: http://www.hpsc.ie/A-Z/Hepatitis/HepatitisC/HepatitisCreports/

Is there a vaccine available for hepatitis C?
Currently there is no vaccine available for hepatitis C.

Who should be tested for hepatitis C?
National screening guidelines for hepatitis C were published by the Department of Health in July 2017. These contain detailed evidence-based recommendations on who should be tested for hepatitis C.
http://health.gov.ie/national-patient-safety-office/ncec/national-clinical-guidelines/prevention/

Other information:

Last updated: 17 January 2018