Facts about hepatitis C
Hepatitis C is a liver disease caused by infection with the hepatitis C virus (HCV). HCV can cause both acute and chronic hepatitis infection, ranging in severity from a mild illness that lasts only a few weeks to a serious, lifelong illness resulting in cirrhosis and liver cancer.
The virus is mainly acquired by contact through broken skin with infectious blood. In Europe, the main route of HCV transmission is via injecting drug use as a result of sharing contaminated needles. More rarely, the virus can be transmitted sexually, in healthcare settings due to inadequate infection control practices or perinatally from an infected mother to the baby.
A silent disease with no symptoms
Most people with acute HCV infection do not have any symptoms. Those who develop chronic infection are often asymptomatic until decades after infection when symptoms develop secondary to serious liver damage.
Around 30% of people with chronic hepatitis C suffer from liver damage and a small number of those develop cancer. Hepatitis C is considered to be one of the leading causes of liver cancer and liver transplants in Europe.
HCV: no vaccine but a cure
The infection can be cured, especially if it is detected and treated with the appropriate antiviral drug combinations. Antiviral treatment can now cure over 90% of persons with HCV infection.
In terms of prevention, there is currently no effective vaccine available against hepatitis C and the most effective preventive measures to reduce the risk of exposure to HCV include education, harm reduction programmes targeted towards people who inject drugs and the implementation of robust infection control practices in healthcare settings
Hepatitis C is a virus that is acquired through the blood. About a fifth of the people who get the virus (called “acute hepatitis C infection”) clear it from their bodies without needing treatment, and sometimes without getting any symptoms. If the infection lasts for longer than six months it is called “chronic hepatitis C infection” and treatment may be needed.
Most people with acute hepatitis C infection do not have any symptoms. Those who do can experience fatigue and jaundice (a yellowing of the skin and eye-balls). People who develop chronic hepatitis C also may never have any symptoms. Others may have no symptoms for many years. Those who develop symptoms tend to suffer general conditions like fatigue, nausea and abdominal discomfort. Around 30% of people with chronic hepatitis C develop liver damage (called cirrhosis) and a small number of those go on to get cancer.
Ways to catch hepatitis C
Hepatitis C is passed on through infected blood. Most people in Europe who get hepatitis C are injecting drug users who have caught the infection by sharing contaminated needles. Hepatitis C can also be passed on by tattooing, body piercing and acupuncture, if these are done in unsterile conditions.
Pregnant women with hepatitis C may pass the infection on to their babies.
In the past, blood transfusions could be a way of catching hepatitis C. Now, all blood donors should be screened and all blood products tested to stop this from happening. People on renal dialysis may be at higher risk.
People most at risk
Anyone can get hepatitis C if they have under-the-skin contact with contaminated blood. However, the main risk groups include injecting drug users, people who have received unscreened blood transfusions or products in the past, those on dialysis and babies born to hepatitis C infected mothers. There is a low risk of catching the infection by living in the same household as someone with hepatitis C and sharing items like toothbrushes, razors or hair clippers which could carry contaminated blood or by regular sexual contact with an infected person. Healthcare workers also have a low risk of getting the infection from accidents involving contaminated needles or other equipment.
The World Health Organisation (WHO) estimates around 3% of the world’s population have hepatitis C. There are low levels of the disease (less than 1%) in northern Europe, Canada and Australia; levels of around 1% in the USA and most of Europe; and higher levels (over 2%) in Africa, Latin America and Central and South-East Asia.
Hepatitis C is diagnosed by a blood test.
Having a test should be discussed with a primary care doctor before and after testing. People with severe or longer lasting disease should be seen and assessed by a liver specialist. Hepatitis C is treated by a combination of drugs for a specific period of time, although medical experts are still developing the best treatment and regimes may vary. Overall, treatment can successfully clear the virus in more than half the patients. People who develop serious liver disease may need a transplant.
How to avoid getting hepatitis C
People in the at-risk groups noted above should be regularly tested so they can be quickly diagnosed and treated if they catch hepatitis C. Precautions should be taken, especially in healthcare, tattooing, acupuncture and body piercing premises, to reduce the risk of coming in to contact with any blood in case it is infected.
Some countries routinely test pregnant women for hepatitis C so they can be treated and their babies protected if they have the infection.
Injecting drug users should receive education and help to support them in using clean needles, stop sharing equipment or quit injecting altogether.
There is no vaccination available against hepatitis C.
What to do if you have hepatitis C
People with hepatitis C do not need to be isolated. Alcohol consumption should be stopped or reduced. Infected people should not donate blood or carry an organ donor card. They can reduce the chances of passing the infection to others by not sharing needles, razors, toothbrushes. The need to test family members or other close contacts should be discussed with a healthcare professional.
EU case definitions
List of case definitions for reporting communicable diseases to the Community network under Decision No 2119/98/EC of the European Parliament and of the Council.