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Hepatitis C

A Curable Infection That Requires Early Detection

Hepatitis C was once a lifelong condition - now it can be cured in over 95% of cases with 8-12 weeks of treatment. Many people don't know they're infected. Testing is the first step to cure.

What is Hepatitis C?

Hepatitis C is a blood-borne viral infection primarily affecting the liver. Unlike Hepatitis A and B, there is no vaccine, but revolutionary direct-acting antiviral medications now cure over 95% of infections. Without treatment, chronic Hepatitis C can lead to serious liver disease over decades. Early detection through testing is crucial as most people have no symptoms until liver damage occurs.

Symptoms

  • 70-80% have no symptoms for years
  • Fatigue
  • Mild abdominal discomfort
  • Loss of appetite
  • Nausea
  • Muscle and joint pain
  • Jaundice (in acute phase, if symptomatic)
  • Later symptoms indicate liver damage: easy bruising, confusion, fluid retention

Causes

  • Sharing needles or drug preparation equipment
  • Blood transfusion before 1991 (when screening began)
  • Needlestick injuries
  • Mother-to-baby transmission (5% risk)
  • Unsterile tattooing or piercing
  • Sharing razors or toothbrushes with blood
  • Sexual transmission (lower risk, higher in HIV+ MSM)
  • Chemsex and rough sexual practices

Who Is at Risk?

  • People who inject or have injected drugs (even once)
  • People who received blood products before 1991
  • People with HIV, especially MSM
  • People who engage in chemsex
  • Healthcare workers with needlestick exposure
  • Children of Hepatitis C positive mothers
  • People with tattoos from unregulated settings
  • People from high-prevalence countries
  • Prisoners (current or former)

Potential Complications

  • Chronic infection (75-85% of those infected)
  • Liver fibrosis and cirrhosis
  • Liver cancer
  • Liver failure requiring transplant
  • Cryoglobulinaemia (blood vessel inflammation)
  • Kidney disease
  • Type 2 diabetes increased risk
  • Faster progression if co-infected with HIV or drinking alcohol

How We Diagnose

Testing involves an antibody test first - if positive, a PCR test confirms active infection by detecting viral RNA. We can also determine the genotype (virus type) which may guide treatment. Liver assessment through blood tests or FibroScan helps evaluate any existing damage. All HIV-positive individuals and those at risk should be tested regularly.

Treatment Options

Hepatitis C is now curable with direct-acting antivirals (DAAs) such as sofosbuvir/velpatasvir or glecaprevir/pibrentasvir. Treatment typically lasts 8-12 weeks with cure rates over 95%. Treatment is well-tolerated with few side effects. Post-treatment, you'll need a test to confirm the virus has cleared. Reinfection is possible, so risk reduction remains important.

Prevention

Never share needles, syringes, or drug equipment
Use new equipment for each injection
Ensure sterile equipment for tattoos/piercings
Don't share razors or toothbrushes
Use condoms, especially for anal sex
PrEP users should test regularly for Hepatitis C
No vaccine available - prevention is key
Treat and cure to prevent transmission

Frequently Asked Questions

Is Hepatitis C really curable?

Yes. Direct-acting antiviral medications cure over 95% of people with Hepatitis C. Treatment usually takes just 8-12 weeks with tablets. This is a medical breakthrough - until 2014, treatment was much less effective and had severe side effects. Now, cure is the expected outcome.

Is Hepatitis C sexually transmitted?

Sexual transmission is possible but less efficient than blood-borne transmission. Risk is higher for men who have sex with men, especially those with HIV, during rough sex, chemsex, or fisting. Heterosexual transmission between monogamous partners is rare but not zero.

Should I be tested for Hepatitis C?

Yes if you've ever injected drugs (even once, years ago), received blood products before 1991, are HIV positive, engage in chemsex, have had an accidental needlestick, or have unexplained liver problems. When in doubt, test - it's a simple blood test.

Can I get Hepatitis C again after being cured?

Yes, being cured doesn't provide immunity. If you continue behaviours that risk exposure, reinfection is possible. However, reinfection can also be cured. Regular testing is recommended if you remain at risk. Harm reduction strategies help prevent reinfection.

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