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Everything You Need To Know About Hepatitis C

You've probably heard of it - but what is it and are you at risk?

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1. What is Hepatitis?

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Hepatitis literally means “inflammation (swelling) of the liver.” Loads of things can cause Hepatitis, including viral infections (known as viral hepatitis), excess alcohol and certain prescription/non-prescription drugs.

Some types of hepatitis will get better by themselves, whilst others may cause permanent damage to the liver and even death.

2. What is Viral Hepatitis?


This is a group of viruses, the most common of which are Hepatitis A, B and C.

All are diagnosed via a blood test. The global death toll from Viral Hepatitis exceeds that of HIV, Malaria and Tuberculosis (TB) - but most people still know very little about it.

3. And Hepatitis C..?


Hepatitis C or "Hep C" is more common in certain areas of the world, e.g. Africa and the Middle East. But even in the UK, more than 200,000 people have chronic (long-term) infection with the virus. It's spread via blood contact, in several ways.

4. So how do you actually get it?


Hep C is most commonly passed on by:

- Sharing needles, e.g. to inject drugs (“slamming”) or via unclean tattooing equipment

- Sharing straws to snort drugs, e.g. cocaine

- Sharing razors and toothbrushes

- From mother to baby in the womb

5. What about sex?


Catching Hep C through sex is rare, particularly if you are in a monogamous, heterosexual relationship and are HIV-negative.

It's more common if you're HIV-positive, particularly if you're a man who has sex with men (MSM), if you have “traumatic” anal sex (such as fisting), or if you're carrying another STI (like Gonorrhoea).

Other things that make you more likely to contract Hep C are if you have group sex, share lube or sex toys or use drugs whilst having sex (Chemsex). It's also seen more in 'serosorting' (when HIV positive people choose sexual partners who are HIV positive too).

6. How is it diagnosed?


Hep C is diagnosed by a blood test. You may be offered a blood test if you:

- Have injected drugs

- Have had sex with someone with Hep C

- Are HIV-positive

- Are from an area of the world where Hep C is more common

- Are a sex worker

- Have liver disease

- Received a blood transfusion pre-1990

- Have a tattoo

- Are an alcoholic

- Are an ex-prisoner

7. What are the symptoms?


Over half of adults with Hep C have no symptoms and don’t even realise they've been infected. This means many people are unaware they carry the virus until the disease is severe.

If you do get symptoms, they can take up to 5 months to show. They include:

- Feeling tired and generally unwell

- Muscle aches

- Abdominal pain

- Jaundice (yellowing of the eyes and skin and itchy skin)

- Very pale poo

- Dark urine

8. How is it treated?


In some people, Hep C clears up by itself, causing no permanent damage. However, if it stays in the body for over 6 months this is “Chronic Hep C.”

Chronic Hep C is curable. Newer treatment known as Direct Acting Anti-Viral Drugs (DAAs) have recently become available. They can be super effective with just three months treatment and have fewer side-effects than previous medications.

9. Amazing! Can anyone get DAAs?

The main issue with DAAs is their high cost, which is posing a major barrier to them being made available worldwide.

In 2015, after many years of waiting for some, the NHS finally agreed to fund the roll out of DAAs to those who need it. But negotiations with drug companies are ongoing - to try and get the price of these costly drugs down.

All patients starting DAAs must be fully committed to taking the treatment every day and eliminating any risk of reinfecting themselves during treatment, e.g. not injecting drugs or taking sexual risks - as repeat treatments cannot be guaranteed.

10. What if it's not treated?


If you have Hep C you should be referred to a liver specialist for further tests and to see if you need treatment.

Complications of chronic, untreated Hep C include scarring of the liver (cirrhosis) and liver cancer, both of which can lead to death.

11. Is there a vaccine?


Whilst there are vaccines for Hepatitis A and B, no vaccine exists for Hep C so prevention is key.

In addition, people that have cleared Hep C once are not then immune to getting it again - you can catch Hep C multiple times.

12. How do I avoid getting it?


- Don't share needles/injecting equipment/straws if you are using drugs

- Sex - Use condoms, gloves for fisting and avoid sharing lube and sex toys

- Get a test if you think you're at risk

13. What's the future looking like?


The more people we can cure of Hep C, the more we can prevent it's spread.

Excitingly, the effects of these new DAA drugs are already being felt. Provisional data suggests up to a 40% increase in people accessing treatment for Hep C in 2015. This is alongside an 11% fall in the number of deaths due to liver cancer and end stage liver disease caused by Hep C.

The UK is now working towards "the elimination of Hepatitis C as a major public health threat in the UK by 2030," as part of the 2016 WHO Global Health Sector Strategy (GHSS) on Viral Hepatitis. Watch this space.

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