Hepatitis C is a notifiable condition 1 How hepatitis C is spread Hepatitis C is spread by blood-to-blood contact through needle puncture, broken skin or a break in mucous membranes the thin moist lining of many parts of the body such as the nose, mouth, throat and genitals. Other ways hepatitis C can spread are: through non-sterile tattooing, body piercing and acupuncture through non-sterile medical or dental procedures, particularly in countries where hepatitis C is more common from mother to infant during delivery if the mother has high levels of hepatitis C virus in her blood in occupational settings through needle stick injuries and accidental exposures to infected blood or blood products through transfusion of infected blood or blood products in Australia before screening was introduced in Hepatitis C is much more common in prisons due to multiple risk factors.
The risk of transmission spreading of the infection is low in the following situations: Sexual transmission — this has been documented but appears to be rare. However, blood contact during unprotected intercourse should be avoided, for example, during menstruation, when there is broken or inflamed skin, unprotected penetrative intercourse where bleeding is caused, or unprotected anal intercourse.
Condoms provide an effective barrier in these situations. Sexual transmission is also more likely to occur when the person has a high viral load the amount of virus measured in the blood or also has human immunodeficiency virus HIV infection. Mother-to-baby transmission — the risk of transmission in pregnancy and childbirth is low unless the mother is also infected with HIV.
Women with hepatitis C are encouraged to breastfeed, except when they have cracked nipples. Household transmission is rare and does not occur through usual family and domestic contact. However, personal grooming items such as razors, nail files, manicure scissors and tooth brushes may contain minute traces of infected blood and should never be shared. The risk of spread is increased when there are higher levels of virus in the blood.
This occurs during acute infection or if the immune system is suppressed, for example, when the person also has HIV infection. These may include: fatigue poor appetite upper right sided abdominal pain low grade fever lasting 2 to 10 days jaundice yellow skin and eyes see image nausea. While many people do not have any symptoms, others may experience a variety of symptoms, including: tiredness and fatigue, which may be severe malaise feeling of being unwell pain or discomfort in the upper right side of the abdomen nausea, vomiting and diarrhoea muscle aches a fine body rash.
Diagnosis Hepatitis C is diagnosed by blood tests. There are two types of tests to confirm hepatitis C infection antibody test hepatitis C PCR test Antibody test This detects antibodies against hepatitis C virus anti-HCV and is the most commonly used test. Incubation period time between becoming infected and developing symptoms 6 to 9 weeks, but can range from 2 weeks to 6 months.
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Infectious period time during which an infected person can infect others One or more weeks before symptoms develop in the acute stage; lifelong in chronic infection. Treatment Improved antiviral therapy is available and new treatments have increased the number of people who have been able to clear the virus are cured of hepatitis C and avoid ongoing symptoms and liver damage. Prevention Exclusion from childcare, preschool, school and work is not necessary.
Infected health care workers must comply with the requirements of their professional boards. This means: Not sharing or re-using any injecting equipment - not only needles but also syringes, filters, spoons, swabs and tourniquets.
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Avoiding body tattooing or body piercing performed by those who are untrained and unregulated. Sterile technique under sterile conditions in premises which are regularly inspected by environmental health officers is recommended. Equipment, ointments, dyes and dye pot surfaces should be sterile. Ask about sterilising procedures. Covering any open sores, cuts or abrasions with waterproof dressings. Always using standard precautions if blood or body fluids must be handled. This will generally eliminate the risk of spreading of hepatitis C. Safely disposing of found or used needles and syringes in a sharps safe or other sealable and puncture-proof container.
People with hepatitis C virus or at risk of infection with the virus should not donate blood, organs or other tissue. All donated blood and body organs are screened for hepatitis C virus.
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Further, they sought for time to delayed HBsAg-seroclearance among these adult high-risk groups. This is according to a study in the Journal of Viral Hepatitis. Louisiana, for example, has a hepatitis C epidemic alongside some of the highest rates of HIV, syphilis, maternal mortality, diabetes and smoking, leaving its health department in a dilemma over which programs and patient needs to prioritize.
A narrative review summarizing the most recent guideline updates has been published in Clinical Gastroenterology and Hepatology. The majority of people do not experience symptoms when they first acquire hepatitis C, a period known as acute infection. Among people living with HIV, routine liver function tests sometimes reveal elevated liver enzymes that can be a sign of liver inflammation due to hepatitis C. Most people develop chronic hepatitis C that lasts more than six months.
People living with HIV appear less likely to spontaneously clear hepatitis C. People with chronic infection will continue to be infectious and can pass on the virus to others, whether or not they have symptoms.
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Over the longer term, about half of people with chronic hepatitis C will experience some symptoms. The most common include fatigue, loss of appetite, muscle and joint pain, and feeling generally unwell. Some people may experience 'brain fog' mild cognitive problems or depression. Symptoms may worsen or become more numerous over time.
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These symptoms can have a negative impact on work, family life, social life and sex life. If this is the case for you, be sure to tell your doctor about the problems the symptoms cause you. Chronic hepatitis C can contribute to conditions beyond the liver, known as extra-hepatic conditions. Studies have found that people with hepatitis C have a higher risk for joint and skin problems cryoglobulinaemia , heart disease, strokes and diabetes. Research increasingly shows that infection with HIV, hepatitis C or both contributes to chronic inflammation, which can lead to problems throughout the body.
Over years or decades, chronic hepatitis C can cause serious liver damage including fibrosis, cirrhosis and liver cancer. Some people never experience any of these complications.
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People with HIV have faster liver disease progression, on average. In the most severe cases, hepatitis C can lead to liver failure, the need for a liver transplant or liver-related death. This is much more common in certain groups, such as people who inject drugs. People living with HIV are less likely to naturally clear hepatitis C. They also tend to have more aggressive liver disease progression, particularly if they have a low CD4 cell count. Research done in the era of effective and well-tolerated antiretroviral therapy finds that people with well-controlled HIV can do nearly as well as HIV-negative people.
People living with HIV do not respond as well to the old interferon-based therapy for hepatitis C, but this is not the case with the new direct-acting antivirals. People living with HIV and hepatitis C co-infection can be treated with most of the same hepatitis C regimens as HIV-negative people and their cure rates are the same. Some people may become reinfected with hepatitis C after being cured. Some studies show quite a high rate of reinfection in gay and bisexual men. There is no evidence that people who are cured of hepatitis C are protected against future reinfection, so it is important to take precautions to avoid reinfection.
Speak to your healthcare team if you think that you need help to avoid reinfection, such as treatment to reduce or stop injecting drugs, access to clean injecting equipment or psychological support to reduce risk-taking behaviour.
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People living with HIV and hepatitis C can benefit from adopting a healthy lifestyle, including eating a balanced diet. Try to maintain a healthy weight. Being overweight is linked to fatty liver disease , which can worsen liver damage. Since people living with HIV and hepatitis may have an increased risk of cardiovascular disease and diabetes, your clinic should regularly monitor your blood fats or lipids cholesterol and triglycerides and blood sugar glucose. People living with hepatitis C should limit how much alcohol they drink, and those with liver damage should avoid alcohol altogether.
Not smoking and cutting down or stopping recreational drug use are also important for overall health. Liz Highleyman. December