Who is a hepatitis C carrier?

A carrier is someone who has been exposed to hepatitis C but instead of losing the virus in the early stages of infection, infection becomes long-term (i.e. chronic).

How is hepatitis C transmitted?

HCV is a blood-borne virus. It is also found in other body fluids but it seems that direct blood-to-blood contact is usually needed for transmission to occur. The main modes of transmission are:

  • Sharing of needles by IV drug users (most common mode of transmission).
  • Non-sterile tattooing and body piercing equipment.
  • Blood transfusions or blood products (before HCV screening of donor blood began in July 1992).

The risk of sexual transmission appears to be low, except in persons with a current infection with another STD, or where blood-to-blood contact occurs in other ways. Mother-to-child (perinatal) transmission is relatively uncommon.

There is no vaccine against hepatitis C.

How can I avoid infecting others?

You can reduce any risk to your family and friends by some simple precautions:

  • Cover open sores or cuts.
  • Don’t share razors, towels or toothbrushes
  • Clean up any spilt blood with household bleach (do not put bleach on your skin)
  • Do not donate blood (donated blood is tested and blood from HCV carriers is excluded)
  • Although transmission by conventional male/female sex is uncommon, you are advised to use a condom

What are the symptoms of hepatitis C?

Chronic hepatitis C infection may have no symptoms. But many carriers experience fatigue and other problems such as joint pains and skin irritations.

What are the risks to carriers?

Some people with chronic hepatitis C may eliminate the virus, but for most, hepatitis C leads to very slow, progressive liver damage. In some this may eventually lead to liver scarring (cirrhosis) and liver failure, or to liver cancer. The time course can be very long, however, and most carriers will not develop serious complications until 10 to 50 years after infection. The disease progresses more rapidly in males, those over 40 years, and in those who drink excess alcohol.

Can I drink alcohol?

Drinking excess alcohol speeds up hepatitis C-related liver disease. You should not drink more than the occasional glass of wine or beer, and should abstain altogether if your liver function test results are elevated.

Any alcohol intake should be small. Some authorities recommend that people with significant liver disease should not drink alcohol at all.

What is a Genotype?

There are six main strains or "genotypes" of the hepatitis C virus, and subtypes within these. The genotype can influence the level of viral replication, the course of the disease, and the response to treatment. In New Zealand and Australia, the main genotypes are 1a, 1b and 3a. Genotype 1 is the most difficult to treat with standard interferon therapies but a better response has been shown with pegylated interferon in combination with ribavirin.

What about vaccination against hepatitis A
and B?

Co-infection with hepatitis A or hepatitis B may have an impact on the outcome of chronic hepatitis C infection. People chronically infected with hepatitis C are advised to be tested for past infection with hepatitis A and B and vaccinated if susceptible (i.e. not currently infected and not immune ) to these viruses.

Is there any treatment to get rid of the virus?

Once you are a carrier there is no easy way to get rid of the virus. Interferon in combination with ribavirin is the standard treatment. A longer-acting version of interferon (pegylated) is available for genotype 1 carriers or others with severe liver disease.

Interferon treatment is not easy. It requires self-injection and is commonly associated with flu-like symptoms and a range of other possible side-effects.

What do the blood tests mean?

Anti-HCV detects the antibody to the hepatitis C virus and indicates current or past infection.

HCV RNA (PCR test) detects hepatitis C viral particles present in the blood (the only way to confirm current infection).

ALT is the most important of several liver functions tests. It can provide an indication of current liver disease by measuring the amount of a particular liver enzyme present in the bloodstream. It also gives an indication of whether a patient would benefit from treatment.