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Hepatitis C symptoms and treatment

Hepatitis C is part of a group of hepatitis viruses that attack the liver. It is commonly found in infected blood. It is also rarely found in semen (cum) and vaginal fluids. 

The virus is usually passed on through using contaminated needles and syringes or other items with infected blood on them. It can also be passed on through unprotected sex, especially when blood is present. 

It often has no noticeable symptoms. Some people’s bodies can clear the infection on their own but others may develop chronic (long-term) hepatitis C and will need to take antiviral treatment to cure the infection and prevent liver damage.  

What is hepatitis C?

Hepatitis C (also known as hep C or HCV) is part of a group of hepatitis viruses that attack the liver. 

Chronic hepatitis C can be serious and without appropriate treatment and care, can cause liver disease and liver cancer. Treatment, where available, can cure hepatitis C in most cases. 

How do you get hepatitis C?

Hepatitis C is most commonly spread through blood-to-blood contact. It is very infectious and the virus can stay alive outside the body for up to several weeks. 

The infection can be spread by: 

  • sharing needles and syringes, particularly when injecting drugs 

  • medical and dental equipment that has not been properly sterilised 

  • the transfusion of unscreened blood and blood products. 

  • unsterilised tattoo and body piercing equipment 

  • sharing contaminated razors, toothbrushes or towels (this is rare).  

It can be transmitted sexually, especially during anal sex or other types of sex that may involve blood, although this is less common. Sharing uncovered or unwashed sex toys can also pass it on. 

The risk of hepatitis C infection is increased when you have another STI – especially one that causes sores. People with HIV are also more likely to get hepatitis C. 

The virus can also be passed on from a pregnant woman to her unborn baby. For more details on hepatitis C in pregnancy read our ‘in detail’ tab.

How do you prevent hepatitis C?

There is no vaccine for hepatitis C but there are a number of ways to reduce the risk of infection. 

Never share needles and syringes or other items that may be contaminated with infected blood, even old or dried blood can contain the virus. 

Only have tattoos, body piercings or acupuncture in a professional setting, where new, sterile needles are used 

You can also stop the spread of the virus by practising safer sex. Use condoms, especially during anal sex, rough sex or if you’re menstruating. Use dental dams and latex gloves for rimming, fingering and fisting. Knowing the status of your sexual partner is another important way to stay safe. 

If you have HIV, taking your antiretroviral treatment keeps your immune system strong. This way so you’re less likely to get other infections, including hepatitis C. For more details on hepatitis C and HIV read our ‘in detail’ tab.

Taking pre-exposure prophylaxis (PrEP), the contraceptive pill or any other type of contraception – apart from condoms – doesn’t protect you from hepatitis C and other STIs. 

Having regular STI tests is one of the best ways to look after your sexual health. If you are having sex with multiple partners, it’s even more important to use condoms and get tested regularly even if you don’t have any symptoms.  

If you’ve been diagnosed with hepatitis C you should avoid sex until you have finished your treatment and a health care professional says it’s safe. 

What are the symptoms of hepatitis C?

Many people with hepatitis C don't have any symptoms, especially during the first 6 months.  

The hepatitis C infection can go through two stages: acute and chronic. In the early ‘acute’ stage, these symptoms can include: 

  • flu-like symptoms, tiredness, high temperature and aches and pains 

  • loss of appetite 

  • tummy (abdominal) pain 

  • yellowing of the eyes and skin (known as jaundice). 

For some people the infection will clear without treatment.  

In most cases an acute infection will develop into long-term ‘chronic’ infection. Chronic infection may not become apparent for a number of years until the liver displays signs of damage.  

Symptoms vary but some of the most common include: 

  • problems with short-term memory, concentration and completing complex mental tasks (often called ‘brain fog’)  

  • depression or anxiety  

  • mood swings 

  • constantly feeling tired 

  • nausea, vomiting or tummy pain 

  • dark urine (pee) 

  • pale faeces (poo) 

  • jaundice 

  • itchy skin 

  • feeling bloated 

  • joint and muscle pain. 

How do I test for hepatitis C?

A simple blood test will show whether you have the virus. You may also be given an extra test to see if your liver is damaged. 

If you’ve got hepatitis C you should be tested for other STIs. It's important that you tell your recent sexual partner/s so they can also get tested and treated. Many people who have hepatitis C do not notice anything wrong, and by telling them you can help to stop the virus being passed on. It can also stop you from getting the infection again. 

How is hepatitis C treated?

Treatment for hepatitis C depends on how long you have had the virus. 

People with acute (short-term) infection do not always need treatment because their immune system may clear hepatitis C on its own. If you test positive during the acute stage, your doctor may ask you to come back after a few months to re-test and to see if you need any treatment. 

If you develop chronic (long-term) infection, you will need treatment to help clear the virus. Treatment with drugs called direct-acting antivirals (DAAs) can cure hepatitis in most cases. These are usually taken for 8-12 weeks. Your doctor will also check your liver for any damage.   

If you’ve had hepatitis C in the past, you’re not immune to future infections – which means you can get it again. You can also still get other types of hepatitis and having hepatitis C together with another type is more serious. 

If you’ve already had hepatitis C, it’s advisable to have the vaccination against hepatitis A and B to protect your liver from further damage. 

Whether you have symptoms or not, don’t have sex until your healthcare professional says you can. 

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What are the long-term effects of untreated hepatitis C?

Without treatment, chronic (long-term) hepatitis C can cause the liver to stop working properly. This scarring of the liver is called cirrhosis. A small number of people with cirrhosis develop liver cancer. Other than a liver transplant, there’s no cure for cirrhosis. But, treatments can help relieve some of the symptoms. 

What effects does hepatitis C have during pregnancy?

Hepatitis C can be passed on from a pregnant woman to her child during pregnancy and birth, but this is rare. The risk of passing hepatitis on is slightly higher for mothers with both HIV and hepatitis C (called co-infection).   

Antivirals used to treat hepatitis are not currently recommended for pregnant women. This is because there isn’t enough information to know if the drugs are safe for your unborn baby. 

If you have hepatitis C and are pregnant speak to your doctor. They will be able to give you advice on how to keep yourself and your baby safe during pregnancy and birth. 

If you’re planning to have a baby, your doctor may recommend that you treat the hepatitis C before you get pregnant. 

Breastfeeding with hepatitis C is considered safe. But if you have cracked or bleeding nipples, it’s generally recommended to stop breastfeeding until they have healed.  

Hepatitis C and HIV

Co-infection (having both) hepatitis C and HIV is common. This is because they are both transmitted in similar ways. While both infections can be treated, it can complicate things. It’s important that your doctor is fully aware of your infections so they can decide on the best treatment. 

If you have HIV you’re more likely to develop chronic hepatitis C. The infection is also more likely to progress quickly and become serious. The infection is also more likely to progress quickly and become serious. This is true even when you take your antiretroviral treatment for HIV and your viral load is low. 

If you think you’ve been exposed to hepatitis C, it’s important to get tested and treated with direct-acting antivirals (DAAs) if necessary. Your doctor may change your antiretroviral treatment if you are also being treated for hepatitis C. 

How do I tell my recent sexual partner(s) I have hepatitis C?

If you test positive for hepatitis C, it’s important to tell any recent sexual partner(s) so they can also get tested, and treated if necessary. If you feel it is safe to do so then telling a partner is the responsible thing to do – it shows you respect them and want them to stay healthy. 

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