Hepatitis C

Hepatitis C is a blood-borne virus that causes inflammation and damage to your liver. If left untreated, over time hepatitis C can cause chronic liver disease, cirrhosis and liver cancer. It is sometimes called hep C, or HCV.

For transmission to occur, hepatitis C positive blood must directly enter the bloodstream of another person. Hepatitis C can be treated and cured.

Globally it is estimated that 71 million people have a chronic (lifelong) hepatitis C infection. In Australia it is estimated that 188,951 people are living with chronic hepatitis C with 43,641 Queenslanders with a lifelong infection.

How do you get hep C?

Hepatitis C is transmitted through blood-to-blood contact. 

Hepatitis C transmission examples

High risk

  • Sharing injecting drug equipment, including needles, swabs, spoons, water, filters and tourniquets
  • Being injected by another person
  • Having a tattoo or body piercing done with unsterile equipment

Moderate risk

  • Cultural or traditional practices that involve blood, sin penetrations or blood rituals
  • Contact with blood through blood transfusions, blood products, medical (including cosmetic surgery) or dental procedures – low risk since February 1990 in Australia, in developing countries the risk would be different
  • Sharing toothbrushes, razors, and tweezers
  • Blood-to-blood contact through open wounds

Low risk

  • From a mother with chronic hepatitis C to her newborn baby (approximately 1%-5% risk of transmission)
  • Sexual transmission is extremely unlikely unless there is blood present, for example during menstruation, anal sex, rough sex, or in the case where someone has a sore that may be bleeding
  • Needle stick injury – in health care it is estimated to be a 3% risk, in the community it is very unlikely.

What does not transmit hepatitis C

Hepatitis C is present in other body fluids, however not in high enough quantities to be a risk for transmission. You can not get hepatitis C from the following:

  • Close personal contact including hugging, shaking hands, and kissing
  • Coughing, sneezing or spitting
  • Animals including mosquitoes
  • Sharing toilets, sinks and showers
  • Sharing food, eating utensils, cups and plates
  • Providing personal care including changing nappies
  • Blood transfusions or medical procedures in Australia after 1990

How do you know if you have hepatitis C?

A blood test is the only way to know if you have hepatitis C. The blood test for hepatitis C requires two tests, an antibody and a PCR (or DNA) test.

To get tested or find out more information, contact your local doctor, sexual health clinic, Aboriginal Medical Service or contact us for more information.

Hepatitis C symptoms

  • General aches and pains
  • Yellowing of the eyes and skin
  • Nausea
  • Abdominal pain and discomfort
  • Loss of appetite
  • Light coloured faeces and dark urine
  • Fatigue and brain fog

As many as 80% of people will not experience symptoms.

How long will it take to show symptoms?

The incubation period (time between being exposed to getting sick) for hepatitis C is between 2 weeks and 6 months.

Is there a vaccination for hepatitis C?

There is currently no vaccination for hepatitis C, however being blood aware is your best mechanism to prevent hepatitis C transmission.

How can you prevent hep C?

  • Never share injecting drug equipment (including needles, water, spoons, filters and tourniquets) and dispose of these safely
  • Cover open wounds or cuts with bandages and clean up any blood spills with disposable gloves and bleach
  • Always get your tattoos and piercings done by a professional who uses sterile equipment and follows occupational procedures for infection control
  • Don’t share items that may have traces of blood on them like tweezers, razors or toothbrushes
  • Where possible, avoid medical procedures in countries where standard precautions may be lacking or organs, tissues, blood, or blood products may not have been properly screened. In Australia, since 1990, the risk of acquiring hepatitis through medical procedures is extremely low.
  • It is safe to breastfeed but if your nipples are cracked or bleeding you should stop temporarily
  • Wear gloves when providing someone with first aid or cleaning up blood and bodily fluid spills 

Standard precautions

Standard precautions are basic levels of infection control and procedures that we can do to keep ourselves and others safe. The basic principle of infection control around blood is to treat all blood as potentially infectious. There is no need for additional precautions when providing care to someone who is living with hepatitis when standard infection control measures are in place and are followed.

In the workplace standard precautions which protect everyone include:

  • Hand washing
  • Wearing gloves when handling blood and body fluids
  • Use of personal protective equipment
  • Access to a blood spill kit
  • Routine cleaning
  • Immunisation of staff
  • Management of sharps, blood spills, linen and waste
  • Covering broken skin with waterproof bandaids

At home these standard precautions can be continued to ensure safety of family members including children.

Being blood aware

Being blood aware doesn’t mean having to be fanatical about avoiding contact with other peoples blood. It simply means taking reasonable, sensible steps to reduce the overall chance of being exposed to blood-borne viruses.

Blood awareness applies when dealing with blood or other body fluid accidents. We should all treat blood as potentially infectious, so we take all possible precautions to reduce harm.

  • Your skin is your ‘first line of defence’ against infections. Make sure you have no uncovered cuts, abrasions or dermatitis when giving first aid. Cover any cuts you have with a waterproof bandaid
  • Wear disposable gloves when dealing with any blood or other bodily fluids
  • Disposable materials (e.g. paper towels) should be used when cleaning up blood or other bodily fluid spills or splashes
  • Any surfaces which have had blood or other bodily fluid splashes should be cleaned with detergent and water
  • Vaccination against infections such as hepatitis A and B are important
  • When giving resuscitation in the event of a first aid emergency, use safe practices (such as using a mouth shield).

It is important to remember that hepatitis C is a blood-borne virus and is not passed on through social contact between people. You cannot get hepatitis C from saliva, tears or sweat.

You will need two blood tests to see if you have hep c.

The antibody test

This test shows whether or not you have antibodies to the hepatitis C virus. A positive result does not automatically mean you have hepatitis C. It may mean you had hep C in the past and have cleared the virus, either naturally or through treatment.

A negative result means that you do not have hep C.

The PCR test

Shows if there is active hepatitis C in your blood.

You have to have a positive antibody test and a positive PCR test to be hepatitis C positive.

HCV genotype

This test detects which genotype of hepatitis C you have. This test is no longer required for treatment, but can show if you have one or more strains of the virus.

Who should get tested for hepatitis C?

  • People who inject drugs or who have ever injected drugs
  • People in prison or who been in prison
  • People with tattoos or body piercing
  • People who received a blood transfusion or organ transplant before 1990
  • Children born to mothers with hepatitis C
  • People living with HIV or hepatitis B
  • Sexual partners of a people who has hepatitis C (individuals at higher risk of sexual transmission include men who have sex with men and people with HCV–HIV coinfection)
  • People with evidence of liver disease (persistently elevated alanine aminotransferase level)
  • People who have had a needle-stick injury
  • Migrants from high-prevalence regions (Egypt, Pakistan, Mediterranean and Eastern Europe, Africa and Asia)

Is treatment available for hepatitis C?

There are highly effective treatments available for hepatitis C which are known as direct-acting antivirals (DAAs). These tablet-based treatments have been available on the Pharmaceutical Benefit Scheme (PBS) in Australia since March 2016.

There are different treatment options, but the most commonly used treatments are pangenotypic, which means that they treat all genotypes of hepatitis C. The success rate for cure is as high as 95% and most people do not experience any side effects.

*This image was originally developed by Hepatitis NSW, 2017.

How much does hepatitis C treatment cost?

Hepatitis C medicines are listed on the Pharmaceutical Benefits Scheme (PBS) which means the Government subsidies the cost of the medications for people who hold a Medicare card. As of August 2020, the patient co-payment amounts are:

  • General – $41.00 (Medicare Card)
  • Concessional – $6.60 (Medicare Card, along with Healthcare Card or Pension Card).

There are other options available for people living in Australia who are not eligible for Medicare. Contact Hepatitis Queensland for more information.

How do I access treatment?

You can access treatment from: 

Visit our health services directory for treatment locations nearby.

How do I fill my prescription?

Pharmacies in the community can dispense hepatitis C treatment scripts written by a GP. Not all pharmacies will keep these medications in stock. You may need to speak to them about ordering it in. This generally will take 24 hours to up to a week in regional areas.

Who can access hepatitis C treatment?

In Australia, all people with chronic hepatitis C, who hold a Medicare Card can access treatment.

If someone with hepatitis C is also living with cirrhosis or another advanced liver health condition they will need to be treated under the care of a specialist. Your GP can refer you to a specialist.

There is no reason that someone who currently injects drugs, drinks alcohol, has a mental health condition or is in a correctional centre should not be offered treatment for hepatitis C.

At what age can someone access hepatitis C treatment?

Recent changes to the Pharmaceutical Benefits Scheme (PBS) have seen the 18+ age restriction removed as a requirement for treatment. This means that children aged 12 to 18 years can now access treatment under the care of a specialist.