About Hepatitis C

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Infectious Agent

The hepatitis C virus (HCV) causes an infection of the liver that was first identified in 1989.  HCV is carried in the blood and is responsible for 90% of the non-A, non-B hepatitis cases following blood transfusion prior to 1989. Six genotypes have been identified.

Occurrence

In Canada, the estimated prevalence of hepatitis C is 0.8%.  Hepatitis C has worldwide distribution and is one of the most common causes of global chronic hepatitis, liver cirrhosis and liver cancer.

Modes of Transmission

Hepatitis C is spread by direct blood-to-blood contact with a person who is infected with the virus. People with chronic hepatitis C infection may feel healthy even though they carry the virus. They can transmit HCV to others who come into contact with their blood.

Clinical Characteristics

The incubation period is approximately 2 – 26 weeks. The onset of illness is usually insidious with about 25 % of those infected experiencing anorexia, mild abdominal discomfort and nausea or vomiting; jaundice occurs in 20% - 30% of those infected. A high proportion (70% - 80%) of people infected with hepatitis C progress to chronic infection.

Diagnosis

Diagnosis depends on detecting the antibody to the HCV (anti-HCV) through a laboratory test of the blood.  Other laboratory tests check for the presence of HCV genetic material in the blood (HCV RNA) or the HCV genotypes (1, 2, 3, etc.). Type 1 is the most common in North America.

Treatment

There are effective treatments for hepatitis C. Drug therapy is aimed at inhibiting HCV replication, eradicating infection and improving the progression of the disease.  Medical specialists in viral hepatitis are best able to discuss the various therapeutic options.

Risk Factors

In Canada, the greatest risk for becoming infected is through sharing drug-using equipment, even if it was only once or twice a long time ago.  Other risk factors include having received a blood product prior to 1990, undergoing medical or dental treatment with unsterile equipment, and sharing personal equipment such as razors or toothbrushes. See below for persons at risk. 

Persons at Risk for Hepatitis C

Persons at Risk Level of Risk
 Recipients of blood, tissues or organs prior to 1990 High
 Recipients of blood-clotting factors (e.g. Factor VIII) prior to 1992 High
 Injection drug users High
 Individuals who 'snort' drugs High
 Hemodialysis patients Medium
 Individuals getting tattoos and body piercings with tools that are not sterile
 (e.g. in prison)
Medium
 Individuals who have sex with a hepatitis C carrier Medium
 Babies born to mothers infected with hepatitis C Low
 Health-care workers Low
* Source: Adapted from Public Health Agency of Canada Hepatitis C Fact Sheet

Prevention

There is no vaccine to protect against hepatitis C. Prevention measures include all activities that protect against blood exposure, i.e. exposure to the blood of other people.

Additional information on hepatitis C can be obtained from the following websites:

Alberta Health and Wellness
Notifiable Disease Guidelines – Hepatitis C

Canadian Liver Foundation
Hepatitis C

Canadian Nurses Association
Hepatitis C:  A Nursing Guide

Public Health Agency of Canada
Hepatitis C Fact Sheet

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References

1.      American Academy of Pediatrics. (2006). Hepatitis C. In L. K. Pickering (ed.), Red Book: 2006 Report of the Committee on Infectious Diseases. 27th edition (pp. 355 – 359). Elk Grove Village, Illinois: American Academy of Pediatrics.

2.      American Public Health Association. (2008). Hepatitis C. In D. L. Heyman (ed.), Control of Communicable Diseases Manual, 19th edition, (pp. 293 - 295).Washington. DC: American Public Health Association.

3.      Public Health Agency of Canada. (2008). Frequently asked questions about hepatitis C. Accessed on Feb. 2, 2009.