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Hepatitis C What is it ? Hepatitis C was identified in 1989. It is estimated that over 287,000 people in Australia have been exposed to the virus—around 1 in 100 people. Of these, around 215,000 are living with chronic hepatitis C. Hepatitis C is a viral infection that persists as a chronic infection in 75% of people exposed to the virus. Hepatitis C is a slowly progressing disease. While most people with chronic hepatitis C won’t develop serious liver damage after 40 years, around 20% will develop cirrhosis of the liver which can lead to liver cancer or liver failure.

Hepatitis SA

Ph 1300 437 222 or (08) 8362 8443 Fax (08) 8362 8559 3 Hackney Rd Hackney SA 5069 PO Box 782 Kent Town SA 5071 www.hepsa.asn.au

How is it transmitted? Hepatitis C is a blood-borne virus. It is transmitted when the blood of someone infected with the virus enters the bloodstream of another person. It can be transmitted by: • sharing any equipment when injecting drugs, • skin penetration, such as tattooing or bodypiercing with non-sterile equipment, • receiving blood products prior to 1990 in Australia, or • medical procedures in some overseas countries. What is the window period? The window period is 2-26 weeks, with an average between 6-9 weeks. What are the symptoms? Most people do not experience symptoms of acute infection. Chronic symptoms include fatigue, nausea, muscle aches and pains, abdominal discomfort, and depression. Is there treatment? Hepatitis C can be treated very effectively with direct acting anti-virals (DAAs) at over 90% success rate. They are taken orally as tablets, mostly once a day, in various combinations with each other and/ or with ribavirin and/or pegylated interferon. Most combinations are interferon-free. How is it prevented? • Do not share injecting equipment. • Avoid blood-to-blood contact. • Follow standard infection control guidelines for First Aid. • Avoid sharing personal items (ie toothbrushes or razors). • Avoid tattooing and body-piercing with unsterile equipment. There is no vaccination for hepatitis C. Last update: September 2012 SA Health has contributed funds towards this Program.

Hepatitis A? B? C? Cover images © Leo Reynolds

How is it prevented? • Vaccination: universal hepatitis B vaccination for infants and people at high risk has been implemented in Australia since 2000 • Immunoglobulin injection after exposure • Avoid blood-to-blood contact. • Follow standard infection control guidelines for First Aid. • Do not share injecting equipment. • Avoid tattooing and body-piercing with unsterile equipment. • Practice safe sex. • Avoid sharing personal items (ie toothbrushes or razors).

• What’s the difference? • How are they transmitted? • Are there any cures?


About Hepatitis The word ‘hepatitis’ means inflammation of the liver. Hepatitis can be caused by alcohol, chemicals, viral infections, some prescription drugs and, less commonly, a breakdown of the autoimmune system. Hepatitis A, B and C are names given to different viruses which can cause inflammation of the liver (commonly referred to as viral hepatitis). Although some symptoms may be similar (like fatigue, flu-like symptoms and nausea, low-grade fever and non-specific aches and pain), each virus has different modes of transmission and different outcomes. Hepatitis is often described as acute (short-term) or chronic (long-term, which means the virus persists in the body beyond 6 months). When a person has been exposed to the hepatitis virus, the body will develop antibodies as the immune system tries to eliminate the virus. The period of time between exposure to the virus and when antibodies can be detected, is known as the window period. While there are vaccines to protect against hepatitis A and B, there is no vaccine for hepatitis C.

Hepatitis A What Is It? Hepatitis A is a viral infection that is usually shortlasting (2-3 months), does not lead to chronic longterm infection, and thus rarely result in long-term problems. How is it transmitted? Hep A is usually spread when faeces from an infected person is passed on to another person’s mouth. This is often known as an oral-faecal route of transmission. It can be transmitted by: • eating or drinking things contaminated by faeces,

• plates and cutlery which have been touched by an infected person and not washed thoroughly, • not washing hands after going to the toilet, or • oral-anal sex (rimming) without using some kind of barrier protection (eg cling-wrap or dental dams). What is the window period? The window period is 2-7 weeks, with an average of 4 weeks. What are the symptoms? Acute symptoms in adults include light-coloured faeces, dark urine, fatigue, fever and jaundice (yellowing of eyes and sometimes the skin). Symptoms usually last 1-3 weeks. Some people, especially young children, may have no symptoms. How is it prevented? • Vaccination • Washing hands after going to the toilet • Immunoglobulin injection after exposure If travelling to developing countries, consider vaccination and seek advice on food and water risks.

Hepatitis B What Is it? Hepatitis B was first properly identified in 1965, although it has been known about since the Nineteenth Century. Between 90,000 and 160,000 people in Australia are chronically infected with hepatitis B. About 90% of adults infected by hepatitis B will recover from the acute infection and become immune for life. The remaining 10% will have chronic hepatitis B that may require treatment to manage the progression of the disease. 20% to 30% of those with chronic hepatitis B are at risk of serious liver disease.

Over 90% of babies who contract hepatitis B remain affected for life. How is it transmitted? Hepatitis B is usually transmitted via exposure to infected blood and, to a lesser degree, bodily secretions such as saliva and semen. Hepatitis B can be transmitted: • from mother with hepatitis B to baby during or around the time of birth, • to children through household contact, • unprotected sexual activity, • sharing any equipment when injecting drugs, • via skin penetration, such as tattooing or body piercing with non-sterile equipment, or • by medical procedures in some overseas countries What is the window period? The window period is 6-26 weeks, with an average between 8-12 weeks. What are the symptoms? Most people experience symptoms in the acute phase of infection – flu-like symptoms, dark urine, light faeces, jaundice, fatigue and fever. Occasionally these symptoms can be very severe. Symptoms of chronic hepatitis B infection include fatigue, nausea, muscle aches and pains, abdominal discomfort or jaundice. Is there treatment? Not all people with chronic hepatitis B need, or will benefit from, treatment. Treatment options include Interferon which is aimed at boosting the immune system to remove the virus, and anti-viral drugs used to suppress viral replication. The main goal of current hepatitis B treatment is to suppress replication of the virus and reduce the risk of progressing to advanced liver disease. Currently these drugs are used as a single agent in treatment (monotherapy).


Hepatitis A? B? C?