Hepatitis C

Hepatitis C is an infection caused by the hepatitis C virus, or HCV. In later stages it can seriously damage the liver by causing cirrhosis and liver cancer.

The hepatitis C virus is carried in the blood, and you can become infected with hepatitis C if you come into contact with the blood of an infected person. The highest risk of infection is from sharing used needles, syringes or other drug-using equipment.

You cannot be infected by hepatitis C through everyday contact such as holding hands, hugging, kissing or by sharing toilets, tableware, or kitchen utensils.

More than 110,000 people in Ontario are infected with the hepatitis C virus. Symptoms often do not appear for many years, and about 35,000 Ontarians do not realize they are infected.

Many people infected with the hepatitis C virus can be treated successfully with therapeutic drugs.

Symptoms

Most people do not experience any symptoms when they first become infected, and symptoms may not appear until 10 or 20 years later when the disease has progressed. Most people who have developed chronic hepatitis C will not have symptoms until their liver disease becomes serious.

Upon becoming infected, some people may feel ill for short periods, and in rare cases may become jaundiced (yellowing of the skin and eyes).

How hepatitis C is different from hepatitis A and hepatitis B

Hepatitis C is much more serious than hepatitis A and significantly more serious than hepatitis B.

Hepatitis A is spread from person to person if hands are not washed after going to the toilet, or through contaminated food or water. Hepatitis A does not lead to long-term infection or long-term liver damage. In rare cases the disease can cause death. There is a vaccine against hepatitis A.

Hepatitis B is spread through contact with contaminated blood or body fluids: from infected mother to baby, by sexual contact or by the sharing of contaminated equipment for injection-drug use. Some people infected with hepatitis B will develop long-term infection and are at increased risk of serious liver disease.

There is a vaccine against hepatitis B.

Hepatitis C is spread through contact with the blood of someone who is infected with the hepatitis C virus. The highest risk of infection is from sharing used needles, syringes or other drug-using equipment. Those who become infected have a very high risk of developing chronic hepatitis C, which can lead to serious liver damage. Some people with cirrhosis develop liver cancer or liver failure.

There is NO vaccine against hepatitis C.

Hepatitis C genotypes: A family of viruses

The hepatitis C virus is not just a single organism but a 'family' of related viruses, in the same way that the bear is a family of mammals. Each member 'virus' of the hepatitis C 'family' is called a 'genotype', and every genotype is different from the others (in the same way that a black bear is different from a polar bear).

There are 11 known genotypes of the hepatitis C virus, and each one can be further classified into a 'subtype', depending on where in the world it is usually found. The letter after the genotype number ('a' or 'b' for instance) indicates that genotype 1a and 1b are the most common in Canada.

How hepatitis C is transmitted: Risk Factors

Hepatitis C is spread through direct contact with the blood of an infected person. Currently, the greatest risk of becoming infected by the hepatitis C virus in Canada is through drug-using equipment, including equipment used for injecting, snorting and smoking drugs. If you have EVER shared drug-using equipment - even if it was a long time ago, and even if you only did it once or twice - you could have been exposed to hepatitis C.

However, there are other ways in which you could have been exposed to the virus:

  • If you had a blood transfusion or were treated with a blood product before 1992, you may have been exposed to hepatitis C. For example if you had an operation before 1992, you may have received blood infected with the hepatitis C virus. Currently, all blood and blood products are carefully screened for hepatitis C.

Less common ways in which hepatitis C can be transmitted:

  • From infected mother to baby, before or during birth
  • Sexual activity that includes contact with blood or the exchange of blood
  • Medical and dental treatment where non-sterile equipment is used
  • Tattooing, piercing or acupuncture with non-sterile equipment
  • Sharing razors, toothbrushes, tweezers, manicure or pedicure equipment such as nail clippers, which may be contaminated with infected blood
Disease progression and the liver

If you have been infected with the hepatitis C virus, you have a 75% chance of developing chronic hepatitis C. It may affect you in the following ways:

  • You may live your life without developing liver damage
  • You may develop mild to moderate liver damage
  • You have about one chance in five of developing severe liver damage (cirrhosis) over a period of 20 years or more
  • If your liver is damaged by cirrhosis, you can get liver cancer or experience liver failure requiring a transplant
Resources
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