Hepatitis C

Fast facts

  • Transmitted by blood and percutaneous transfer.
  • Sexual transmission and perinatal transmission are uncommon.
  • In acute infection most people are asymptomatic, but about 75 percent will become chronically infected.
  • Chronic hepatitis C virus (HCV) infections carry a high risk of liver damage, cirrhosis, and liver cancer (hepatocellular cancer – HCC).
  • HCV is slowly progressive but excess alcohol intake and co-infection (with hepatitis B or HIV) speed this up.
  • Treatment is more effective if given early.
  • HCV is curable – with the newer direct-acting antivirals (DAAs) up to 95 percent of patients are cured (sustained virological response – SVR).

What is hepatitis C?

Hepatitis C is a blood-borne virus which infects the liver and can cause inflammation. Hepatitis C virus (HCV) is curable but damage to the liver will increase over time if the infection is untreated. Hepatitis A, B, D and E viruses also infect the liver.

Infection with the hepatitis C virus is often not noticeable in the first months because in most cases people don't have symptoms or feel sick. After this, levels of the virus can rise until the body's immune system produces antibodies to help attack the virus. In some people, this is enough to clear the body of the virus. A blood test which shows antibodies but no virus (negative PCR test) means past infection has now cleared.

For around 75 percent of people, infection with hepatitis C continues as chronic illness. Everyone responds differently to hepatitis C and some have more severe effects on the liver than others. Others may never experience any symptoms and it may take many years for scarring or permanent damage of the liver to occur.

Chronic hepatitis C

  • More than 250,000 Australians have the hepatitis C virus resulting in up to 630 deaths from liver cancer and liver failure each year.
  • Around 25 percent of people will clear the virus naturally in the first year.
  • For the remaining 75 per cent of people the infection continues - if not treated - for the rest of their lives. This is called chronic or long-term hepatitis C.
  • Unlike many other diseases which produce immunity after you're infected, hepatitis C doesn't provide immunity after clearing or treating the virus.
  • Infection can occur again (re-infection) following repeated exposure. 

Most people with hepatitis C do not get serious disease or die from their infection. There are many factors that impact on how a person is affected by or experiences hepatitis C. These include gender, age when infected, obesity, alcohol use, and other infections, such as hepatitis B or HIV.

Genotypes

  • There are several different 'families' of the hepatitis C virus called ‘genotypes.’ They have slightly different RNA or genetic make-up.
  • There are thought to be at least six different genotypes of hepatitis C in Australia, numbered 1 to 6. Different subgroups of these are called 1a, 1b and so on.
  • The most common genotypes found in Australia are genotype 1 (54 percent), genotype 3 (36 percent) and genotype 2 (6 percent). Fortunately, these genotypes also have the highest chance of cure with treatment (around 95 percent).
  • Genotypes 4 to 6, while uncommon in Australia, still have cure rates over 90 percent.