What's it all about?
Hepatitis C Virus (HCV) is a virus that attacks the liver. When the virus enters the body, it causes inflammation of the liver which, in the long term, leads to serious complications (cirrhosis, cancer). The virus is robust, living up to 3 days in the open air and several weeks in a closed environment, such as inside a syringe.
Evolution of HCV
Of those who contract HCV, around 1 in 4 will recover from the infection within 2 to 6 months, as the immune system produces antibodies to eliminate the virus. For those whose infection becomes chronic (3/4 of sufferers), the evolution of hepatitis C infection of the liver follows certain stages:
- Fibrosis: tiny scars created to defend against inflammation;
- Cirrhosis: generalized scarring so that the liver cannot function normally (usually occurs 20 years after infection);
- Liver failure: as cirrhosis worsens, the liver becomes less able to eliminate waste and toxins from the body, and has difficulty producing coagulants. Transplantation is inevitable at this stage;
- Liver cancer : the damage caused sometimes leads to cell carcinogenesis.
A person living with HCV (PLHCV) may be asymptomatic (symptom-free) for many years. When symptoms do occur, they may include fever, fatigue, decreased appetite, joint pain, dark urine and jaundice.
HCV in numbers
The World Health Organization estimates that 58 million people worldwide are living with HCV, with 1.5 new infections every year.
In Canada, estimates are 204,000 HCVP, including 9,500 new infections for 2019.
Transmission
HCV is transmitted by blood-to-blood contact with an infected person:
- Share injection equipment : syringe, swab, spoon, filter;
- Share sniffing equipment (straw, pencil, paper) or smoking materials (crack pipe);
- Tattooing or piercing with non-sterile needles or contaminated ink;
- Share objects that may have come into contact with blood: toothbrushes, nail clippers, razor blades, knives, etc.
In the case of sexual intercourse, the risk is low. However, the risk increases when sexual intercourse is unprotected and blood is present (during menstruation or receptive anal sex, for example).
However, certain populations are disproportionately affected by HCV:
- Injecting drug users;
- Incarcerated persons;
- Aboriginal communities;
- Men who have sex with men (MSM);
- The immigrant population;
- People born between 1945 and 1975.
How to protect yourself
The best way to protect yourself from hepatitis C is to:
- Always use sterile equipment (injection, crack pipe, straw) when using drugs;
- Always have your own personal hygiene items;
- Make sure that the tattooist tears open the envelope containing the new needle to be used for tattooing/piercing, and that the ink used is for one person only. The virus can live for 72 hours in the open air or in the ink;
- Wear a condom during sexual relations;
- Wear latex gloves when you may be exposed to blood.
Treatment
HCV treatments have greatly evolved since 2015: they are shorter and have fewer side effects.
Treatment consists of taking 1 to 3 tablets every day for 8 to 12 weeks. The cure rate is over 95%. Some side effects may occur, but these diminish over time. Treatment can cure hepatitis C and prevent progression to liver failure.
Unlike hepatitis A and B, there is no vaccine to prevent infection.
Note that 1/4 of people whose HCV has cleared naturally, and people who have recovered from HCV with treatment, can contract HCV again if exposed to the virus. The body does not develop permanent immunity.