Hepatitis C is a serious liver infection caused by the Hepatitis C virus (HCV). Unlike Hepatitis A and B there is currently no vaccine available for Hepatitis C making awareness, prevention, and early detection critical. In 2023, 3,406 hepatitis C cases were reported in Ontario. If left untreated, it can lead to severe liver damage, cirrhosis, or liver cancer. However, with proper treatment, most people can completely eliminate the virus from their bodies.

What is Hepatitis C?

Hepatitis C is a viral infection that primarily affects the liver, causing inflammation and potential long-term damage. Many people do not experience symptoms from Hepatitis C for years making regular screening for those at risk essential.

The virus is spread through blood-to-blood contact, making it a major concern among people who have unprotected sex with multiple partners, share needles or receive unscreened blood transfusions. In recent years, improved screening and antiviral treatments have significantly reduced transmission, and improved cure.

Causes

Hepatitis C spreads when the blood of an infected person enters the bloodstream of an uninfected person. Examples of causes include:

Sharing needles or syringes - the most common cause of HCV infection, especially among people who inject drugs
Being born to an infected mother - while rare, transmission from mother to infant can occur
Sexual transmission of Hepatitis C is rare - particularly among men who have sex with men (MSM) with HIV or rougher sexual practices that lead to bleeding

Prevention Strategies

Avoid sharing needles or drug equipment
Safe sex practices particularly using condoms
Ensure medical and tattoo equipment is sterilized - Always go to licensed facilities.

Symptoms

Most people with Hepatitis C experience zero or mild symptoms for years. Symptoms occur as a result of liver damage and may include:

Feeling very tired
Fever
Loss of appetite
Nausea or vomiting
Pale feces, dark urine
Pain on the right side of the abdomen
Jaundice (yellowing of eyes or skin)

Testing

People who engage in high risk sexual encounters such as having multiple partners or MSM should test for Hepatitis (A, B and C), STIs and HIV every 3 months. Regular testing is essential for early diagnosis to prevent liver damage, reduce risk of transmission and to offer earlier therapeutic intervention. Testing for Hepatitis C involves a 2 step-process:

Screening test (HCV Antibody Test) – This checks for antibodies to HCV, indicating past or present infection.
Confirmatory test (HCV RNA Test) – If the antibody test is positive, this test confirms whether the virus is still in the blood and if an active infection is present. In this step, the doctor can also check the type (genotype) of Hepatitis C virus and compare the viral load.

People who have had Hepatitis C in the past can still get infected with the virus again.

Treatment

If you test positive for Hepatitis C, your doctor can refer the case to a hepatologist who can assess and provide a treatment plan.

Hepatitis C is now curable for most people. Direct-acting antiviral (DAA) medications taken for 8 to 12 weeks have revolutionized treatment, with cure rates above 95%. The type of medication you are prescribed depends on the type (genotype) of Hepatitis C you have.

Common medications include: