Hepatitis C

Hepatitis is a disease that causes damage to your liver.

There are different kinds of hepatitis, caused by viral infections or alcohol use.

• Some types of hepatitis will pass without causing lasting damage to the liver.
• Other types can last for many years, causing scarring of the liver and increasing the risk of liver cancer.

Hepatitis that is caused by viral infections is called viral hepatitis. The three most common types of viral hepatitis are hepatitis A, hepatitis C, and hepatitis C.

• Hepatitis A is a type of viral hepatitis that is passed on through contaminated food and water or during sex. Find out more about hepatitis A here.
• Hepatitis B is a type of viral hepatitis that is passed on through blood and bodily fluids. Find out more about hepatitis B here.

First identified in 1989, Hepatitis C is a virus that lives in the blood.

• Hepatitis C is passed on through blood to blood contact. 
• For some people, hepatitis C is cured naturally by the body’s immune system soon after infection.
• For most people, hepatitis C is cured by a highly effective 8-12 week course of treatment. 
• Hepatitis C can have lots of symptoms and over time, causes damage to the liver. 

Symptoms of hepatitis C are different for everyone.

• Most people with hepatitis C experience symptoms like fatigue, memory loss, nausea, low mood, headaches, or muscle and joint pain. If left untreated, people may have yellowing of the eyes and skin. This is called jaundice.
• For some people who have hepatitis C, there may not be symptoms you can see or the symptoms may go unnoticed. This is because the symptoms of hepatitis C are common symptoms in lots of different health conditions and can be missed by your doctor.
• Even if you do not experience any symptoms of hepatitis C, the virus still causes damage to the liver.
• To learn more about the symptoms of hepatitis C, check out Hep C Trust's guide to symptoms.
• If you think you have been at risk of hepatitis C recently or in the past, the first step is getting a hepatitis C test. Find out where you can get tested in your local area here.
• If you are worried about hepatitis C, we’re here to help you. Get in touch with us for support and advice here.

Hepatitis C is passed on through blood to blood contact.

This is when the blood of a person who has hepatitis C gets into the bloodstream of someone who doesn’t have hepatitis C.

Unlike HIV, hepatitis C can live outside the body for up to 3 weeks. It can be present in very small amounts of blood, often invisible to the naked eye.

• In Scotland, hepatitis C is most commonly passed on through sharing needles or other injecting equipment such as syringes, water, filter spoons or tourniquet.
• The opportunity for blood to blood contact between someone who has hepatitis C and someone who doesn’t is relatively rare. However, it’s important to get tested for hepatitis C if you think you have been at risk. 

Other ways hepatitis C can be passed on include:

• By sharing a tooter or banknote when snorting cocaine. This is because cocaine causes blood vessels to burst in the nose, making it more likely for a person who has hepatitis C to pass it on by sharing snorting tools.
• Contaminated piercing or tattoo equipment (including ink). This is a low risk in Scotland however, if you have had a tattoo or piercing abroad, there may not be the same infection control and you should consider getting a hepatitis C test. Find out where you can tested in your local area here.
• Acupuncture, electrolysis, medical or dental treatment in countries where infection control may be poor
• Having received a blood transfusion in the UK before September 1991
• Having received blood products in Scotland before 1987 o Having received blood products in England before 1986
• Having received an organ or tissue transplant in the UK before 1982
• Sexual contact with someone who has hepatitis C. This is a low risk and can happen when both partners have broken skin allowing blood to pass from the bloodstream of a person who has hepatitis C into the bloodstream of a person who does not have hepatitis C
• Being accidentally exposed to blood where there is a risk of passing on hepatitis C. For example, a healthcare worker with a needle stick injury
• Being exposed to hepatitis C through close household contact (sharing toothbrushes or razors) with someone who has hepatitis C
• From mother to baby during birth. This is a low risk however if a mother is also infected with HIV, the risk of passing on hepatitis C to the baby is higher.
• Hairdresser and barber equipment such as scissors, clippers, and razors, where they have not been sterilized or cleaned after each use. This is a low risk in Scotland however, this risk may be higher in countries where infection control may be poor

If you’re not sure if you have been at risk now or in the past, get in touch with us for support and advice here.

Hepatitis C is NOT passed on through:

• Spitting
• Kissing or hugging
• being bitten
• contact with unbroken skin
• being sneezed on
• sharing towels, blankets, mugs or cutlery
• using the same toilet, bath, shower or swimming pool
• CPR, or mouth to mouth resuscitation
• contact with animals or insects like mosquitoes

If you think you have been at risk of hepatitis C recently or in the past, you can find the nearest place to get a hepatitis C test by searching our simple service directory here.

If you’re unsure, have any questions or concerns, you can get in touch with us for support and advice.

• Getting a hepatitis C test is quick, easy and confidential.
• Hepatitis C tests are provided to anyone free of charge on the NHS.
• If a test does not find hepatitis C in your blood, the result is ‘negative’. If a test finds hepatitis C in your blood, the result is ‘positive’.

There are two types of test for hepatitis C, these include:

• Dry blood spot test: this is where a small amount of blood is taken from your finger and blotted on a filter paper. This is then sent to a laboratory, where the blood is screened for hepatitis C. You will usually receive results from this test in 2-3 weeks.
• Dry Blood Spot tests are available in some GP surgeries and from Waverley Care testing services in Glasgow and Edinburgh.
• If you have a ‘positive’ result on a dry bloodspot test, you will be asked to take a second blood test to confirm the results. This is because some tests may not give you a reliable result for a longer period after infection. If the second test is also positive, you will be referred to a specialist hepatitis C clinic. If you have any questions or concerns, get in touch with us for support and advice.

• Blood test: a blood test is when a blood sample is taken from a vein in your arm. It is usually taken from the inside of the elbow or wrist, where the veins are close to the surface of your skin. When the blood sample is taken, it is sent to a laboratory where it will be screened for hepatitis C. The results are then sent back to where you were tested. This might be your GP, hospital or sexual health clinic. You will sometimes receive the results on the same day however, it can take up to a few weeks. When you are getting a blood test, ask your doctor or nurse when you can expect the results.

Hepatitis C is passed on through blood to blood contact.

In Scotland, hepatitis C is most commonly passed on through sharing needles or other injecting equipment such as syringes, water, filter spoons or tourniquet.

• You can prevent hepatitis C transmission by never sharing injecting equipment.
• If you are worried about hepatitis C transmission, we’re here to help you. Get in touch with us for support and advice.

For more information on hepatitis C risk factors, check out:

• Hep C Trusts Guide to Risk Factors
• Hepatitis Scotland's Guide to Risk Factors

There are now highly effective direct-acting antiviral treatments available that can cure hepatitis C. 

Here are the most frequently asked questions about hepatitis C treatment:

• Can treatment cure hepatitis C? Yes! New highly effective hepatitis C treatment means you now have at least a 90% chance of clearing hepatitis C, if you take your medication as prescribed by your hepatitis C doctor or nurse.
• What does treatment involve? Hepatitis C treatment involves taking 1-3 tablets a day for 8-12 weeks. Before you begin treatment, you will be assessed by your doctor or nurse, to see if there is any damage to your liver and to find out what treatment will work best for you.
• How do I get hepatitis C treatment? You need to be assessed for hepatitis C treatment, before you can begin the treatment regimen. This is for two main reasons. Firstly, to find out what impact hepatitis C might have had on your body already. Secondly, to find out what treatment works best for your body and doesn't interfere with any other medication you may be taking. Assessment for hepatitis C treatment is also an opportunity to think about what support you might need through treatment. Find out more about the support we can offer you through our simple service directory here.
• What does an assessment for hepatitis C treatment involve? You will be assessed for hepatitis C treatment at your nearest treatment clinic. The assessment involves 2-3 appointments before you begin treatment, where you will get blood tests and a fibroscan (a non- invasive scan specifically for your liver, similar to an ultrasound). The blood tests and fibroscan help your doctor or nurse find out which treatment works best for you. 
• Am I eligible for hepatitis C treatment? If you're diagnosed with hepatitis C in Scotland, you can get treatment at your nearest treatment clinic. Get in touch with us for advice and support. If you're not sure where your nearest treatment clinic is located, check out Hepatitis Scotland's service finder here.
• Will the treatment work? If you take your hepatitis C treatment medication as prescribed by your hepatitis C doctor or nurse, you have at least a 90% chance of curing the condition. If you need support to help manage hepatitis C treatment, we're here to help - get in touch with us for advice and support. 
• Can I get hepatitis C treatment if I'm living with HIV? If you're living with HIV and taking your HIV medication as prescribed by your HIV doctor, you can get treatment for hepatitis C. You can do this by talking to your doctor about hepatitis C treatment. If you have HIV and hepatitis C, this may damage your liver at a faster rate. This means you may be assessed for hepatitis C treatment quickly. 

Further information:

• For more information on hepatitis C treatment, visit Hep C Trust's guide to treatment here. 
• For more information on dealing with doctors during hepatitis C treatment, visit Hep C Trust's helpful guide here. 

Coping with a new diagnosis can be a scary time for anyone. There can be lots of unknowns, from having new information about your health to take in and appointments to attend, to figuring out who to tell and how to tell them.

We’re here to support you every step of the way – get in touch with us for support and advice.

In the days, weeks and months after you are first diagnosed with hepatitis C, you may experience lots of emotions. It’s normal to feel anger, shock, depression, anxiety or even denial. You might feel like you don’t want to talk about it or, that you can’t talk about anything else. Everyone responds differently to a new diagnosis and there is no right or wrong way to feel. 

• Reaching out for emotional support is the first step in coping with a new diagnosis and finding out about treatment. Hepatitis C is curable with treatment and, it is important to remember you are not alone and there are people there to support you. You can reach out to us, where we will work with you helping you understand what’s going on.
• You can also get support from our Peer Mentors, who have each experienced a new hepatitis C diagnosis and can help you through hepatitis C treatment by learning from their experience.
• Alongside support services and Peer Mentoring, it’s important to find a family member or friend who you can share your diagnosis with, if possible. Finding someone to tell can be difficult, but when thinking about who to approach first it’s worth considering; who is someone whose response you can more or less expect will be supportive?
• There can often be lots of practical things to consider with a new diagnosis. These might include making sure you can get to your hepatitis C treatment clinic, finding ways to take your medication when you’re on treatment or getting benefits and housing in place. 
• Locating a support group is another way of coping with a new diagnosis. Depending on where you live there may be an in-person support group. You can find out more by entering your location in our simple service directory.
• There are lots of great podcasts, videos and resources which can help you learn about the experiences of others living with hepatitis C, including My Hep C Story by Hepatitis Scotland

Finishing hepatitis C treatment can be a big goal in life, but for some people it can mean one question - what now?

When you're finished hepatitis C treatment, it's important to know:

• Your body needs time to heal. Hepatitis C damages the liver, so when you finish treatment your liver will begin to repair some of the damage and your body will begin to recover. 
• If your liver has a little damage, your hepatitis C doctor or nurse will explain this to you. It's recommended that you eat well, take regular exercise and refrain from alcohol use to help your body recover. 
• If your liver has a lot of damage (sometimes called cirrhosis of the liver), your hepatitis C doctor or nurse will continue to monitor your liver and you may continue to have appointments with a liver clinic. To find out more about hepatitis C and the liver, check out Hep C Trust's guide here.
• Finishing hepatitis C treatment can mean lots of emotions and you might find adjusting to life after hepatitis C is challenging. We're here to help you think about and plan for the future beyond hepatitis C. Get in touch with us for support and advice. 

Finding out that your partner, family member or friend has a health condition like hepatitis C can be a worrying time. You might be concerned about the health of your loved one or not know what to say.

The first thing to know is hepatitis C is curable, with highly effective treatment. Here are some frequently asked questions that will help you better understand hepatitis C:

• How can I help? Learning about hepatitis C, the symptoms and treatment can help you support your loved one and understand what they're going through. Being patient with your loved one and letting them know you are there for them can make a big difference.
• My loved one has just been diagnosed, what now? Finding out about a new diagnosis can mean lots of emotions, from shock and confusion to anger. You can help your loved one cope with a new diagnosis by listening to their concerns, learning about hepatitis C treatment and staying positive by remembering that hepatitis C is curable. 
• My loved one is on treatment, what do I do? Being there for someone while they are on treatment for any health condition can be challenging. The best thing you can do if your loved one is on hepatitis C treatment is to understand the treatment, it's side effects and the symptoms of hepatitis C. By knowing more about hepatitis C, you can better understand what your loved one is going through and be patient with any ups and downs they might experience. For some people, having appointments at treatment clinics can be a lot to cope with - offering to go along to appointments with them can also provide some comfort.
• How do I stay safe? Remember, you can only get hepatitis C if the blood of a person with hepatitis C gets into your bloodstream (also known as blood to blood contact). That means you can stay safe by preventing any risks of infection. Find out more about staying safe with Hepatitis Scotland's guide here.
• Can you get hepatitis C through sex? There is a very low risk of passing hepatitis C on through sex. However, if you are having sex with someone who has hepatitis C, where there is a risk of blood to blood contact (such as sex during menstruation or anal sex), you should use a condom to prevent hepatitis C infection. It's also recommended that you avoid any sexual activity that involves biting, scratching or anything causing cuts/breaks to the skin, to prevent hepatitis C infection.

If your partner, family member or friend has hepatitis C and you need advice or support, get in touch with us here. 

If you have hepatitis C as well as HIV and/or hepatitis B, this is called coinfection. 

In other words, coinfection means being infected with more than one virus.

• If you are living with hepatitis C, as well as HIV or hepatitis B, this will cause your liver to become more severely damaged, faster. It can also mean treatment for hepatitis C is less effective.
• If you are living with hepatitis C, as well as HIV or hepatitis B, it is recommended that you use a condom during sex as this increases the chance of passing the viruses on to your sexual partners.
• If a mother who is living with hepatitis C is also infected with HIV, then the risk of passing on hepatitis C to the baby is higher.
• It's important to talk to your doctor about treatment, as well as preventing onward transmission of the viruses if you are coinfected.

If you are living with hepatitis C, HIV or hepatitis B, we're here to help you through it. Get in touch with us for support and advice.