Hepatitis C

What is hepatitis C?

Hepatitis C is a liver infection caused by the hepatitis C virus (HCV). Infection with the virus causes liver inflammation and can cause liver disease.

How do you get hepatitis C?

Hepatitis C is transmitted from contact with infected blood. You can get infected if even a small amount of infected blood gets into your blood stream. Sharing needles, syringes, or other equipment to inject drugs can transmit hepatitis C. People also get hepatitis C from needlesticks and sharps injuries in healthcare settings.

It’s also possible to transmit hepatitis C by sharing toothbrushes, razors, or tattoo and piercing equipment.

More and more gay & bi men and other men who have sex with men—particularly men who have HIV—are getting hepatitis C, even though historically, sexual activity was though of as a low-risk activity for transmission. Some of these cases might be from sharing injection equipment, but it seems that most are due to sexual transmission.

Hepatitis C transmitted during sex usually happens during condomless anal sex. Risk of transmission goes up with any sexual activity that damages the lining of the anus—such as fisting, sex sessions that last a long time or rough sex. Group sex, party drug use before sex and using unwashed sex toys can also put you at risk of hepatitis C if you’re exposed to blood or you have breaks in your skin.

The hepatitis C virus also lives in semen, but whether or not this adds to the risk of transmitting hepatitis C during condomless anal sex is unknown.

What are the symptoms or signs of hepatitis C infection?

A lot of people with hepatitis C won’t experience any symptoms. Other people may get flu-like symptoms, nausea, or abdominal pain pretty soon after getting infected. During the first 2 to 6 months after getting infected, some people clear the virus from their body on their own. Others go on to develop a chronic hepatitis C infection, which can result in cirrhosis and liver cancer after many years.

How do I get tested for hepatitis C?

A blood test is used to diagnose hepatitis C. This is called an HCV antibody test. If you’re living with HIV, you should have a hepatitis C test at least once a year. Testing every 6 months is recommended if:

  • You have had more than 10 partners in the past six months;
  • You have had condomless anal sex;
  • You have used recreational drugs; and/or,
  • You have had group sex.

If you have hepatitis C now or have had it in the past, you have hepatitis C antibodies in your blood. But even if your body clears the infection on its own, you could get re-infected if you come into contact with the virus again. You don’t develop immunity to the hepatitis C virus (unlike hepatitis A and hepatitis B).

For people who don’t clear the virus on their own, the infection will be monitored with liver function tests.

Can hepatitis C be treated?

There are newer treatments now available for hepatitis C that can clear the virus from your body and prevent the virus from causing cirrhosis (scarring) of the liver, liver cancer or liver failure. These new treatment options might work for you if you’ve older treatments didn’t work. Treatments can have a range of side effects that can go from mild to very severe.

Not everyone can be cured of hepatitis C, since hepatitis C medications work better on some strains of the virus than others. But, the sooner you are diagnosed, the sooner you can get treated, and you have a better chance of being cured with early treatment. Chronic hepatitis C infection can be monitored with liver function tests.

Some people find complementary therapies and lifestyle changes to be helpful in managing hepatitis C symptoms.

Treatment options for people who are coinfected with HIV and hepatitis C can be more complicated. Your doctor will be able to tell you more about your treatment options. Talk to your doctor about your treatment options.

How can hepatitis C be prevented?

There isn’t a vaccine you can get to prevent hepatitis C infection.

Here’s what you can do to reduce the likelihood that you’ll get hepatitis C:

  • Use condoms and water- or silicon-based lube during anal sex, especially if there is blood or other STIs;
  • Wear gloves and use water- or silicon-based lube during fisting;
  • Don’t share sex toys with sex partners. Or, put a condom over insertive sex toys and change them between different partners;
  • Wash hands and sex toys before and after sex and between partners;
  • Don’t share injection equipment like needles, syringes, swabs, spoons, filters, water or tourniquets. Always use new injection equipment;
  • Wash your hands before and after using injection drugs;
  • Don’t share personal items like toothbrushes, razors, nail clippers, or nail scissors;
  • Make sure body artists use new and sterile equipment if you get tattoos, body piercings or other body art; and,
  • Wear disposable gloves if you give someone first aid or are cleaning up blood or other body fluids.

If you are living with hepatitis C:

  • Be careful if you get blood on anything. Clean your blood off surfaces carefully if you cut yourself. Wear disposable gloves and use household bleach to clean up blood spots or spills. Then use cold water to rinse the surface;
  • If you cut yourself or have some other skin wound, cover it with sterile, waterproof dressing;
  • Put any tissues, napkins, bandages, or wound care items exposed to your body fluids in a sealed or knotted plastic bag before throwing them away;
  • If you get blood stains on your clothes, rinse the blood out first and then wash your clothes on a regular wash cycle; and,
  • Wear a condom and use a water-based lube during sex.

Hepatitis C & HIV coinfection

People living with HIV are more likely to have hepatitis C than people who are HIV-negative. This might be because behaviors that expose a person to HIV might also expose them to hepatitis C.

A person coinfected with hepatitis C and HIV:

  • May have more difficulty getting an accurate hepatitis C test result (i.e., may be more likely to get a false-negative or indeterminate test reading);
  • May have a higher concentration of the hepatitis C virus in their body fluids;
  • May have higher HIV viral loads but probably won’t experience faster HIV disease progression;
  • Can safely treat both infections, although usually not beginning at the same time since this can make side effects worse (getting HIV under control is usually the first priority); and,
  • Must have their liver enzymes monitored regularly since HIV medications can cause liver inflammation or damage.