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FAQ


Can Hepatitis C be caught by kissing?

NO. Hepatitis C is a blood borne virus there must be blood to bloodstream contact for the virus to pass from one person to another. Kissing is not a risk. Sharing needles for drug use or other paraphernalia is the highest risk today.


How many kind of hepatitis C are there?

There are 6 different types of Hepatitis C called genotypes 1, 2,3,4,5 & 6. In the UK, genotypes 1, 2 & 3 are most common.


Is Genotype 1 the worst one to have?

NO. Any genotype may cause liver disease. Genotype 1 does take longer to treat than genotypes 2 and 3 (1 year rather than 6 months). The success rate for treatment is also lower. BUT genotype 1 will not cause someone to be more ill.


Is there treatment for Hepatitis C?

YES. The treatment for Hepatitis C means taking a weekly injection of Interferon and a twice-daily dose of Ribavirin tablets.


Does the treatment for Hepatitis C work?

YES. Treatment can be successful and at least 50% of people can be cured of Hepatitis C BUT it is not always successful.


Once you have Hepatitis C have you got it for life?

Not necessarily. 1 in 5 of all people who catch Hepatitis C will get rid of the virus themselves without any treatment. And at least half of the rest can be cured with treatment.


If you have Hep C are there things you can do to help yourself?

YES. There are things you can do to help stay healthy:

  1. Avoid alcohol
  2. Have a healthy diet
  3. Take regular exercise
  4. Learn to relax

Is Hepatitis C a new disease?

NO. Hepatitis C has possibly been around forever. However tests to identify it were only developed in 1989. Before then it was known as nonA-nonB Hepatitis.


Do only injecting drug users get Hepatitis C?

NO. Anyone could catch Hepatitis C from another infected person by:

  1. Sharing toothbrushes or razors
  2. Unsterilised tattooing or piercing equipment
  3. Unprotected sex especially anal sex
  4. Unsterile medical equipment (e.g. in an underdeveloped country)
  5. Blood transfusions received in the UK before 1991
  6. Sharing other drug paraphernalia such as straws or pipes
However sharing of injecting paraphernalia is the most common route of transmission in the UK today.


How soon after being at risk should someone be tested for Hepatitis C?

Six months. Because it can take the body up to 6 months to develop antibodies to the virus, there needs to be this time between being exposed to the virus and being tested to be sure.


Can Hepatitis C lie dormant in the body?

NO. The virus will always be present in the blood stream. If you have been told you are positive for Hep C antibodies (ELISA) and the test for viral particles is negative (the PCR test) then you do NOT have Hep C. You were exposed to the virus and cleared it yourself.


Where should people be tested for Hepatitis C?

Everyone should have a full pre test discussion before being tested. A specialist testing service will offer this. In Glasgow; C-Level has a confidential testing service. The Brownlee Centre the Sandyford Centre and some Community Addiction Services also offer a testing service.


Will Hepatitis C kill you?

NO, PROBABLY NOT. Hepatitis C can be a very serious disease and may lead to liver failure BUT most people with Hep C can lead long and healthy lives. By taking care of yourself and not drinking alcohol you can stay healthy. (C-Level can offer you lots of advice, support and information)


Who should you tell if you have Hepatitis C?

You don't have to notify anyone unless you work for the NHS and do exposure prone work (like working in an operating theatre). It makes sense for your GP to know so he/she can take care of your health. You may want to tell your partner or other family members. (Talk to someone at C-Level about who, when and what to tell)


Can you pass Hepatitis C to your sexual partner?

YES. Sexual transmission can happen BUT blood to blood contact is needed to pass the virus. The risk of this is increased by:

  • Having any other sexually transmitted disease (STD)
  • Anal sex
  • Multiple partners
Sexual transmission between monogamous heterosexual partners is quite rare.


Can you still get life insurance and a mortgage if you have Hep C?

YES. Although you may have to pay higher premiums for health or life insurance, you can still get a mortgage. If you already have insurance before being diagnosed your premiums should not be increased. This is the same for anyone with any chronic health problem.


What is the difference between acute and chronic Hepatitis C.

ACUTE refers to being in the first 6 months of having Hepatitis C. The disease is in a very active phase, the viral load will be high, the liver will be inflamed and a third of people will feel ill.

CHRONIC means that the disease is constantly present (i.e. still there after 6 months), many people with chronic Hep C feel perfectly well and their liver function can be good, although they do have the virus and can pass on the virus.


If a pregnant woman has Hepatitis C will she pass it on to her baby?

Perhaps, a Hep C positive mum has only a 5% chance of passing the Hepatitis C virus to her baby when it is being born (A one in twenty risk). Babies born to Hep C positive mums should only be tested at around 18 months old to make sure that any antibodies from the mum will have cleared away.


Can you recognize someone with Hepatitis C because their skin and eyes will appear yellow?

NO. It is unusual for someone to develop jaundice (and have yellow looking eyes and skin) from Hepatitis C infection. It happens very occasionally at initial infection or can be a sign of liver failure in the latter stages of the disease. Most people with Hepatitis C will never look jaundiced.


Can you catch Hepatitis C if you have NEVER shared needles and syringes?

YES. All injecting equipment can carry Hepatitis C infection; needles, syringes, spoons/cookers, water, filters and tourniquets can all be routes of transmission. Most injecting drug users are helped by someone else to inject the first few times. This is very often when people become infected, either by some shared paraphernalia or from the other person’s hands, which may carry, invisible traces of blood from their own 'hit'.


Is it true that as long as you don't ever inject you cannot catch Hepatitis C from drug use?

NO. sharing a straw (or rolled up banknote) to snort drugs can pass the virus from one person to another. Sharing crack pipes can also be a risk because of the deep burns that people sometimes get on their fingers.


What are the routes of transmission for Hepatitis C?

  • Blood to blood
  • Injecting drug use, sharing needles, syringes, spoons, filters, water, tourniquets
  • Snorting drugs, sharing straws
  • Smoking drugs, sharing crack pipes
  • Medical treatment in under developed nations
  • Blood transfusion before 1991
  • Tattoos or piercing
  • Sexually
  • Mother to baby
  • Sharing toothbrushes, razors, nail clippers

How many people in the world have Hepatitis C?

270 million, this is the number estimated by the World Health Organisation.


Viral hepatitis – is Hepatitis C the only viral hepatitis?

NO. There are at 7 known, identifiable kind of viral hepatitis with more being researched, Hepatitis A, B, C, D, E, F, & G


Can you get vaccinated against Hepatitis C?

NO, there is no vaccine to protect against Hepatitis C. The only vaccines available are to protect against Hepatitis A and Hepatitis B.


What will happen to you if you catch Hepatitis?

For every 100 people who catch Hepatitis C;

20 people will clear the virus within the 6 first months of being exposed
60 will remain chronically infected but may not develop any serious symptoms
20 will begin to develop serious liver disease within 20 years


What is an antibody?

This is what your own body makes to fight off infection. Having hepatitis C antibodies shows you have been exposed to the virus at some time in the past and your body has produced antibodies to attack the Hep C virus. The antibody test (ELISA) cannot be used to diagnose the disease; if this test is positive a further test is done to look for the virus itself (PCR test). Only if the PCR test is positive will you get a positive diagnosis of Hepatitis C.


What are the side effects from Interferon treatment?

Like all medications there is a long list of potential side effects from Interferon; however some people may only experience a few very mild side effects while others may feel worse.

The side effects can include:

  • Flu like symptoms (joint and muscle aches, sweating)
  • Tiredness/fatigue
  • A drop in white blood cell count (neutropaenia)
  • Depression
  • Hair loss
Treatment specialists monitor everyone on treatment to try and minimize any side effects and will offer advice on how to cope with them.


What are the side effects from Ribavirin treatment?

Like all medications there is a long list of potential side effects from Ribavirin; however some people may only experience a few very mild side effects while others may feel worse.

The side effects can include:

  • Skin rashes and itching
  • A drop in red blood cell count (anemia)
  • Thyroid problems
  • Fetal abnormalities (so you must not become pregnant or get anyone pregnant while on treatment)

If you are still using drugs will you be able to get treatment for Hepatitis C?

MAYBE, treatment can be hard to cope with and you must take your injection at the same time each week, and your tablets at the same times each day. So if your life is still chaotic treatment may not be offered. If you are stable and your consultant agrees you may be offered treatment. Being on methadone will NOT stop anyone accessing treatment.


Can I still be an organ donor if I have Hepatitis C?

NO, organs from anyone with a blood borne virus will not be accepted for donation because the person having the transplant would also become infected with the virus.


Can you get Hepatitis C from an insect bite like a mosquito?

NO, although some say this is a theoretical risk there are no known cases worldwide. If this were the case then many, many more millions of people would be affected and this has simply not happened.


Does Hepatitis C turn into HIV or AIDS when it becomes serious?

NO, Hepatitis C and HIV are two entirely different things. Both are caused by different blood borne viruses which are not related.


Can I get treatment for Hepatitis C from my doctor?

NO, at present treatment for Hepatitis C must be supervised by a consultant. Your doctor can refer you to be seen by a consultant at your nearest specialist hospital.


Why do some people get really ill with Hepatitis C while others are OK?

We don't really know what the differences are between people. However we do know that lifestyle can play a big part in how Hepatitis C affects people. Those who drink alcohol, especially if they drink a lot, will be far more likely to develop liver disease sooner than those who do not drink.


How many kinds of Hepatitis C are there?

There are 6 different genotypes. Genotypes 1, 2 and 3 are the most commonly found types in the developed world although all 6 types are found. Within each genotype there are also different types called quasi-species so for example someone could have HCV genotype 1b or genotype 2a etc.


If you have had Hepatitis C and got rid of it would you then be immune?

NO, you can always be re-infected with the same or another genotype, so it is important not to place yourself at risk again.


Can you catch Hepatitis C from cutlery?

NO, you will sometimes read that spoons can be a route of transmission for Hepatitis C, this means spoons used for cooking up a drugs hit, not spoons which are used for eating.


Does Hepatitis C affect the brain?

YES, indirectly because your liver is affected you can experience physiological, psychological or cognitive problems. Physiological symptoms can be headaches. Psychological problems can be; depression, anxiety, mood swings or panic attacks. Cognitive problems can be confusion, memory loss or difficulty concentrating.


What does having extra-hepatic symptoms mean?

Extra hepatic refers to symptoms that are not found in the liver itself. They are caused by the liver functioning being disturbed (even though the liver itself need not be diseased) and other organs being affected. Extra hepatic symptoms include;

  • Digestive problems – abdominal bloating, diarrhea, constipation, nausea or loss of appetite
  • Psychological & cognitive problems – anxiety, depression, mood swings, panic attacks, confusion, memory loss, poor concentration
  • Physiological problems – right shoulder pain, muscle ache, joint pain or headaches

What is liver disease?

Hepatitis C causes the liver to become inflamed, if this happened often enough the liver can become permanently damaged causing liver disease. The first sign of damage is scarring of the liver and is called fibrosis. If the fibrosis gets worse it develops into cirrhosis (this is just exactly the same as cirrhosis caused by alcohol abuse). Cirrhosis can cause problems such as;

  • Ascites is a build up of fluid in the abdomen.
  • Esophageal varices are varicose veins in the gullet, which can burst and lead to massive blood loss.
  • Cirrhosis can also lead to liver cancer

When would someone need a liver transplant?

If the person has developed de-compensated cirrhosis (this means that all of the liver is affected and there are no longer parts 'compensating' or making up for the damaged parts) a transplant will be needed. Not everyone will get a transplant because there are never enough donors. If someone has an alcohol problem or is still on methadone they will not get a transplant because the new liver would be unable to cope.


What is milk thistle?

This is a cheap, easily bought herb that contains a substance called sylimarin that is known to help the liver. It is routinely prescribed in other parts of Europe and is believed to help the liver cells regenerate themselves. Many people in the UK take milk thistle to help the liver; it is not believed to have any toxic effects. However it should never be taken while on treatment as it can speed up the liver metabolism meaning the medication doesn't last as long as it should in the bloodstream. It may also interfere with other medication such as painkillers. Always consult a qualified herbalist before starting to take herbal remedies and discuss your plans with your treatment specialist.


What does the liver do?

The liver has thousands of functions. Everything that enters your bloodstream; what you drink, what you eat, what you breathe in, what you absorb through your skin is processed by the liver. Everything you need to be alive relies on the liver, the liver detoxifies poisons, makes immune factors and clotting factors, it breaks down the chemicals you need from your food and it makes the chemicals which give you energy. Hormones, neurotransmitters and other chemicals manufactured elsewhere in the body depend on the liver providing the raw materials. So everything that happens in your body can be affected by any problems in the liver. The liver is absolutely essential for life.


Does Hepatitis C treatment make you bald?

One of the side effects of Interferon can be hair loss although it is not likely to lead to total baldness some people find their hair gets really thin. The hair will grow back when treatment stops.


Can you get pregnant while on treatment for Hepatitis C?

It is essential that children are NOT conceived when either parent is on treatment. The Ribavirin is fetotoxic, in other words it can cause birth defects. This toxicity is present in the eggs and the sperm. So whether you are male or female you should not start a family while on treatment, to make sure that this doesn't happen using 2 forms of contraception at the same time is recommended i.e. being on the pill and using condoms.


What foods may make confusion and memory loss worse?

Many people with Hepatitis C find that ammonia rich food such as ground and processed and cured meat, mature cheese and gelatin make their cognitive symptoms worse. When these are cut from the diet or intake is greatly reduced there is an improvement in cognitive functioning. The meats to avoid are sausages, burgers, pies, spam, bacon, gammon, ham, salami etc. The cheese to avoid is hard cheese like mature cheddar etc Gelatin is in lots of different sweets, cakes and biscuits.


If you have digestive problems what should you eat?

Many people with Hepatitis C find that cutting out citrus fruit, oranges, lemons, limes, tangerines, Satsuma's etc. helps reduce nausea. If appetite is poor it is recommended that the person takes small snack sized meals 4 or 5 times a day rather than 3 large meals.


How can you make sure you don't give Hepatitis C to your family?

Make sure that any personal items that could contain microscopic amounts of blood are never shared. These items are razors, toothbrushes, nail brushes and nail clippers. Keep these in a wash bag separate from the family things. If you cut yourself make sure you clean up any blood spill properly. Mop up blood with paper towels and dispose of them in the bin, cover the area with bleach or Milton and leave for 10 minutes to kill any remaining virus then mop up again with paper towels and put them in the bin. If cleaning up someone else's blood make sure any cuts on your own hands are covered by a waterproof plaster and ideally wear rubber gloves before starting.


How long does the Hepatitis C virus survive outside the body?

Some research suggests that the virus can remain active in dried blood for up to 2 months. More recent research (with chimpanzee blood) has found that the virus will remain active for at between 16 hours and 4 days.


Can you get Hepatitis C from a blood transfusion?

Not now. All blood donations in the UK are screened for Hepatitis C and other blood borne viruses and have been since 1991. Blood received before then was not screened so if someone had a transfusion before 1991 they have a less than 1% chance of having been exposed.


Is there a risk from medical treatment such as operations, vaccinations and dental treatment?

There is almost no risk from any medical treatment in the developed world. Universal precautions, the sterilizing of all equipment between patients and single use needles means infection should not happen. Very occasionally if there has been a breakdown in the use of universal precautions a risk occurs. Whenever this has happened all potentially exposed patients are notified and encouraged to come forward for counseling and testing. Medical treatment in less developed countries where they cannot afford single use needles or there is inadequate sterilization can be more risky.

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