Hepatitis C: Frequently Asked Questions

Hepatitis C is an inflammation of the liver caused by a virus transmitted solely through contact with blood of an infected person. Worldwide, between 170 and 240 million people have hepatitis C. There are approximately 242,500 cases in Canada and 50,000 in Quebec, with 2,000 new cases each year.

Hepatitis C is the leading reason for liver transplants in Canada. Globally, there are more deaths due to the hepatitis C virus than to HIV.

Prevention

Is there a vaccine that prevents hepatitis C infection?

No.

Is there another vaccine that may help prevent other diseases?

There are vaccines for hepatitis A and hepatitis B. You can get them separately or together in Twinrixrx (against HAV and HBV). There are also vaccines against influenza and pneumococcus that are useful, particularly if you have HIV/AIDS or HIV/AIDS+HVC (hepatitis C).

Transmission

Can I contract hepatitis C from having sex?

Transmission can occur during unprotected sex, if the sexual activity involves blood-to-blood contact.

Can the infection go away by itself?

Yes, 25 to 40% of the people who contract Hep C clear the disease « by themselves » within the first 6 to 12 months.

What is Hepatitis C?

Can I get a positive blood test, but not actually have hepatitis C?
Yes. In this case, you are one of the 25 to 40% of people who succeed in ridding themselves of the disease (your body rejects it). The antibodies produced from having HCV in your body show up in the blood test. They will show up in blood tests for a long time and perhaps for the rest of your life.

Is there a type of HCV (or genotype) that is more dangerous than another?

No. But the genotype you have is important because the treatment is successful in different percentages for each genotype. Also, the number of months required for treatment differs according to genotype.

Does hepatitis C have specific signs or symptoms?

Most people (80% experience fatigue and a lack energy. Other symptoms may include sore muscles and joints, skin problems, cryoglobulinemia, irritability, night sweats, nausea, etc.

Liver, cirrhosis, consequences

What does hepatitis C do to my liver?

It causes lesions that prevent the liver from doing its normal work. Since the liver is an organ that suffers in silence, you may not be aware of the damage being done to your liver.

What is « cirrhosis »?

Cirrhosis is a consequence of chronic liver disease characterized by fibrosis and liver lesions. The growth of these lesions leads to the death of liver cells, eventually resulting in liver cancer.

What are « enzymes »?

Enzymes are biological catalysts. Enzyme levels are an important indicator of a damaged or diseased liver. High enzyme levels are normally an indication that the liver has sustained a certain amount of damage. They are also an indication that the HCV virus is present.

If my enzyme levels are normal, does it means that hepatitis C virus is « dormant ? »

No. The hepatitis C virus does not sleep! A number of factors may cause enzyme levels to fluctuate, including alcohol, streets drugs and prescription medication; however, enzyme levels are not indicative of the seriousness of the lesions. It is possible the have normal enzyme levels and still have significant lever damage.

Treatments

What new treatments are called?

They are called DAA (direct acting antiretrovirals). At the pharmacist, they are called Sovaldi, Harvoni or Holkira Pak.

Does it is still interferon in new treatments for hepatitis C?

Less and less. The new DAA treatments are without interferon. Harvoni and Holkira pak are only for patient F3/F4 in Québec, they are with or without ribavirin. In the next 5 years, these treatments could be prescribed progressively to every patient with a chronic hep C.

What is the difference with the new drugs ?

They work directly in the cell and are therefore more effective because they directly target the virus and his replication. As they are more efficient, they can be shorter treatments like 8, 12 or 24 weeks.

What are the side effects of the treatment ?

Headache, fatigue and nausea.

Medicinal herbs and HCV

Just because the label says « natural » doesn’t mean the product is harmless. Be very careful. These products must also be « processed » by your liver, and they may be toxic or cause interactions with your medication. You absolutely need to ask your doctor BEFORE you take any « natural products » or « over-the-counter medications ».What is written on the product label doesn’t necessarily tell you what’s inside the bottle ! Be VERY CAREFUL. There is no such thing as a « magical natural product » that will cure your disease!

Everyday life

If I have hepatitis C, what kind of precautions should those around me should take ?

The only way the hepatitis C virus can spread is through blood-to-blood contact. To prevent transmission, people should avoid sharing personal hygiene items such as razors, scissors, nail clippers, toothbrushes, etc.

If I have hepatitis C, do I have to be on a specific diet ?

It is only common sense to try to eat as healthily as possible. Try to avoid any kind of excess. Eat a wide variety of foods in order to get all the nutrients your body needs. Engage in moderate and regular physical activity. While you’re on treatment, drinking lots of water can alleviate some of the side effects.

Can I get pregnant and have a baby if I have hepatitis C ?

The risk of mother-to-child transmission may be up to 5%, and 7 times higher if the mother has both HCV and HIV/AIDS. While a woman is on HCV treatment, she should avoid becoming pregnant until 6 months after the cessation of treatment, because ribavirine can cause fetal malformations. This applies to both the man and the woman in the couple. Regardless of whether it is the man or the woman who is undergoing HCV treatment, if a couple wish to have a baby, they should wait until 6 months after the end of the treatment to start trying to have a baby.