Advice and Information about Hepatitis C For patients, carers and the public

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1 Advice and Information about Hepatitis C For patients, carers and the public What is Hepatitis C virus (HCV)? Hepatitis means inflammation of the liver. Many things can cause Hepatitis, including excessive alcohol, drugs, medicines, viruses and chemical agents. HCV is one of several viruses that can affect the liver. It circulates in the blood and may cause liver inflammation including long-term damage. HCV is found all over the world. Before 1989, the inflammation was known as non-a, non-b Hepatitis. About 1 in 100 people may be infected in Scotland. How is HCV passed on? HCV is infectious and spread in many ways, but most commonly through blood: Sharing needles, syringes and other injecting equipment e.g. filters, spoons, water. Through skin puncture by blood-contaminated sharp instruments, e.g. needle-stick injury, tattoo, acupuncture, body piercing, electrolysis. Less common ways include: Receiving transfusion of unscreened blood or blood products (UK blood products have been screened for HCV since 1991). Unprotected sexual intercourse. Babies born to mothers who have HCV may become infected. Through exposure to blood, e.g. splash to open cut or mucous membranes, penetrating human bite, sharing razors or toothbrushes. HCV is not transmitted by: Hand shaking, kissing, cuddling. Coughing or sneezing. Sharing cups, cutlery, toilet seats, etc. 1

2 How to avoid getting or passing on HCV If you inject drugs get support to stop injecting. If you inject drugs do not share needles, syringes, water, or anything you use to prepare your fix. Avoid skin piercing procedures (e.g. tattooing) with unsterilised equipment. Cover cuts or wounds after washing, with a waterproof dressing e.g. plaster. Clean up spilled blood immediately, wearing rubber gloves. Use a weak bleach solution for hard surfaces (follow instructions). On carpets and soft furnishings, use hand hot or warm soapy water to clean the area and dry as well as possible. Use condoms for sexual intercourse, especially if you or your partner have more than one sexual partner. Do not share toothbrushes or razors. This advice will also help prevent other infections, e.g. Hepatitis B and HIV. There is no vaccination against HCV. Is there a test for HCV? HCV infection may have occurred many months or years ago. Blood tests are available, the anti-hcv test checks for antibodies your immune system forms if you have been exposed to the virus. It becomes positive if you have been exposed. It is negative if you have not come into contact with HCV. However these antibodies may take up to six months to appear after infection has occurred. This is known as the incubation or window period. The HCV PCR test tells us if you have ongoing infection. If it is positive, you are still infectious. If it is negative, it is highly unlikely that you are infectious. Having the HCV test itself does not affect current or future insurance policies. However, a positive result may, and declaration to your insurer is advised. If you think you have been exposed to HCV, early testing is recommended. What happens if you are infected with HCV? Although there are usually no symptoms, these may include: Tiredness/depression/muscle aches/fever. Loss of appetite/nausea/vomiting. Abdominal pain. Jaundice (yellowing of the skin or the white of the eyes). 2

3 What happens if your HCV test is positive? As long as infection persists, you remain infectious to others. Testing for other infections (e.g. Hepatitis B and HIV) which can be passed on the same way is advised. If you have an acute infection As most people do not have symptoms at the start, HCV infection is usually diagnosed many years after the infection. However, when diagnosed early, specialist treatment can be very effective. If you have ongoing chronic infection If tests show that you continue to be infected with HCV, you should discuss referral to a specialist with your doctor or nurse. Up to 8 out of 10 infected people will develop chronic (long-term) Hepatitis C, with or without symptoms. This can lead to severe liver damage including cirrhosis (irreversible liver scarring) and in some cases, liver cancer. Further investigations usually include specialised blood tests and scans of the liver. Avoiding alcohol helps to reduce further liver damage. Vaccination against Hepatitis A and B and annual flu is advised, as is a single dose Pneumococcal vaccine. Anti-viral drug treatment can be effective and may be offered to you by the specialist. Complimentary and herbal remedies should be discussed with your doctor/specialist. Sharing information Telling your doctor, dentist, midwife and other healthcare professional that you have HCV infection will help them provide the best care for you. Please also: Consider telling someone close to you so that they can support you from the start. Consider telling anyone who may have had direct contact with your blood or shared injecting equipment with you. Consider telling past and present sexual partners so that they can think about being tested. Do not donate blood or semen, or register as an organ donor. 3

4 Where to go for testing, advice and immunisation Your GP. NHS Grampian: The City Clinic, Sexual Health Services, Woolmanhill Hospital Aberdeen and other locations, Rosebank Clinic, Royal Cornhill Hospital (For attending patients only). For concerns in pregnant drug users: Hazelhead Pregnancy Support Team, Aberdeen Maternity Hospital, Selected needle exchanges, drug agencies and community pharmacies. For general information on HCV. British Liver Trust, www.britishlivertrust.org.uk. Health Protection Team, NHS Grampian, For services providing Needle Exchange ABERDEEN CITY: Dickies Pharmacy, 68 Gardner Drive, Kincorth, Aberdeen, Douglas Dickie Chemist, 96 Victoria Road,Torry, Aberdeen, Drugs Action, 7 Hadden Street, Aberdeen, (Telephone for information regarding additional Aberdeen outreach exchanges). Healthy Hoose, 2B Logie Place, Aberdeen, Holburn Pharmacy, 560 Holburn Street, Aberdeen, John Ross Chemist, 109 Hayton Road, Aberdeen, Rowlands Pharmacy, City Hospital, Park Road, Aberdeen (side door entrance) ABERDEENSHIRE: Aberchirder Pharmacy, 55 Main Street, Aberchirder, Buchanhaven Pharmacy, 23 Skelton Street, Peterhead, Charles Michie Chemist, 24 Market Square, Stonehaven, Duke Street Pharmacy, 26 Duke Street, Huntly, Kemnay Pharmacy, 17 High Street, Kemnay,

5 NHS Grampian Substance Misuse Service, Kessock Road, Fraserburgh, Northern Horizons, Turning Point Scotland, Chalmers Hospital, Banff. Northern Horizons, Turning Point Scotland, Peterhead, Strachan Pharmacy, 29 Main Street, Turriff, Will Chemists, 35 West High Street, Inverurie, MORAY: Bishopmill Pharmacy, 20 North Street, Bishopmill, Elgin, Dufftown Pharmacy, 15 Balvenie Street, Dufftown, Lloyds Pharmacy, 23a Clifton Road, Lossiemouth, Lloyds Pharmacy, 48 High Street, Elgin, Norvik Pharmacies Ltd, 1 High Street, Buckie, Studio 8, Turning Point Scotland,73 High Street, Elgin, Your Local Boots Pharmacy, 88/94 High Street, Forres, Your Local Boots Pharmacy, Glassgreen Centre, 2 Thornhill Road, Elgin, This publication is also available in large print and on computer disk. Other formats and languages can be supplied on request. Please call Equality and Diversity on or or grampian@nhs.net Ask for publication CGD February