Office of Communicable Diseases

Hepatitis C

What is Hepatitis C?

Hepatitis C is a liver disease caused by the hepatitis C virus (HCV). It is found in the blood of people infected with hepatitis C virus. Hepatitis C was formerly called nonA-nonB hepatitis.

How is Hepatitis C Spread?

Spread occurs through exposure to blood infected with the hepatitis C virus. Studies indicate HCV is found in other body fluids, but it is not clear if the virus can be spread from these fluids, compared to blood.

Who is at Risk?

The following groups of persons are at risk for contracting the HCV:

• Persons with hemophilia treated with blood products made before 1987-Prior to 1987, there were no effective methods to test for HCV in clotting factor products.
• Recipients of blood transfusions or solid organ transplants prior to 1992 -Since 1992, all donor blood is screened for HCV. Any blood testing positive cannot be used, and is destroyed.
• Injecting drug users -transfer of HCV by sharing needles or drug preparation equipment, contaminated with HCV-infected blood, even if you only experimented once or tried drugs in the past.
• Long term hemodialysis patients.
• Sexual partners with hepatitis C virus or multiple sexual partners - the risk of transmission between steady (monogamous) partners appears to be quite low, and there is no current recommendation for changes in sexual practices for persons with a steady sexual partner. However, persons with multiple sexual partners may be at higher risk of becoming infected.
• Health care workers with frequent blood exposure or a history of accidental needle stick injury.
• Intranasal drug users (i.e. cocaine use) through sharing contaminated straws or other equipment used for snorting.
• Infants born to mothers who are infected with the hepatitis C virus.
• Household contacts (people living with a hepatitis C infected person) through sharing blood contaminated personal items, such as toothbrushes, and razors.

Hepatitis C virus is NOT spread through casual contact or in typical school, office, or food service settings. It is NOT spread by coughing, sneezing, or drinking out of the same glass or through toilet seats.

How do I know if I have Hepatitis C? (Common Symptoms)

Most people who are infected with the hepatitis C virus have no symptoms, however they can still infect others. Individuals that are infected with hepatitis C and become ill exhibit symptoms including loss of appetite, vague abdominal discomfort, nausea, vomiting, and sometimes yellowing of the skin and eyes (jaundice). Other symptoms may include feeling fever and very tired. Symptoms can range from mild to severe. Once infected, most persons will carry the virus in their blood for the rest of their life.

How Serious is Hepatitis C?

Hepatitis C is serious for some persons, but not others. A small number of people who become infected with HCV may actually clear the virus and have no long -term effects. A greater number of people carry the virus for the rest of their lives. Most of these persons have some liver damage but many do not feel sick from the disease. Some persons with liver damage due to hepatitis C may develop cirrhosis (scarring) of the liver, liver cancer, and liver failure, which may take as many as 10-30 years to develop.

How Can I Avoid Hepatitis C? 

If you are not infected with Hepatitis C Virus:

• Don't ever shoot drugs! If you shoot drugs, stop and get into a treatment program. If you can't stop, never reuse or share syringes, water or drug works (ENCORE).
• The surest way to protect yourself against any sexually transmitted disease is not to have sex at all or to have sex only with one steady, uninfected partner.
• If you are having sex, but not with one steady partner, you should use a latex condom. Be sure to use it correctly and every time to help protect you and your partner from diseases spread by having sex.
• If you are a health care worker, always follow routine barrier precautions and safely handle needles and other sharps.
• Do not share toothbrushes, razors, or other personal care articles. They might have blood on them.

If You Are Infected with the Hepatitis C Virus: 

• Do not donate your blood, body organs, other tissue, or sperm.
• Do not share toothbrushes, razors, or other personal care articles that might have blood on them.
• Cover your cuts or open sores.
• If you shoot drugs, stop and get into a treatment program. If you can't stop, never reuse or share syringes, water, or drug works (ENCORE).
• If you have one steady sex partner, there is a very low chance of giving HCV to that partner through sexual activity, and you do not need to change your sexual practices.
• If you want to lower the small chance of spreading HCV to your partner, you may want to use latex condoms. Ask your doctor about having your sex partner tested.
• If you are having sex, but not with one steady partner, you should use a latex condom correctly and every time to help protect you and your partners from diseases spread by having sex. The surest way to prevent the spread of any sexually transmitted disease is not to have sex at all.
• Get hepatitis A and hepatitis B vaccinations to protect your liver from these infections.
• Avoid drinking alcoholic beverages.

What are the Treatments and Services Available for Hepatitis C? 

If you feel you may be at risk for hepatitis C infection, you should contact your doctor. Early diagnosis is important so you can be counseled about how to prevent transmission of HCV to others and you can be checked for liver disease and get treatment, if indicated.

The most important thing you can do if you test positive for hepatitis C virus is to contact your doctor about additional tests and treatment. There are two therapies available for the treatment of persons with long-term hepatitis C: interferon and a combination of interferon and ribavirin. You should check with your doctor to see if treatment would help you.

Substance abuse counseling centers

For a referral on alcohol and other drug problems, contact a 24-hour helpline at (401)725-0410 or 1-800-622-7422.

For information on the ENCORE program, click here.

For information on Support Groups, click here.

What are the Disease Rates in Rhode Island?

"Hepatitis C virus (HCV) infection is the most common chronic bloodborne infection in the United States. CDC staff estimate that during the 1980's, an average of 230,000 new infections occurred each year (CDC, unpublished data). Although since 1989 the annual number of new infections has declined by >80% to 36,000 by 1996 data from the Third National Health and Nutrition Examination Survey (NHANES III) conducted during 1988-1994, have indicated that an estimated 3.9 million (1.8%) Americans have been infected with HCV. Most of these persons are chronically infected and might not be aware of their infection because they are not chronically ill." (Excerpted from MMWR 1998; 47; No. RR-19)

In January 1998, the Rhode Island Department of Health initiated a surveillance project to collect information on people in Rhode Island who are infected with hepatitis C virus.

Who Can I Contact at the Department of Health About Hepatitis C?

For more information, contact Lorraine Asselin Moynihan M.A., M.S.W. at 222-7544.