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Hepatitis C

What is hepatitis C?

Hepatitis C is a form of hepatitis caused by a virus that infects the liver. There’s no vaccine for hepatitis C.

How common is hepatitis C?

Hepatitis C is the most serious type of hepatitis. It was only discovered in 1989 but has been around since long before then.
In this country hepatitis C is a common problem among people who inject drugs. It’s nowhere near as widespread among gay and bisexual men as hepatitis A and B.
There’s no significant spread among HIV negative gay and bisexual men but it’s much more common among HIV positive guys. Among those with HIV it’s a growing problem, especially among men who inject drugs, fuck without condoms, or fist without gloves or who have sex on chems. About 7% of gay and bisexual men with HIV have hepatitis C.

What causes hepatitis C?

Hepatitis C is caused by a virus that’s usually passed on through contact with tiny amounts of blood, which can happen when sharing injecting drug equipment or during unprotected fucking, fisting or rimming.

What are the symptoms of hepatitis C?

Very few people notice any symptoms when they are first infected with hepatitis C. Even over time symptoms are difficult to spot, and it can take many years before you begin to feel ill. But eventually it can cause the same symptoms as hepatitis A and B:

  • mild flu-like symptoms
  • nausea
  • extreme tiredness
  • itchy skin
  • stomach pain
  • jaundice

Other symptoms can include extreme tiredness, mental confusion and depression.

Many people with untreated hepatitis C eventually develop some kind of liver disease, such as scarring of the liver (cirrhosis) or liver cancer. You may need a liver transplant.

Hepatitis C can be fatal.

How is hepatitis C passed on?

The hepatitis C virus is very easily passed on; it’s 10 times more infectious than HIV. The virus is in blood and is spread when infected blood gets into another person’s body. It’s seen as unlikely (but not impossible) that it can be passed on in semen.

It can be passed on through:

  • injecting drugs or steroids if equipment is shared, such as syringes or swabs, ‘works’ or anything used to take drugs, and possibly also sharing pipes or rolled up bank notes for snorting
  • anal sex and rimming if condoms aren’t used, especially as fucking and arse-play can cause bleeding
  • fisting
  • group sex scenes where sex toys or injecting equipment are shared; the virus is also spread when hands and cocks (even if gloves and condoms are used) go from one arse to another
  • infected blood can get in to shared containers of lube (so use pump dispensers instead)
  • chemsex increases the risk of hepatitis C as this sex is rougher and lasts longer, making bleeding more likely
  • sex scenes that draw blood, for example play piercing, CP and body piercings that bleed
  • ‘do-it-yourself’ or amateur piercing or tattooing where hygiene guidelines aren’t followed and contaminated equipment is used or shared
  • medical and other procedures involving blood that are done abroad without steps taken to prevent the spread of infections.

Having HIV and hepatitis C can make your blood and cum more infectious for hepatitis C.

Blood transfusions in the UK are safe as donations are checked for hepatitis C.

How is hepatitis C prevented?

There’s no vaccine for hepatitis C.
These can reduce the risk of getting hepatitis C:

  • not sharing injecting equipment, swabs, filters, syringes, spoons, water, etc when injecting drugs or steroids
  • not sharing straws or banknotes when snorting drugs
  • using a condom for anal sex
  • using latex gloves for fisting
  • not sharing pots of lube
  • avoid sharing toothbrushes, nail scissors, razors and so on with someone you know has the hepatitis C virus.

It’s a good idea not to share sex toys as the virus can live in dried blood for a few weeks. Alternatively, cover them with a fresh condom for each person they’re used on or wash them with a mix of one part bleach and 9 parts water then rinse.
You should also take steps to prevent the spread of infections during any sex scene that draws blood or if being pierced, tattooed or undergoing medical procedures.
There should be no risk in the UK with medical care or reputable piercing and tattooing establishments.
The iBase guide Safer HCV sex for gay men has some more useful information.

How is hepatitis C treated?

Infection is confirmed through a blood test which looks for hepatitis C antibodies, which can take up to six months to appear in the blood.
For guys with HIV who may be immunocompromised, the antibody may not be detectable and it may take an RNA test to detect the virus .
Treatment can lasts 12 weeks to six to 12 months and involves weekly injections and or daily pills. This treatment often has flu-like side effects but now has a high success rate.
If hepatitis C is cured, it can be caught again.
If you have hep C, you should get the vaccination against hep A and B to protect your liver from further damage .
Cutting down on drugs and alcohol will also do your liver a favour.

Hepatitis C and HIV

Hepatitis C may get worse more quickly if you have HIV as well. If you have both infections you and your doctor may have to decide which illness needs treating first, as HIV drugs and hepatitis C infection can both damage the liver.

More information

You can get more information about hepatitis C from these organisations:

The Hepatitis C Trust

hepctrust.org.uk
Helpline: 0845 223 4424

The NHS Hepatitis C Service

nhs.uk/hepatitisc

HIVandHepatitis.com

hivandhepatitis.com

HCV Advocate

hcvadvocate.org

Last review: 09/11/2018
Next review: 09/11/2021