Hepatitis C

Hepatitis C viruses (HCV) are transmitted through blood. The infection often becomes chronic and, if left untreated, can lead to liver cancer, cirrhosis, and even liver failure. It is generally treatable and—if detected early—can be cured within about 3 months.

Transmission

Hepatitis C is mainly transmitted through blood. The risk of transmission during substance use (for example, when equipment is contaminated and/or shared with others) is highest. Transmission through sexual contact is generally rare. There is an increased risk, particularly with practices involving blood contact (e.g., fisting, anal sex that results in mucosal injuries, or group sex involving the shared use of sex toys or gloves). Among people living with HIV—especially those not receiving effective HIV treatment—sexual transmission has been observed more frequently in certain MSM networks. Even if you’ve had hepatitis C before, you can still become infected again.

Protection

• Condoms and internal condoms reduce the risk of infection. You can also use them to prevent transmission through shared toys.
• When fisting or having sex with multiple partners: Change the condom, gloves, or toy before you have sex with someone else.
• When fisting, gloves can protect against hepatitis. Everyone should use their own lubricant or their own container of lubricant. Important: Lubricants containing oil can damage latex. Use latex gloves only with oil-free lubricant.
• Fisting causes many small injuries to the intestinal mucosa, which can increase the risk of HIV infection. If you have sex after fisting, be sure to take precautions to protect yourself against HIV protection.
• When using substances, use only your own equipment and avoid sharing it with others. Infections occur primarily when injecting drugs such as ketamine, crystal meth, or heroin, if syringes or other equipment such as tubes are shared: HCV can “survive” in blood residue for up to three weeks.
• Let your sexual partners know if you have an HCV infection, and wait until you have completed medical treatment before having sex again.

Symptoms

A hepatitis C infection often goes unnoticed or is not recognized right away.

Three to six months after infection, fatigue, upper abdominal discomfort, reduced performance, itching and joint complaints may occur. Sometimes yellowing of the (mucus) skin or eyes occurs.

Some infections clear up on their own after about 6 months. However, most infections become chronic and must be treated to prevent serious complications, including liver failure.

Testing & Treatment

Hepatitis C is diagnosed through a blood test. Sexual health centers, drug treatment centers, AIDS service organizations, Checkpoints, and doctors’ offices can test you for hepatitis C.

First, an antibody test is performed; if the HCV antibody test is positive, the results are confirmed with an HCV PCR test to determine whether the infection is active or has already resolved. If an active infection is confirmed—whether acute (< 6 months) or chronic (> 6 months)—antiviral treatment can be started immediately.

In cases of hepatitis C infection, medications work to block the replication of the virus. With the direct-acting antiviral drugs (DAAs) available today, hepatitis C can be cured within 8–12 weeks in most cases. The cure rate is over 95%.

Hepatitis C medications can cause severe side effects when taken in combination with other medications, substances, or herbal remedies (ranging from reduced effectiveness to overdose). These should therefore be discussed thoroughly with the appropriate healthcare providers.

If you have an infection, you should avoid consuming any substances (such as alcohol and others) that put a strain on your liver. You should only take medication after consulting with a healthcare professional.

In people with HIV, whose immune systems are weakened, a hepatitis C infection can progress more rapidly and severely.

It is important to note: Every chronic hepatitis C infection should be treated! Otherwise, sooner or later, the virus will damage the liver.

Since hepatitis C is almost always curable today, professional associations and the WHO recommend treating every confirmed chronic hepatitis C infection as early as possible.

Even after successful treatment, it is always possible to become reinfected with hepatitis!

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