Hepatitis C

Infection with hepatitis C is most common in countries like Egypt, Mongolia and Pakistan, where as many as one in 20 people have chronic hepatitis C. On average, around 5 % of the population in Africa are affected with 4.6 % in countries in the eastern Mediterranean and about 4 % in Southeast Asia. This compares with the UK and other parts of Europe, where around 1 % of people are thought to have chronic hepatitis due to the hepatitis C virus.

Hepatitis C virus is passed on through blood to blood contact. It is relatively rare for hepatitis C to be passed on during sex, but it can occur; this happens in about 3% of cases. Potential methods of transmission include:

• Transfusion of contaminated blood or blood products
• Medical treatment or dental work that is carried out in a region of the world where equipment may be contaminated or poorly sterilised
• Body piercing or tattoo equipment that is not sufficiently cleaned between clients
• Sharing a toothbrush or a razor
• Taking illegal drugs: shared needles can pass on hepatitis C
• Types of hepatitis C

• Genotype 1: more common in some parts of the southern Mediterranean and the Middle East, but it has spread around the world
• Genotypes 2 and 3: common in northern Europe, parts of India and in the Indian subcontinent
• Genotype 4: thought to have originated in the Middle East and is particularly common in Egypt
• Genotype 5: common in southern Africa
• Genotype 6: a mainly Far Eastern virus

With increasing global travel and movement, all 6 genotypes can be found anywhere.

Acute and chronic hepatitis C

Hepatitis C, like hepatitis B, has an acute and chronic stage of infection. Symptoms of the acute stage of infection are non-specific and generally mild, which is why so many people do not realise they are infected. After 6 months, the infection can become chronic, and this happens in 80% of people. It may be symptomatic in patients who also have HIV.

Chronic hepatitis C can occur without symptoms or long-term effects on the liver but it can also lead to liver damage such as cirrhosis or liver cancer if left untreated. Even if someone has no symptoms, the virus is still actively multiplying in the body and they can pass on the infection if they share a needle, for example.

Getting a blood test for hepatitis C is quick and easy and can identify people who have chronic infection.