Hepatitis C

What is Hepatitis C?

Hepatitis C (Hep C) is a blood borne virus which lives, and replicates itself, in the liver. Most people won’t know they are infected as there are few symptoms. However, if left untreated, the virus can begin to damage and scar the liver, leading to liver cirrhosis, liver cancer or liver failure.

With treatment, it’s usually possible to cure Hep C after just a few months. Screening is important to support people to access treatment and to reduce the risk of the virus progressing too far.

How is Hepatitis C transmitted?

Hep C is a blood borne virus which means it is only transmitted through infected blood finding its way into the blood stream of another person. Those most at risk of contracting Hep C are:

• those who inject or have injected drugs or shared drug paraphernalia (this includes those who snort drugs)
• those who had tattoos or piercings in unclean environments or where the equipment is unclean
• those who had a blood transfusion or organ transplant in the UK before 1996.

Hep C is not a sexually transmitted infection, but it can be transmitted through sexual intercourse if blood from one person enters the bloodstream of another.

Hep C and drug use

People are at increased risk of contracting or transmitting Hep C if they have, or are, injecting drugs or inhaling them nasally with a tube. Needles, syringes, used filters, shared water and spoons used to ‘cook’ the drugs, can all carry infected blood. Research shows that the virus can live on a hard surface up to 5 days, and longer in a used syringe.

Prevention, screening and treatment for Hepatitis C

All organisations working with high risk groups have a key role to play in ensuring people are screened for Hep C and are able to access treatment if this is required. This means working with other agencies to ensure there is fair access to health services for your clients, increasing pathways, and fostering partnership working across services.

Prevention

There is no vaccination against Hep C but there are several steps that can be taken to reduce the risk of transmission:

• Raise awareness of Hep C and the high risk of transmission for people who inject drugs
• Provide information about how to get screened and make links with your local clinics
• Ensure that people using drugs have access to sharps boxes and that these are removed regularly.

Screening

Screening for Hep C is essential for anyone who may be carrying the virus. Screening is simple and minimally invasive; in some cases, this can be done through a finger prick testing kit but it’s usually a blood test. Testing is available from GPs, sexual health and GUM clinics and in drug treatment services.

You can also get a free home test kit for Hep C which you can order online here.

Treatment

In the past, Hep C treatment was invasive and caused terrible side effects. It has greatly improved now and is provided through taking one tablet each day. There are minimal side effects but is highly effective at curing people.

It can be difficult for individuals in high-risk groups to adhere to the treatment pathway due to their complex lifestyles. Consider how best you can support individuals with their treatment through your support work and by building partnerships with local health and advocacy services that are designed to make treatment more accessible.

Occupational exposure to Hepatitis C

As the virus is transmitted through being exposed to infected blood, the risk of contamination is fairly low in day to day work. However, this risk increases if staff may be directly exposed accidentally through needle stick injuries or from other sharp objects which may be contaminated. Extra caution should also be taken if staff and clients have open wounds, skin abrasions or where skin is damaged.

As an employee you are legally required to take care of your own health and safety, and that of others affected by your actions. Your employers have a legal duty to protect staff at work and should have clear policies and procedures to assess and prevent the risk of transmission, and how to respond if an accident does happen. Ensure you’re aware of your organisation’s policy.

The role of homelessness services

People experiencing homelessness are amongst the high risk groups for Hep C. Some of the people you work with will have been tested in the past and been given a diagnosis of Hep C, but may avoided treatment due to stigma and the unpleasant side effects that used to be a feature of treatment.

There is a real opportunity for homelessness service providers to improve the health of the people they work with, and to help eliminate Hep C for good:

• Staff training
• Raise awareness amongst people accessing services
• Create accessible opportunities for testing
• Support people through treatment
• Challenge stigma

Support for homelessness services

The Hepatitis C Trust work closely with homelessness services to make contact and engage with individuals who may have Hep C. They aim to reduce stigma by fostering an open dialogue about the disease and support staff and individuals to feel more comfortable to talk about it.

They have been delivering peer-to-peer support nationally since 2010 and can offer staff training, poster campaigns, workshops and presentations. Not only that, their vans can visit hostels to screen residents and HCT Peers support people through the care pathway to access treatment. More information on their Community Peer Programme can be found here.

The Hepatitis C Trust also offers a free confidential helpline available Monday to Friday 10.30am - 4.30pm: 020 7089 6221.

You can also contact them by email: helpline@hepctrust.org.uk