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Hepatitis C

Hepatitis C virus (HCV) is a single-stranded RNA virus that is parenterally transmitted and is a major cause of chronic hepatitis and cirrhosis. The HCV genome has been completely sequenced, and the virus has recently been cultured and fully characterised.

What is the prevalence of HCV infection in Australia?
Screening of healthy blood donors in Australia using current tests shows a viral carrier rate of about 0.3% among apparent healthy new blood donors. However, the prevalence in the population at large is thought to be approximately 1%, because assessment of potential blood donors screens out many people at increased risk of HCV infection. In particular, the likelihood of having HCV infection is substantially increased if a person has used illicit injecting drugs. The cumulative risk increases with duration of injecting drug use. The risk among "ever-users" of injecting drugs is 70%, and over 90% in those who have been using injecting drugs for more than two years at any stage of their life. Anybody who has ever used illicit injecting drugs, even once, has a 20-fold increased risk, over the general population, of having HCV.

How is the virus is spread?
HCV is spread by inoculation with blood or bloodcontaminated body fluids. (Suggsestion: HCV is spread by contact with infected blood or blood contaminated bodily fluids) The majority of Australian people with chronic HCV,acquired the infection by sharing needles or other equipment during injecting drug use. A smaller proportion acquired the infection through transfusions of blood or blood products prior to 1990 - before screening of blood products was introduced. Chronic HCV may be identified in migrants, particularly those from Mediterranean countries, the Middle East, South America and South-East Asia. These countries have higher rates of endemic HCV infection and it is thought that HCV transmission through non-sterile needles and medical procedures, as well as traditional or folk medical practices, was responsible for much of this infection.

What is the role of HCV in Chronic Liver Disease and Primary Liver Cancer?
The majority of patients with chronic HCV infection are asymptomatic. If symptoms are present they are usually non-specific, such as fatigue, mild malaise and right upper quadrant abdominal discomfort. Many patients have no signs of liver disease. Individuals with chronic HCV infection may have mild chronic hepatitis or more severe forms of liver injury.