HEPATITIS C

 

Causative organism Hepatitis C virus
Incubation period Up to several months for acute infection
How far back to trace 6 months prior to onset of acute symptoms; if asymptomatic according to risk history
Usual testing method Serology for hepatitis C is the screening test then if positive a hepatitis C RNA test to confirm persistent infection through detection of circulating viral RNA
Common symptoms Most people experience no symptoms
  Some people may have acute hepatitis with nausea, dark urine, jaundice, abdominal discomfort, fatigue
Likelihood of transmission The likelihood of transmission via sex is generally low. However, sexual transmission between HIV positive MSM is relatively common and has also been reported between HIV negative MSM
Likelihood of long-term sexual partner being infected <5% (if no other risk factors)
Protective effect of condoms Unknown
Transmission by oral sex Probably rare
Duration of potential infectivity Unknown, but possibly lifelong; increased if high viral load. PCR-negative people appear to be non-infectious
Important sequelae Severe hepatitis, chronic liver disease, cirrhosis and liver cancer
Direct benefit of detection and treatment of contacts

Cure
Prevention of on-going transmission
Usual management of contacts

Counselling and testing (antibodies may take up to 6 months to develop)
Referral for investigation and treatment if HCV antibody positive and HCV RNA positive
Sex or injecting partners of people with Hepatitis C-infection should be should be referred for investigation and treatment
Contact tracing priority

High for needle-sharing contacts, blood donors and recipients
High for children born to an infected mother
Low for sexual contacts but higher for MSM with HIV co-infection.
Minimal if PCR test negative
Notification

Acute viral hepatitis C is notifiable by all doctors in all Australian states and territories, and New Zealand
If the index patient has received or donated blood within 6 months of developing symptoms, also advise the relevant blood bank

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