HEPATITIS C

 

Causative organism Hepatitis C virus
Incubation period Up to 14–182 days (mean 14–84 days)
How far back to trace 6 months prior to onset of acute symptoms; if asymptomatic according to risk history
Usual testing method Hepatitis C antibody (anti-HCV) is the screening test. If positive a hepatitis C RNA (PCR) test is used to confirm active 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 GBMSM (cis and trans) living with HIV is relatively common and has also been reported between GBMSM (cis and trans) not living with HIV
Likelihood of long-term sexual partner being infected <5% (if no other risk factors)
Protective effect of condoms Likely
Transmission by oral sex Rare
Duration of potential infectivity

25% of people with acute hepatitis C infection will clear the virus spontaneously within 6 to 12 months.

Those with chronic infection who are untreated will remain infectious until treated.

Important sequelae Severe hepatitis, chronic liver disease, cirrhosis and liver cancer
Direct benefit of detection and treatment of contacts

Cure
Engage people living with hepatitis C into treatment and effective clearance.

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 See National HCV Testing Policy
Sex or injecting partners of people with Hepatitis C-infection should be should be encouraged to be tested

Contact tracing priority

High for needle-sharing contacts, current blood donors (12 months prior to testing HCV Ab+) and blood donor recipients before 1990
High for children born to an infected mother (5% risk of transmission)
Low for sexual contacts but higher for GBMSM living with HIV.
Low if RNA 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

Reference

Iversen J, Dore GJ, Catlett B, Cunningham P, Grebely J, Maher L. Association between rapid utilisation of direct hepatitis C antivirals and decline in the prevalence of viremia among people who inject drugs in Australia. J Hepatol 2019;70:33-9.

National HCV Testing Policy

 

Page last updated April 2021

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