What is Hepatitis C?
Hepatitis C is a virus that can damage the liver. Unlike hepatitis A and B, there is no vaccine to protect against hepatitis C.

How could I get hepatitis C
Hepatitis C is carried in the blood and has been detected in other body fluids. But blood (even in tiny or invisible amounts) is the main source of infection. The virus is mainly spread through contact with the blood of a person who has hepatitis C. You can't catch it through everyday contact such as holding hands, hugging or kissing, or through sharing toilets, crockery and kitchen utensils.

Hepatitis C is passed on by:

• sharing equipment for injecting drugs, even if you did this only once or twice, or a long time ago. Needles and syringes are the greatest risk, but spoons, water and filters could also carry infection
• receiving a blood transfusion (before September 1991), or blood products like clotting factors (before 1986). All blood in the UK is now screened.

Less commonly, hepatitis C can be passed on by: a hepatitis C positive mother to her baby, (before or during birth); unprotected sex (without a condom) with someone who has the virus; medical and dental treatment abroad (where unsterile equipment may be used); tattooing, ear piercing, body piercing or acupuncture (with unsterile equipment); sharing razors or toothbrushes contaminated with blood from someone who has the virus.

See your doctor or nurse if you think you could have been in contact with the virus in any of these ways.

What are the symptoms?
Many people who have the hepatitis C virus have no signs or symptoms at all - for years or even decades. But even without symptoms you can still pass the virus on to others.
Symptoms, though not common, may include:

• muscle aches and a high temperature
• mild to severe fatigue
• nausea, loss of appetite
• weight loss
• depression or anxiety
• pain in the area of the liver (right side of the stomach)
• mild jaundice (yellowing of the skin and whites of eyes)
• joint pains
• poor memory or concentration.

How might the virus affect me in the long term?
Around one in five people who become infected with hepatitis C will clear the virus naturally. However, most people who become infected remain so for a very long time. This may affect them in different ways:

• Some people can remain well throughout their life
• Some people experience a range of symptoms (see What are the symptoms? above)
• About one in five people will develop severe liver damage (cirrhosis)
• In some people, cirrhosis can lead to liver cancer or complete liver failure

How do I know if I have the virus?
If you think you could have been in contact with the hepatitis C virus at any time in the past, you can have a simple blood test to find out if you may have been infected.

Where can I get a test?
Your doctor will be able to carry out tests for hepatitis C. Local drug agencies and sexual health/ GUM (genito urinary medicine) clinics may also offer testing. (See information and support at the end of this booklet for details on how to contact these services.)

What if the test result is positive?
The blood test will tell you whether you have been infected with the virus at any stage in the past. It will not tell you if you still have it. You can be referred to a specialist to see if you still have the virus and how it is affecting your liver.

Is treatment available?
Treatments for hepatitis C are improving all the time. A form of drug therapy is available that can clear the virus in about half of those treated. Your doctor and specialist will discuss with you whether treatment is appropriate.

How can I help myself?
If you are infected with hepatitis C, the most important thing you can do to minimise damage to your liver, is to limit the amount of alcohol you drink, or to cut out alcohol altogether.

What if the test result is negative?
This probably means that you have never been in contact with the hepatitis C virus. However it can take up to six months for your body to react to the virus, so the test may not be positive if you have been infected recently. Your doctor may advise you to have a second test.

How can I avoid becoming infected or passing on the virus to others?

• If you inject drugs, NEVER share or pass on drug injecting equipment. This includes needles, syringes, spoons, water, filters or anything else that might be contaminated with blood. Contact the National Drugs Helpline for details of drug services in your area and safer injecting advice - 0800 776600.
• If you are considering having ear piercing, body piercing, a tattoo or acupuncture, check that equipment such as needles and ink pots are not being re-used and are sterile.
• If your sexual partner has hepatitis C, there is a small risk that it could be passed on to you during sex. Condoms minimise the risk. Using condoms will also help to protect you against unwanted pregnancy, HIV and many other sexually transmitted infections.
• Avoid sharing any toiletry equipment that could have been contaminated with blood, for example razors, toothbrushes, nail scissors, tweezers.

Information and support
If you have any worries or questions, you can talk to your doctor or nurse.

The National Hepatitis C Resource Centre (a Mainliners project) maintains a list of local support groups for people with HCV, plus information and leaflets. The centre also co-ordinates a national forum to represent the needs and views of people with hepatitis C:

National Hepatitis C Resource Centre
PO Box 31844
London SE11 4DT
Tel: 020 7735 7705
Advice line: 020 7582 5226 Mon, Wed, Fri, 12pm to 3pm.
e-mail: advice.info@hep-ccentre.com
Website: www.hep-ccentre.com

The British Liver Trust (BLT), provides information on all forms of liver disease. Hepatitis C and Hepatitis C and injecting drug use are leaflets available free from the BLT by sending a stamped, self-addressed envelope to:
The British Liver Trust
Ransomes Europark
Ipswich IP3 9QG
or they can be downloaded from their website: www.britishlivertrust.org.uk
Tel: 01473 276 326.
e-mail: info@britishlivertrust.org.uk

The Children's Liver Disease Foundation specialises in supporting children with liver disease:
Children's Liver Disease Foundation
36 Great Charles Street
Birmingham B3 3YJ
Tel: 0121 212 3839
e-mail: info@childliverdisease.org
Website: www.childliverdisease.org

The Haemophilia Society provides information and support for people living with or affected by haemophilia who are concerned about hepatitis C:
Freephone helpline: 0800 018 6068 Mon to Fri, 9am to 5pm.
Fax: 020 7387 8220
e-mail: info@haemophilia.org.uk
Website: www.haemophilia.org.uk

NHS Hepatitis C factsheet is available from your doctor or local sexual health/ GUM clinic.

The National Drugs Helpline provides confidential information and advice to drug users and anyone concerned about drugs - 0800 77 66 00.

You can also contact your local sexual health/ GUM clinic for free, confidential advice and treatment. Details of GUM clinics can be found in the telephone book, or at www.lovelife.uk.com

Drinkline provides confidential information and advice about sensible drinking - 0800 917 82 82. They can put you in touch with your local alcohol advice centre where help is available on a one- to- one basis.