HEP C

Hepatitis, particularly Hepatitis C (also called HCV), is a serious risk for injection drug users. HIV Edmonton is dealing with a growing number of people who are co-infected with HIV and HCV. For more information, please e-mail contact@hivedmonton.com, or call (780)488-5742.

 

WHAT IS HEPATITIS?
Hepatitis means inflammation of the liver. It can be caused by a number of things including: viruses (such as Hepatitis A, B, C, D, E and G), alcohol, medications, chemicals and hereditary or metabolic diseases.

 

WHAT IS HEPATITIS C?
Hepatitis C is a liver infection caused by the hepatitis C virus (HCV). It was first identified in 1989 but has been around for many years. Before it was identified it was called Non-A Non-B hepatitis because they had already been identified and this virus was not the same.

 

WHAT ARE THE SYMPTOMS?
Most people with hepatitis C may feel healthy and are symptom free for many years. However, if the liver has been damaged, people may experience fatigue, nausea, vomiting, loss of appetite, fever, headache and abdominal pain. Itchy skin, jaundice (yellowing of the skin and eyes), dark urine or light colored stool can also be symptoms of Hepatitis C. For some people symptoms may appear 6 weeks to 9 months from when they were infected For many people, symptoms do not show up for 20 years or more.

 

IS THERE A TEST FOR HEPATITIS C?
Yes. The Hepatitis C antibody can be found in a blood test but simply having the antibodies, does not mean you have recovered from the disease. It usually takes about 70 days after infection for the blood test to be positive. It is also important to remember that because many people do not show symptoms for years, you may have Hepatitis C and not know it.

 

IS THERE A VACCINE FOR HEPATITIS C?
At this point there are vaccines for both Hepatitis A and B but not for Hepatitis C. Hepatitis C is a virus that mutates or changes rapidly which makes the development of a vaccine very difficult.

 

WHAT IF I TEST POSITIVE?
If a blood test shows that you have HCV, it means that at some time in your life you have been exposed to the virus. To find out if the virus is affecting your health, you need to see your doctor for more tests. Your doctor may recommend blood tests to see if the virus is affecting the way your liver works. You may need a physical exam, an ultrasound X-ray, a referral to a specialist and/or a liver biopsy. If your first tests are normal your doctor may ask you to come back for a yearly check up.

 

DO PEOPLE RECOVER FROM HEPATITIS C INFECTION?
Most people who test positive for HCV will always test positive. That means the infection continues in about 80% of cases. A small number of people are able to clear the virus from their blood after they are infected. HCV may lead to liver damage, cirrhosis and, once in a while, liver cancer, and may take up to 20 - 30 years to show up. Many people with HCV will remain healthy and do not experience liver disease.

 

HOW DOES HEPATITIS C SPREAD?
The Hepatitis C virus exists primarily in the liver and is carried in the blood. It is not known to be carried in semen, vaginal fluid or saliva but can be present if there is blood in any of these fluids. Hepatitis C is only spread if infected blood comes into contact with other blood. Hepatitis C can be spread in the following ways:

  • Doing drugs (sharing needles, spoons/water for intravenous drug use). According to the Canadian Liver Foundation, almost 90% of people who have used injection drugs even once in their lifetime, have Hepatitis C
  • Receiving blood transfusion (in Canada blood donated before 1990 was not screened for HCV).
  • Sharing needles used for ear or body piercing, tattooing, electrolysis, acupuncture.
  • Sharing personal items such as razors, toothbrushes, nail clippers and earrings.
  • It is also possible for pregnant women or women giving birth may pass the virus to their babies, but this rarely happens. Current studies suggest that Hepatitis C can not be spread from mother to baby during breast feeding, however, if the nipples are cracked or bleeding, it is recommended that breast feeding not continue until they have healed.
  • Because Hepatitis C is spread through blood, it is not usually spread through sexual contact. However, it can be spread by having unprotected sex with a menstruating woman who has the virus, through sexual contact where there is blood present or if there is a sexually transmitted disease present.

 

WHO SHOULD BE TESTED FOR HEPATITIS C?

  • Anyone who has shared needles, spoons, water or equipment for intravenous drug use
  • Canadians who have received blood transfusions before 1992
  • Hemophiliacs
  • Those who have had renal dialysis
  • Long term sexual partners of persons with Hepatitis C
  • Babies born to mothers who have Hepatitis C
  • Individuals who are experiencing signs of liver disease or who have abnormal liver blood tests


IS THERE A CURE FOR HEPATITIS C?

At this time there is not a cure for Hepatitis C nor is there a vaccination for it like there is for Hepatitis A and Hepatitis B.

 

IS THERE A TREATMENT FOR HEPATITIS C?

The standard treatment for Hepatitis C is Rebetron. Rebetron is a combination of interferon and rebetrol. The interferon is injected 3 times weekly and the rebetrol is taken orally twice daily.

 

SOME DOs AND DON'Ts IF YOU HAVE HEPATITIS C

DO mix one part bleach with 10 parts water to clean up blood spills. Wash hands well after cleaning up.

DO throw away tissues or menstrual pads in a place where no one else will handle them.

DO be careful with used needles or razor blades. Throw them away into a hard container such as a bleach bottle or coffee tin. Close the lid, tape it shut and put it in the garbage.

DO tell your health care worker (doctor, dentist, nurse) that you have had Hepatitis C.

DO make sure you use a condom or avoid sexual contact if your partner is menstruating.

DO NOT take acetominephen if possible as it is hard on the liver.

DO NOT consume any more than 4 drinks of alcohol per week if possible.

DO NOT share intravenous drug use needles or equipment.

DO NOT donate blood, organs or semen.

DO NOT share needles of any kind (piercing, tattoo, electrolysis and acupuncture).

DO NOT share toothbrushes, earring or razors. Even tiny amounts of blood on these articles can contain the virus and spread the disease to others who share them.

 

UNIVERSAL PRECAUTIONS
Prepared by: Deborah Foster, B.Sc., M.Sc.

Universal precautions are a set of infection control rules to reduce or eliminate risks of exposure to infectious blood and body fluids. These rules are applied to the body fluids of all people to ensure protection (universality).

These rules are used to reduce exposure to blood diseases such as hepatitis B and hepatitis C, and HIV infection. The guidelines will help to reduce transmission of other diseases, but do not provide adequate protection against air-borne diseases such as tuberculosis, the common cold or influenza.

Rather than trying to identify those who are infected (which is impossible with the tests currently available because the tests are unable to identify very recent infections), using these infection control guidelines provides the best protection available.

All people should be considered potentially infectious And therefore, blood and certain body fluids of all people should be handled as if it is infectious.

Universal Precautions apply to these body fluids:

  • Blood
  • Semen
  • Vaginal secretions
  • Human tissues
  • Any body fluid containing visible blood
  • Cerebrospinal, synovial, pleural, peritoneal, pericardial, and amniotic fluids
  • Universal precautions do not apply to the following fluids unless they contain visible blood:
  • Nasal secretions
  • Saliva
  • Sweat
  • Tears
  • Vomit
  • Urine
  • Feces
  • Sputum
  • In light of universal precautions no one should share:
  • Toothbrushes
  • Razors
  • Thermometers
  • Pierced earrings or body jewelry
  • Any other items that might contain some amounts of blood on them


Numbers for more information in Edmonton:
HIV Edmonton 488-5742
Regional public health 413-7940
AIDS/STD Info. line 1-800-772-2437

Needlestick response team 480-6598
Community Infection control 413-7618
STD clinic 413-5156

Principles of Infection, Infection control and Universal Precautions ? At home with Blood Borne Pathogens

 

EXPOSURE TO INFECTIOUS DISEASES REQUIRES:

  • An infected person
    • A way for the infectious fluid to leave the infected person's body
  • A second person
    • A way for the fluid to enter the second person's body
  • Sufficient concentration of the virus in the fluid
  • Favourable environmental conditions

If any of these steps are missing, transmission will not occur.

 

PRINCIPALS TO REDUCE RISK OF EXPOSURE:

  • Avoid or minimize direct contact with blood, semen, and vaginal secretions;
  • Protect any breaks in your skin with bandages;
  • Avoid or modify any action that increases the possibility of contact with body fluids; specifically, change any procedure to decrease the chance of sharp objects cutting skin or body fluids splashing on mouth or eyes

 

INFECTIOUS FLUIDS CAN ENTER OUR BODIES THROUGH:

  • Absorption through mucous membranes covering the body openings;
  • Through an open, bleeding wound;
  • Through damaged areas of the skin, caused by other severe skin diseases.

Mucous membranes are much thinner than normal skin. Microscopic cuts in the membranes can allow germs to cross the membrane and enter the blood stream. Also, fluids can be absorbed through these membranes, even without any cuts or breaks.

Normal skin is much thicker than mucous membrane and provides a good barrier to blood diseases. Infectious fluids can not be absorbed through skin that is intact.

 

HANDWASHING:

  • Before you provide care to someone wash your hands. Wash your hands after contact also even if you wore gloves
  • Wash hands with hot soapy water, make sure you build up a good lather with the soap
  • Rinse and dry hands with a clean towel
  • Take care of your skin to avoid dry cracked skin that a virus could enter through


HOUSEKEEPING:

  • Use gloves
  • Standard detergents are fine for normal house work
  • Bleach solutions should be used for cleaning bathtubs, showers and toilets


DISHES:

  • Dishes can be washed normally in hot soapy water or in a dish washer


LAUNDRY:

  • Clothes may be washed together with regular detergents
  • Use gloves when handling any clothes stained with blood, semen, or vaginal fluids
  • Wash blood stained items in hot soapy water using one cup of bleach per load
  • If items cannot go into the wash, wipe them dry and take them to the dry cleaners


GARBAGE:

  • Dispose of regular garbage in the usual way
  • If items have blood, semen, or vaginal fluid on them and they are not sharp (such as needles or razors): put them in a strong plastic garbage bag, tie it shut, and double bag it. This can be put out with the regular garbage
  • If items have blood, semen, or vaginal fluid on them and they are sharp: put them into a hard container that cannot break or be punctured, seal the container shut, and throw it into the regular garbage


CLEANING UP BLOOD AND OTHER BODILY FLUIDS:

  • Put on disposable latex or vinyl gloves
  • Use paper towels to soak up most of the blood (or other bodily fluids) first
  • Clean up blood spilled area with full strength bleach ? do not dilute the bleach
  • Leave bleach on spill at least 10 minutes
  • Recent studies have shown that full strength bleach still may not kill hepatitis so take extra precautions even after blood or bodily fluid spill is cleaned up
  • Throw away all towels in a plastic garbage bag that is tied shut and double bagged
  • Rinse down area with water

If you cannot bleach the area just clean it well with hot soapy water and air it out. NOTE: this likely will not kill HIV or Hepatitis


WHAT TO DO IF YOU GET BLOOD (OR OTHER BODILY FLUIDS) ON YOUR SKIN:

  • Get all the blood off as quickly as possible
  • Wash the whole area thoroughly with soap and water for at least two minutes
  • If you skin is broken or the fluid gets in your eyes or mouth? flush with water and contact your doctor, nurse, STD clinic or Needlestick Response Team immediately.


WHAT IF YOU ARE PIERCED OR POKED BY A SHARP OBJECT:

If you are poked or pierced by a sharp object such as a needle, lancet or razor blade, follow the above procedure and call the Needlestick Response Team immediately.