By Lucy Gleysteen
From PHN Issue 33, Summer 2017
Hepatitis means inflammation of the liver. There are different kinds of hepatitis (A, B, C, D, and E). Hepatitis C is a disease caused by the hepatitis C virus (hep C), which lives in the blood and affects the liver. The liver is the body’s filter and processing plant. Often, when people are infected with hep C, they do not develop any symptoms. Rarely, soon after infection, some people will develop an upset stomach, flu-like symptoms, dark urine, grey-colored stool, joint pain, and yellow skin. Out of everyone living with hep C, 75% to 85% will remain infected until they take curative treatment. Only 15% to 25% of people infected with the virus are able to clear it on their own. Long-term or chronic hep C infection can increase an individual’s risk for liver scarring (cirrhosis), liver cancer, and liver failure.
How to Prevent Hep C from Entering Your Body
The primary mode of hep C transmission is through blood-to-blood contact. This can happen during injection or intranasal drug use, unsterile tattooing, sexual activity, and through your open skin coming in contact with objects that have infected blood on them. It is possible for an object to be contaminated with blood and the virus even if you cannot see the blood.
Injection drug use puts you at the highest risk for getting hep C. Blood can be present on injection equipment even if you can’t see it. This includes the syringe, cooker, cotton, hands, and in used water. Engaging in treatment for addiction to help support sobriety is ideal. However, if you are not ready to engage in drug treatment, some strategies for safer drug use include:
- Preparing your own drugs and using new injection, snorting, and smoking equipment every time
- Cleaning the area that you use to prepare drugs
- Washing your hands and the injection site before and after your injection
- Avoiding splitting drugs and sharing equipment
- If you are planning for release, finding the address of a syringe exchange program in the city you’ll be living in
Hep C can be transmitted through shared tattooing or piercing equipment. Hep C can live in an inkpot for several weeks, which means the inkpot should only be used by one person. Always make sure you are getting fresh clean ink every time you get a tattoo. Hep C can also live in the tattooing equipment, so only sterile or new equipment should be used.
- Only have tattooing or piercing done if sterile equipment and new single-use inkpots are used
- Dispose of materials once used
- Label your equipment and inkpot, and take other measures to ensure no one else uses it.
Hep C can live on items like razors, toothbrushes, nail clippers, and tweezers for several weeks. Suggestions for prevention:
- Label your toothbrush and razor to ensure no one else will use them
- If your gums bleed easily, make an appointment to visit the dentist
- Avoid borrowing or sharing the items listed above
There is a relatively low risk for sexual transmission of hep C, but sexual transmission is possible. Risk of transmission increases when you have unprotected sex with multiple partners. Risk is also increased during certain sexual activities, including anal sex or rough sex resulting in skin tears. Strategies for safer sex include:
- Knowing your hep C status and talking to your sexual partners about theirs
- Using condoms, if available in your facility
- Using water-based lubrication, especially if you are having anal sex or rough sex. This will help reduce the risk of vaginal and anal tears. Vaseline, creams, cocoa butter, and oils damage condoms
- Avoiding sex when other sexually transmitted infections (STIs) are present, because STIs often cause inflammation, open cuts, and sores (entry points for hep C)
- Avoiding sex during menstruation
- Some people in prison use plastic wrap or rubber gloves as makeshift condoms if it’s not possible to get condoms
Hep C is NOT Transmitted By
- Kissing, hugging, and snuggling
- Sharing food or beverages
- Coughing or sneezing
- Shaking hands
If You Test Positive
If you test positive for hep C, remember that the virus affects everyone differently. There may be a chance that you are able to clear the virus on your own, but the majority of people exposed to the virus go on to develop a chronic hep C infection. A rapid, or “finger stick,” test will tell you if you have been exposed to hep C, but it cannot tell you if you are living with a chronic infection. You will need a second blood test that looks for the presence of virus in the blood to determine whether you have a chronic infection. To keep your liver healthy, avoid drinking alcohol, because it can accelerate the harm caused by hep C.
Hep C can now be cured with oral medications with minimal side effects, but these can be hard to get. You can talk with your provider about accessing treatment for hep C. If you are returning to Philadelphia, you can receive treatment for hepatitis C at the Philadelphia FIGHT Community Health Centers.