Hepatitis C Basics

The basics on hepatitis C transmission, testing and how it affects the liver


What is hepatitis C?

Hepatitis C is a liver disease caused by the hepatitis C virus.

There are different hepatitis viruses that affect the liver. The three types that are common in Canada are hepatitis A, hepatitis B and hepatitis C.

People can get hepatitis C when blood carrying the virus gets into their bloodstream. Once inside, it infects the liver and causes damage to this very important organ. The more damage there is, the harder it is for the liver to do its job and people can become very sick.

For some people who get hepatitis C, the virus goes away on its own within the first six months after infection. For most people, the virus is still in the body after six months. At this point, hepatitis C will not go away on its own, but there is treatment that can clear (get rid of) the virus from the body.

There is no vaccine for hepatitis C.

The body can protect itself from many viruses. We call this immunity. It can sometimes do this on its own but it often needs the help of a vaccine.

There is no vaccine or other immunity against hepatitis C, so the only way to prevent hepatitis C is by avoiding the virus. Even people who get hepatitis C and clear the virus can get it again.

Hepatitis C statistics

For more on hepatitis C statistics, please visit Epidemiology of hepatitis C in Strengthening Programming.

The liver

The liver is the largest organ inside the body, about the size of a football in the average adult. It is on the right side of the body, under the ribs.

The liver is important because it helps the body fight infections, clean toxins (poisons) from the blood, digest food and more.

The liver is very tough and even has the ability to heal itself. Still, hepatitis C and other viruses, alcohol and some prescription, over-the-counter and street drugs can cause permanent damage to your liver.

Protecting your liver is important… you cannot live without it!

Hepatitis C is spread through blood-to-blood contact

Hepatitis C is spread when blood carrying the virus gets into the bloodstream of another person.

  • This usually happens through breaks in the skin or breaks in the lining of the nose and mouth.
  • Hepatitis C is a strong virus and can live outside of the body for many days. This means that dried blood can also pass the virus.

These are some of the ways hepatitis C can get inside the body:

  • Using drug equipment that has been used by someone else, such as needles, syringes, filters, cookers, acidifiers, alcohol swabs, tourniquets, water, pipes for smoking crack or crystal meth, and straws for snorting.
  • Getting a blood transfusion or an organ transplant that has not been screened for hepatitis C. In Canada, the screening of donated blood and organs for hepatitis C started in 1990. In some other countries, blood wasn’t screened for hepatitis C until more recently.
  • Re-using tools for activities that break the skin, such as tattooing, body piercing, acupuncture and electrolysis. In tattooing, reusing needles as well as ink and ink pots can spread hepatitis C.
  • Re-using medical equipment that should only be used once, such as needles for vaccines. Medical equipment that has been used with other people and not cleaned properly before being used again can also spread hepatitis C.
  • Sharing or borrowing personal items that might have blood on them, such as razors, nail clippers and toothbrushes.
  • During pregnancy or childbirth. A woman who has hepatitis C can pass the virus to her baby during pregnancy or childbirth.
  • Having unprotected sex where blood could be present. For example, during anal sex, rough sex, sex during a woman’s period or when one person has open sores.

For more on ways to prevent hepatitis C, please see Prevention & Harm Reduction.

It is possible to have hepatitis C and another virus, such as HIV or hepatitis B. This is called co-infection and it can make the damage that hepatitis C does to your liver worse.

  • HIV and hepatitis B can pass from one person to another in the same ways as hepatitis C.
  • HIV can also get into the body through semen (cum and pre-cum), anal fluid, vaginal fluid and breast milk.
  • Hepatitis B can also get into the body through semen (cum and pre-cum) and vaginal fluid. There is a vaccine to prevent hepatitis B. In Canada, children and some adults can get this vaccine for free.

Testing is the only way to find out if you have hepatitis C

There are close to 250,000 people living with hepatitis C in Canada. Many people who have hepatitis C don’t know it.

Most people do not show any signs or symptoms until many years after getting hepatitis C.

  • If and when people do have symptoms, they are very general and may feel like other illnesses.
  • As the liver becomes more damaged, symptoms may include feeling tired all the time, body aches, dry and itchy skin, difficulty concentrating, forgetfulness and confusion (called “brain fog”) or a yellowing of the skin and eyes (called jaundice).

The only way to really know is to get tested.

  • If you think someone else’s blood could have made its way into your body—even one time—or you feel unwell, visit your doctor or a health centre to talk about getting tested.

It takes two tests to know if you have hepatitis C.

Unlike some other viruses, there are two separate blood tests for hepatitis C:

The first test: Hepatitis C antibody testing is used to see if a person has ever come in contact with hepatitis C. When hepatitis C first enters the bloodstream, the immune system in the body produces antibodies against the virus. The hepatitis C antibody test looks for hepatitis C antibodies in the blood. A negative test result means that a person has never come in contact with hepatitis C.

A positive test result means that a person came in contact with hepatitis C at some point. But, antibodies stay in the body even when someone clears the virus. Follow-up testing is important: The second test shows if the virus is still in the body.

The second test: Virus testing (called a PCR test, a viral load test or an RNA test) checks for active hepatitis C infection. A negative virus test result means that a person does not have hepatitis C. A positive test result means that a person does have hepatitis C.

For more on hepatitis C testing, please see Testing for hepatitis C.

Stages of liver damage

Without treatment, damage to the liver gets worse over time.

These are the stages of liver damage:

  • Hepatitis C infection. The hepatitis C virus enters the bloodstream, is carried to the liver and infects liver cells.
  • Inflammation. Infected liver cells become damaged and some cells die. This causes the liver to swell. Most people won’t even know this is happening.
  • Fibrosis. Over time, scars may form on the liver. This is called fibrosis. How much fibrosis there is usually depends on how long a person has been infected with hepatitis C.
  • Cirrhosis. As fibrosis increases over many years, the liver can harden and shrink. This is an advanced form of liver disease called cirrhosis.
  • Liver cancer or liver failure. After a long period of time, people may get liver cancer or the liver can stop working (called liver failure).

Points to remember

  • Hepatitis C is a virus that lives in the liver. It is spread through different kinds of blood-to-blood contact.
  • A person can have hepatitis C for many years without symptoms, even though the virus may be damaging the liver.
  • The only way to know if a person has hepatitis C is to get tested.

There is treatment for hepatitis C. Many people finish treatment and are able to get rid of the virus.