If you have had unprotected sex or are worried about possible infection with hepatitis C or other STIs, get tested as soon as possible – even if you don’t have symptoms.

What is Hepatitis C?

Hepatitis C is an infectious disease caused by a virus (HCV) which is one of a group of liver viruses that cause inflammation of the liver – when the liver is swollen and painful.

Is Hepatitis C a serious condition?

Hepatitis C can be serious and, without proper treatment and care, can cause chronic liver disease and liver cancer, leading to death.

How can you get Hepatitis C?

Hepatitis C can be transmitted very easily, and you can get it in the following situations:

  • if you have unprotected sex (sex without a condom or dental dam), vaginal, anal, and oral sex with someone who has hepatitis C (even if they have no symptoms)
  • if you share sex toys that are not washed or covered with a new condom every time they are used
  • if you are fingering, rimming, or fisting – exploring your partner’s anus with your fingers, mouth, or tongue; touching used condoms and sex toys that have been in someone else’s anus.
  • if you use needles and syringes together after they have been contaminated during drug use.
  • if you get tattoos or piercings with unsterilized utensils; through unsterilized medical/dental equipment (rarely, the virus can be transmitted by sharing a towel, razor blades or toothbrush if there is infected blood on them).

Hepatitis C, HIV, and sexual health

  • Having an STI, including hepatitis C, increases the risk of getting HIV. This is because most STIs cause lesions that make it easier for HIV to enter the body.
  • Because they are transmitted in similar ways, some people have both viruses, known as co-infection.
  • If you live with HIV and have hepatitis C, your viral load may be higher because your immune system is weaker. This will make you more likely to transmit HIV if you have sex without a condom.
  • If you are living with HIV, your doctor should regularly test you for hepatitis C and check your liver regularly.
  • If you take antiretrovirals, it’s important to talk to your doctor about how your hepatitis C treatment might interact with your HIV drugs.

How do you protect yourself against Hepatitis C?

  • Practice safe sex:
    • Know the status of any sexual partner.
    • Use a new condom (male or female) or a dental dam every time you have anal, vaginal, or oral sex.
    • use a new dental dam or latex gloves for rimming and fingering or use latex gloves for fisting.
    • cover sex toys with a new condom and wash them after use.
  • Never share needles, syringes or other items that may be contaminated with blood, such as razors, toothbrushes, and manicure tools (even old or dried blood can contain the hepatitis C virus).
  • Get tattoos, piercings or acupuncture in a professional setting and make sure new, sterile needles are used.
There is no vaccine for Hepatitis C.

Note – apart from condoms, other types of contraception (such as contraceptive pills) or PrEP do not protect against sexually transmitted infections.

What are the symptoms of Hepatitis C?

Hepatitis C infection can go through two stages: acute and chronic. In the early stage – acute – most people have no symptoms and don’t know they have them until the liver has been significantly damaged.

For women and men, acute (or short-term) symptoms include:

  • flu-like symptoms, including fatigue, fever and aches and pains
  • feeling nauseous
  • weight loss / loss of appetite
  • irritated skin
  • tummy (abdominal) pain
  • mental confusion (often called ‘brain fog’) and depression – these are typical of hepatitis C.

Acute hepatitis C infection doesn’t always become chronic, but if it does, you often don’t notice any symptoms until the virus has damaged the liver enough to cause signs and symptoms of liver disease, including:

  • mild bleeding and/or bruising
  • fatigue
  • weight loss/loss of appetite
  • jaundice, which means your skin and the whites of your eyes turn yellow
  • dark urine
  • irritated skin
  • fluid build-up in the belly (abdomen)
  • swollen legs
  • confusion, drowsiness, and slurred speech
  • extremely visible (vascularized) blood vessels.

Can I be tested for Hepatitis C?

Yes – a simple blood test will show if you have the virus. You may also have further tests to see if your liver is damaged.

If you have hepatitis C, you should also be tested for other STIs. It’s important to let your recent sexual partners know so they can get tested and treated. Many people who have hepatitis C don’t notice anything, and by telling them, you can help stop the transmission of the virus; you can also prevent reinfection.

How is Hepatitis C treated?

Most people with hepatitis C do not need treatment. However, you will need regular check-ups for three months to see how your body is coping with the virus.

For people who develop a chronic infection, there is treatment, and people with chronic infection do not necessarily develop liver damage.

If you already have hepatitis C, it is recommended that you get vaccinated against hepatitis A and B to protect your liver from further damage.

Whether you have symptoms or not, don’t have sex before you get your doctor’s consent.

Once you’ve had hepatitis C and are cured, you don’t become immune – which means you can re-infect yourself. You can also get other types of hepatitis, and hepatitis C combined with another type of hepatitis causes even more serious complications.

Complications of Hepatitis C

As with most STIs, hepatitis C puts you at risk of getting other STIs, including HIV.

Without treatment, chronic hepatitis C can cause scarring of the liver (cirrhosis), which can cause the liver to stop working properly; a small number of people with cirrhosis develop liver cancer; and these complications can lead to death. Apart from a liver transplant, there is no other solution for treating cirrhosis. However, treatments can help relieve some of the symptoms.