Hepatitis C

Hepatitis C is an infectious liver disease caused by the hepatitis C virus (HCV). Infections of hepatitis C occur when the virus is able to enter the blood stream and reach the liver.

There are other kinds of viral hepatitis such as hepatitis A, hepatitis B, hepatitis D, and hepatitis E. These diseases and the viruses that cause them are not related to hepatitis C even though they also affect the liver. They may have other, different symptoms and different modes of transmission, which means that there are different ways of spreading the disease and different means for preventing and controlling these diseases.

The incubation period (the time between initial contact with the virus and the onset of the disease) for hepatitis C is usually 6 to 7 weeks, but it can range from 2 weeks to 6 months. Not all people infected with the hepatitis C virus will develop symptoms.

Hepatitis C can develop differently, depending on if it becomes an acute or chronic infection. For about 60 to 75% of individuals, no symptoms will be experienced (asymptomatic).  

If present, the symptoms of hepatitis C infection include fever, nausea and vomiting, loss of appetite, stomach pain, tiredness, joint pain, dark urine, pale feces, and yellowing of the skin and eyes (jaundice). Symptoms last about 2 to 12 weeks. Health Canada states that about 60 to 70% of people with hepatitis C do not develop symptoms until their liver has already been damaged.

About 75% of individuals with an acute infection will develop a chronic condition. With chronic hepatitis C infection, about 25% of individuals will recover on their own (spontaneously). Symptoms of chronic infection include nausea, pruritus (itching), malaise, and abdominal pain.

There are 2 main diagnostic tests for hepatitis C - hepatitis C antibody (anti-HCV) test and hepatitis C ribonucleic acid (RNA) test. Which test is used (or both) depends on how long it has been since the suspected infection occurred.

The hepatitis C virus is spread primarily by exposure to blood.

People may get hepatitis C from needles, through exposure to blood in the workplace, from unsterile equipment used for body piercing, tattoos or acupuncture, exposure to dental or medical practices with poor infection control practices or by sharing personal care items including toothbrushes, nail clippers, razors, scissors with infected people. Sharing drug paraphernalia such as needles, spoons, pipes, and straws contaminated with blood has also been associated with a risk. The risk of getting this virus from a blood transfusion is minimal but still exists. All donated blood is screened for the hepatitis C virus.

Hepatitis C has been transmitted between sex partners. It has also been transmitted, although rarely, among household members, possibly because of frequent physical contact with small cuts or skin rashes. An infected mother can pass HCV to her child at birth.

There is no evidence that hepatitis C virus is spread by casual contact. Sneezing, coughing, kissing, and hugging do not pose the risk for hepatitis C. In addition, there is no evidence that hepatitis C virus is spread by food or water.

The hepatitis C virus can survive on surfaces outside the body for up to 3 weeks.

Between 2006 and 2015, the average rate of reported HCV infection in Canada was 32.2 per 100,000 people. The Public Health Agency of Canada also reports that up to 245,987 Canadians may be living with chronic hepatitis C virus (HCV) infection (2011), but that an estimated 44% are unaware of their infection.

When treatment is necessary, hepatitis C is generally treated with direct-acting antiviral drugs. Health Canada now considers hepatitis C to be a curable infection.

The risk of acquiring hepatitis C from the workplace depends on the amount of exposure to human blood or blood products and needlestick injuries. In general, occupational groups with increased risk include workers such as healthcare workers, dentists, and laboratory personnel who are repeatedly exposed to human blood and who are at risk of needlestick injuries.

There is currently no vaccine for hepatitis C. The risk of hepatitis C can be significantly reduced by implementing infection control guidelines suitable for the specific workplace.

Infection control precautions are the first line of defense to protect workers from hepatitis C and other blood-borne diseases. For this reason, the Public Health Agency of Canada recommends routine practices when there is a risk of exposure to blood or certain body fluids.

Please see the OSH Answers document Routine Practices for more information.