Hepatitis C infection is more persistent than Hepatitis A or B.
Spread of Hepatitis C
While less commonly spread via sexual means that hepatitis B, it is still considered as a sexually transmitted disease. The main modes of spread of hepatitis C is through contact with the blood of an infected person.
Hepatitis C is most commonly spread via infected needles and sharp objects compared to sexual transmission.
The Natural History of Hepatitis C infection
The symptoms of hepatitis C infection is similar to that of hepatitis A and B. Approximately 20% of individuals who become infected with HCV will clear the virus from their body within 6 months, though this does not mean they are immune from future infection with HCV.
The other 80% of people will develop chronic hepatitis C infection, during which the virus may cause mild symptoms or no symptoms at all. These people will however carry the hepatitis C virus for the rest of their lives and will remain infectious to others. Like chronic Hepatitis B infection, chronic infection with hepatitis C virus may lead to cirrhosis and liver cancer in the long run.
Currently, there is no vaccine as yet for Hepatitis C. However, being vaccinated for Hepatitis B provides some protection against Hepatitis C.
Screening for Hepatitis C
Screening is usually done with a Hepatitis C antibody serology at 1 month post exposure.
This test unfortunately has a relatively high chance of a false positive result (about 1%). To confirm the diagnosis if the serology test if positive, we would proceed to do a Hepatitis C DNA test.
Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis stated ‘Extended HIV follow-up (e.g., for 12 months) is recommended for HCP who become infected with HCV following exposure to a source coinfected with HIV and HCV.’
In other words for patients who got infected with Hep C and HIV at the same time, they need to be screened for HIV for up to 12 months. Not the usual 3 months window period.
Update March 2015
In recent published guidelines on HIV screening, it is no longer mentioned that a Hepatitis C and HIV co-infection can prolong the HIV testing window period. This could be due to the advent of better and more accurate tests.Click here for more Info on HIV and Hep C Co-Infection Window Period Click here to see the full range of our HIV/STD Services
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Dr. Tan graduated from the National University of Singapore in 2001. His residency was in the two largest public hospitals in Singapore; Tan Tock Seng Hospital and Singapore General Hospital.