Hepatitis C

Most people with new (acute) HCV infection typically have no symptoms (70%-80%) or only have a mild illness.

Symptoms:

• Can appear two weeks to 6 months, but most often within 6 to 7 weeks after exposure
• Mild illness may include any of the following:
  • Loss of appetite, tiredness, stomach pain, nausea, headache, jaundice (yellow skin or eyes), and dark (coffee colored) urine

The safest choice is to never share needles, syringes, or any equipment used to prepare or inject drugs. If you cannot avoid sharing, these steps can lower risk—but they cannot remove all risk:

• Use a new, sterile needle and syringe every time. Get supplies from a pharmacy or another trusted source.
• Use your own cooker/cap, cotton/filter, water, tourniquet, and alcohol pad. HCV can stay in tiny amounts of blood on equipment.
• Do not use a used syringe to divide or prepare drugs. Prepare your portion with clean equipment before anyone injects.
• Mark your equipment and keep it separate. Wash your hands and clean the surface before and after use.
• If sterile equipment is unavailable, cleaning may lower risk but does not make equipment safe. Replace used equipment as soon as possible.
• Dispose of used syringes in a sharps container or a thick plastic container with a tight lid. Do not recap or handle another person’s used needle.

Help protect your community. Encourage anyone you have shared injection equipment with or sexual partners who may have been exposed to get tested for hepatitis C and HIV.

Do not share razors, toothbrushes, nail clippers, glucose-testing equipment, or anything that may have blood on it.

Cover cuts and sores and clean blood spills with gloves and a household cleaner that kills viruses that are found in blood.

Sexual spread is uncommon, but can happen. Use condoms or barriers—especially with multiple partners, HIV, an STI, anal sex, rough sex, or sex that may involve blood. Long-term partners should discuss testing with a provider.

Do not donate blood, organs, tissue, or semen if you currently have HCV.

HCV is not spread by hugging, kissing, coughing, sneezing, sharing food or utensils, or casual contact.

Sharing needles, syringes, cookers, cottons, or water can transmit both HIV and hepatitis C. Having hepatitis C does not mean you have HIV, but it is important to get tested for HIV and talk with your partners about testing.

PrEP prevents HIV before exposure. It is for people who do not have HIV and may be exposed through sex or injection drug use. Daily PrEP pills lower the risk of HIV from injection drug use by at least 74% when taken the way your healthcare provider tells you.

PrEP does not prevent hepatitis C and does not replace using new, sterile injection equipment. Continue safer injection and sexual practices while taking PrEP.

PEP is for a recent possible HIV exposure. If you shared injection equipment or may have been exposed within the past 72 hours, go to an emergency room, urgent care, or healthcare provider right away. Starting PEP quickly is important.

A positive hepatitis C antibody test does not always mean you have a current infection. More testing is needed to show if the virus is still in your blood and if you need treatment. Ask your healthcare provider about the follow-up tests.

There is no vaccine for hepatitis C—but it can be cured. Most people can be cured with 8–12 weeks of once-daily pills. These medicines cure more than 95% of people, are easy to take, and have few side effects. Treatment is recommended for almost everyone with current hepatitis C infection, including people who currently use or inject drugs.

You can get HCV again after being cured. Continue using safer injection practices and talk with your healthcare provider about repeat HCV RNA testing if you may be exposed again. Protecting yourself after treatment helps prevent reinfection.