Hepatitis C is a liver disease caused by a virus (HCV), which affects approximately 150 million people worldwide and approximately 200,000 in France.

WHAT IS HEPATITIS C?

Hepatitis C is an infectious liver disease caused by a virus: HCV. There are several varieties of HCV called genotypes: 6 different genotypes have been identified.

IS IT CONTAGIOUS?

Yes, hepatitis C is a contagious disease. Contagion is mainly through blood. Direct contact with the blood of an infected person is the most common mode of transmission.

HOW DO YOU GET INFECTED?

HCV contamination occurs in two main situations:

• either during a blood transfusion performed before 1992, the date from which systematic screening of blood donors became widespread,
• or during drug use (sharing a syringe or drug preparation equipment, inhalation of cocaine through the nose using a straw).

The risk is also present when using contaminated equipment used for tattooing, body piercing, acupuncture without single-use equipment.

CAN TRANSMISSION OCCUR SEXUALLY?

Only under certain conditions. The risk of sexual transmission is considered zero, moreover the use of a condom is not justified in a stable couple, where one of the partners is positive for hepatitis C. However, there may be sexual transmission in the event of genital lesions or traumatic intercourse, with externalization of blood. The risk of sexual transmission is also greater in the case of HIV co-infection. In these cases, condom use is recommended.

HOW DO YOU KNOW IF YOU HAVE THE HISTORY?

The disease is most often silent. The only way to know if you are infected is to take a screening test. Your doctor may prescribe a specific blood test.

HOW WILL MY DISEASE DEVELOP?

During an initial phase, called "acute", the signs of hepatitis may go unnoticed. This phase occurs in the weeks following contamination. Hepatitis C heals spontaneously in 30% of cases in adults. If it lasts beyond six months, which means that your body has not been able to eliminate the virus, the hepatitis then becomes chronic. In some cases, this inflammatory phase can lead to fibrosis, then cirrhosis and lead to liver cancer.

The severity of the disease depends on the patient's general condition, associated diseases and the level of fibrosis assessed, most often, non-invasively by a biochemical fibrosis score or by Fibroscan®. Liver biopsy is no longer recommended to assess chronic viral hepatitis C outside of associated diseases (obesity, excessive alcohol consumption).

ARE THERE ANY TREATMENTS?

Yes. There are new treatments that are directly active on the hepatitis C virus. Administered orally and well tolerated, these short-term treatments (eight to twelve weeks) allow for the cure of almost all patients. Almost all patients can now have access to these treatments, regardless of the severity of the liver damage.

CAN THE VIRUS BE PRESENT IN WATER OR IN CERTAIN FOODS?

The virus is not naturally present in water and food. Contamination can only occur through contaminated water or food.

WHEN PREGNANT, CAN I CONTAMINATE MY BABY?

The risk of transmission exists during pregnancy and at the time of childbirth. It is 2 to 5% for a natural birth or cesarean section, it is higher in women infected with HIV (up to 15%). It is estimated that one third of children infected at birth will have a risk of developing the disease.

I AM ALSO INFECTED WITH HIV, HOW WILL THIS HAPPEN FOR ME?

The decrease in immune defenses due to HIV infection accelerates the progression of hepatitis C towards cirrhosis and liver cancer. The risk of drug toxicity is also greater. The new hepatitis C drugs are very effective, including in patients co-infected with HIV. The rule is to systematically treat HCV in patients co-infected with HIV.