Hepatitis C is an inflammation of the liver caused by hepatitis C viruses. After infection, most people are initially either slightly ill or exhibit no symptoms. However, hepatitis C can persist for a long time (chronically) and lead to severe damage to the liver in the long term. It is estimated that around 3 in 1,000 people in Germany have chronic hepatitis C. As the infection does not always cause symptoms and those affected therefore remain unaware of their illness, the number of unreported cases is likely higher.
Hepatitis C viruses can be transmitted via the blood of infected people if it enters the bloodstream of another person. In Germany, this happens mainly in connection with drug use, such as through sharing needles with other people. Hepatitis C can also be transmitted via snorting tubes used to ingest drugs through the nose.
Very rarely, the viruses can also be transmitted during sex. This is most likely to occur via direct contact with blood through minor injuries. The injuries can be caused by certain sexual practices, sometimes even going unnoticed. The viruses can also be transmitted during menstruation if the blood comes into contact with the partner’s minor wounds. If a pregnant woman is infected with the hepatitis C virus, the viruses can be transmitted to the child during pregnancy or during birth.
Hepatitis C viruses from the blood can survive outside the body for some time. Hence it is also possible to become infected via objects that come into contact with blood. This occurs in very rare cases in healthcare professions. The viruses are then transmitted through puncture wounds with surgical instruments or syringes, for example. Transmission is also possible via other objects that come into contact with blood. These include shared razor blades, nail scissors or toothbrushes, for example.
In the case of a hepatitis C infection, you may initially not notice any symptoms. But you may feel tired and have no appetite. You may feel pain in your head and limbs. Abdominal pain, nausea and vomiting may occur. You may also have a mild fever. Your skin and the whites of your eyes may turn yellow. This is called jaundice. Jaundice can cause the skin to itch severely. Urine may also turn dark and stools may look lighter than normal.
In up to 80 percent of those infected, however, the disease becomes chronic and then damages the liver in the long term. After a few years, the damage can lead to secondary diseases such as cirrhosis of the liver (advanced scarring and shrinking of the liver) and liver cell cancer.
After infection with the hepatitis C virus, it may take a few weeks or months before symptoms develop. You are contagious if you have hepatitis C viruses in your blood. That is true even if you have no symptoms or if the disease has already become chronic.
The people most at risk of contracting a hepatitis C infection include:
In piercing and tattoo studios, though also in healthcare facilities in poorer countries, hygiene standards are sometimes lower than in Germany. Accordingly, the risk of infection is higher. For medical staff and patients who receive blood or blood products, the overall risk of infection is rather low.
The risk of a chronic course of hepatitis C varies greatly from person to person and depends on various circumstances. People with an HIV infection are at a higher risk of chronic hepatitis C and progressive liver disease.
Laboratories or doctors are required to report names to the Gesundheitsamt (health authority) if they suspect or discover that someone is infected with hepatitis C. If you work in the healthcare sector, you must inform your employer or the relevant occupational health service about your illness.
There is no vaccine against hepatitis C. Having contracted the disease does not protect against re-infection with hepatitis C.
The local health authority will be able to provide you with further advice. Other advice services are offered by Deutsche Aidshilfe, Checkpoints, drug help facilities and opioid substitution treatment doctors.
You can obtain advice and further information from the Federal Institute of Public Health (BIÖG) by telephone on 0221 – 89 20 31 or on the Internet at www.liebesleben.de.
Further (specialist) information can also be found on the Internet on the websites of the Robert Koch Institute (www.rki.de/hcv), the Institute for Quality and Efficiency in Healthcare (www.gesundheitsinformation.de/hepatitis-c.html) and Deutsche Leberhilfe e.V. (www.leberhilfe.org/lebererkrankungen/hepatitis-c-hcv/).