Hepatitis C is a blood-borne virus. This fact sheet outlines some basic information about the virus, particularly with regard to preventing the transmission of hepatitis C in people who inject drugs and steroids.
Sharing of any injecting equipment is a key risk factor in the transmission of hepatitis C.
Hepatitis C and Injecting Drug Use (IDU)
Hepatitis C (HCV) is a major concern for people who inject drugs. We know that approximately 80% of the estimated 240 000 people with Hep C in Australia have acquired the virus through injecting drug use (IDU) – either past or present. It can take as little as one incident of unsafe injecting to transmit the virus.
HCV is a blood-borne virus and as such is spread through one person’s infected blood gaining direct access into the bloodstream of another. Even small amounts of infected blood can transmit the virus, amounts even too small to see with the naked eye. Prior to 1989, hepatitis C had been identified as ‘non-A, non-B’ hepatitis. Currently there is no vaccination to prevent hepatitis C infection.
WHY ARE IDUs MORE LIKELY TO CONTRACT HEP C?
Hep C is spread by blood to blood contact. Injecting is an activity where there is often a great deal of blood present, therefore the opportunity to come into contact with infected blood is significantly increased.
Hep C has been in the Australian community for several decades. Testing for the virus, however, has only been available since 1990. Transmission of the virus therefore has been happening over many years, most particularly in those groups whose behaviour places them at risk of blood to blood contact. A large number of individuals have become infected through unsafe injecting, thus IDUs have an increased chance of coming into contact with someone who is Hep C positive through shared IDU.
Unsterile injecting practices increase the chance of virus transmission. Blood enters the syringe during the injecting process. Hepatitis C can be transmitted at every stage of the injecting procedure. Sharing not only needles and syringes, but other equipment such as swabs, filters, tourniquets, spoons and water can mean that opportunities for contamination (and reinfection) can easily occur. Be careful also of blood that may be on the bench or tabletop on which equipment is being used.
When preparing and injecting drugs, BE BLOOD AWARE, avoid contact with blood.
HOW CAN I AVOID HEPATITIS C INFECTION?
DO NOT SHARE YOUR INJECTING EQUIPMENT WITH ANYONE.
This includes: fits (needles and syringes), filters, swabs, water, spoons and tourniquets. Traces of infected blood may be left on this equipment. Be sure to wash your hands with soap and water before and after using; this will reduce traces of the virus if it is present. Do not let anyone else touch your injection site as even microscopic amounts of blood can transmit the virus.
USE A NEW FIT FOR EVERY HIT
Plan ahead – access the local Clean Needle Program (CNP) to get new fits. For details about your nearest CNP see the number on the back of this pamphlet.
Guidelines for safer injecting:
DO NOT SHARE EQUIPMENT: Even small amounts of blood can lead to infection with Hep C – look after your health and that of your mates.
WASH YOUR HANDS BEFORE AND AFTER INJECTING: This will reduce the likelihood of blood being present on your hands and will also reduce the risk of transferring blood to any of your equipment.
USE ALCOHOL SWABS: Swab the spoon once with a fresh swab. If you have not been able to wash your hands, swab your fingers as well with a fresh swab, wiping in one direction only. Similarly swab the injection site once with a fresh swab in one direction only. This will stop bacteria, dirt etc, being wiped back and forth over the site.
CLEAN UP: After injecting, place your fit immediately into a sharps bin (do not clean it unless you, and only you, intend to reuse it. If so, flush with cool water to remove all blood. The fit should be cleaned again with bleach and water immediately before use). CLEANING FITS MAY NOT REMOVE ALL VIRUSES. Better by far to use a new fit for every hit.
SAFE DISPOSAL: Never recap a fit unless only you have used it. Place it in a hard, rigid walled container. Return it to your local Clean Needle Program when you go for fresh supplies.
If you already have Hepatitis C
You can be reinfected with Hep C, and this can happen more than once. Reinfection can occur because there is more than one strain (or genotype) of the virus, and infection with one does not give immunity to another or even the same strain. Every sharing incident has the potential for the transmission of the virus. Reinfection can place an additional infection into your system and could tax an already compromised liver.
Although household transmission (in a home environment) of Hep C is rare, it is advisable not to share razors, tweezers, toothbrushes, nail brushes or any device which can cause skin abrasions or penetration. Tiny particles of blood may be left on these instruments, making transmission of the virus possible.
Have regular Liver Function Tests (LFTs) and ask your doctor about a referral to a specialist or Liver Clinic. These specialists can discuss any symptoms you may have and advise you on your treatment options.
Drugs and their effects
Alcohol: Recent studies have shown that alcohol consumption can accelerate the damage done by HCV to the liver. It is advisable that you stop or reduce your drinking. If you choose to continue drinking it is advised that you have no more than 4 standard drinks per week (7 for men). Binge drinking is even worse for your liver and should be avoided all together.
Heroin: The impurities in ‘street’ heroin may be difficult for the liver to process. This may exacerbate liver problems as one of the liver’s prime functions is to neutralise toxins.
Speed: As with heroin, impurities in these drugs can undermine the body’s capacity to heal itself and fight HCV and other infections. Speed use is often accompanied by lack of sleep, poor diet and vitamin depletion. When your health is compromised with Hep C, sleeping well, eating well and an adequate fluid intake are very important.
Pills: Removal of benzodiazapines (Valium, Serapax) from the body is much less efficient if the liver has even mild damage, so there is an increased risk of overdosing.
Information on clean needle programs, testing and support
There are Clean Needle Program outlets (CNPs) throughout South Australia where sterile injecting equipment can be obtained. Some pharmacies also stock needles and syringes, however there is a small fee attached to this service.
Clinic 275, a sexual health service based in Adelaide provides free, confidential testing and free Hep B vaccination.
There are three Hep C support/discussion groups in Adelaide for people with Hep C. Contact the Hepatitis C Council for details (see below).
The Hepatitis C Council of SA also has a Telephone Information Line which is available to city and regional callers. Regional callers can call on a free call number (see below).
WHERE CAN I FIND MORE INFORMATION?
ADIS (Drug and Alcohol Information Service) - 1300 13 13 40 Call ADIS for information on Clean Needle Program locations
SAVIVE - (08) 8362 9299 for peer based info, support and referrals for current users
Clinic 275 - (08) 8226 6025
Your local Youth or Community Health Service
Hepatitis Helpline - 1800 621 780
Hepatitis C Council of SA Inc.
Hep C Info Line
(08) 8362 8443
1800 02 11 33 regional callers
This fact sheet based on an original pamphlet by Hepatitis C Council of QLD Inc.
Adapted by Hepatitis C Council of SA Inc. in collaboration with SAVIVE, AIDS Council of SA, September 2000