Hepatitis C

Reporting Obligations

Laboratory confirmed cases must be reported to the Thunder Bay District Health Unit by fax, phone or mail.

  • Fax: (807) 625-4822
  • Phone: 625-8318 or toll-free at 1-888-294-6630, ext. 8318
  • Mail: 999 Balmoral Street, Thunder Bay, ON P7B 6E7

Epidemiology

Aetiologic Agent:

The hepatitis C virus (HCV) is a small, single-stranded RNA virus and is a member of the Flaviviridae family.  At least 6 major genotypes and approximately 100 subtypes exist. There is limited evidence about any differences in clinical outcome between the various types; however, differences do exist in responses to antiviral therapy according to HCV genotypes.

Clinical Presentation:

Most cases are usually asymptomatic or have mild illness; presentation is similar to other hepatitis diseases and when symptoms are present, the onset is slow and insidious with anorexia, vague abdominal discomfort, nausea and vomiting and fatigue. A high percentage (50-80%) of infected persons develop chronic infection..

Modes of transmission:

HCV is primarily transmitted by blood-to-blood contact (parenterally). Sexual and mother-to-child have been documented but appears far less efficient or frequent than the parenteral route.

Incubation Period:

Ranges from 2 weeks to 6 months, most commonly 6-9 weeks.

Period of Communicability:

From one or more weeks before the onset of symptoms; most persons are probably infectious indefinitely.

 

Risk Factors/Susceptibility

Medical:

Blood transfusion; co-infection with existing STI; invasive surgical/dental/ocular procedures; organ/tissue transplant

Behavioural/Social:

Inhalation/injection drug use; shared drug equipment or personal items; tattoo/piercing; electrolysis/acupuncture; high risk sexual practices; occupational exposure; sexual partner is HCV positive; blood exposure (fighting, accident)

 

Diagnosis & Laboratory Testing

Two serology tests can screen for chronic Hepatitis C infection for patients with risk behaviours or potential past exposures to HCV:

1. anti-HCV testing to assess for previous exposure (if positive, the patient will have antibodies for life) and

2. HCV-RNA testing to check for active virus.

For the RNA test, 2.5 ml of frozen serum, separated within 4 hours of collection (at the lab) must be submitted to an Ontario Public Health Laboratory with a completed Hepatitis PCR Requisition.

Testing Information & Requisition

 

Treatment & Case Management

The Primary Care Management of Chronic Hepatitis C – Professional Desk Reference 2009 provides guidelines for who should be screened, determining chronic Hepatitis C infection, evaluation, education, and counseling of the HCV infected adult, and assessing for acute Hepatitis C infection.

Hepatitis C (HCV) – Counselling Guidelines for Health Care Professionals (HCP) (PDF) resource was developed for health care professionals by the Thunder Bay District Health Unit.

The patient is eligible for free Hepatitis A and B vaccines. To order, please use the appropriate vaccine order form; hepatitis A or hepatitis B.

 

Patient Information

Patient Fact Sheet

References

  1. Ministry of Health and Long Term Care, Infectious Diseases Protocol, 2016; Appendix A (2009) and Appendix B (2009).

 

Additional Resources

1. Can J Gastroenterology. "Management of chronic Hepatitis C: Consensus Guidelines, 2015."

2. Can Association for the Study of the Liver. Online app to access and navigate the "Management of chronic Hepatitis C: Consensus Guidelines, 2015."

3. Canadian Liver Foundation. "Healthy Living with Viral Hepatitis."

4. Healthy Canadians, Government of Canada, "Hepatitis C."

5. OHA. "Blood-Borne Diseases Surveillance Protocol for Ontario Hospitals. December 2016".

6. Canadian AIDS Treatment Information Exchange (CATIE). "Hepatitis C."

Last Updated: 26/10/2017