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Hepatitis C

Hepatitis C

Worldwide 300 million people are infected with Hepatitis C.

 

In NZ population 0.45% of the population is positive for Hepatitis C antibodies

 

  • This is approx. 50,000 individuals   - 20 - 30,000 people are still unaware of the diagnosis and need to be found so that treatment can be given to prevent severe liver disease in the future
  • The infection affects ethnic groups in NZ in equal proportions (in contrast to Hepatitis B). Hepatitis C is usually acquired without any symptoms (no hepatitis illness). A "carrier state" does not exist (in contrast to Hepatitis B)
  • >75% have a history of intravenous drug use.
    • This may be only 1-2 episodes of use at a teenage party.
    • Promoting the use of clean needles for people using injectable drugs is important to reduce new infections.
    • If people using injectable drugs are not already receiving assistance, they should be referred to community alcohol and drug services (CADS) and a local needle exchange service.
  • 5%  have a history of blood transfusion prior to 1992 (before routine testing of blood was commenced).
  • 5-10% have other risk factors.
    • Unsterile tattooing.
    • There are high rates in prison inmates (presumably related to i.v drug use).
    • Migrants from countries with high rates (due to re-using unsterilised needles).
    • Regions with high HCV prevalence include Eastern Europe, the Middle East, North Africa, Western and Central Sub-Saharan Africa, Central Asia and the Indian subcontinent
  • 5-10% have no identifiable risk factors.
  • People cannot develop immunity to HCV. Therefore, anyone who has eradicated HCV infection either spontaneously or following antiviral treatment may be re-infected.

 

Lifestyle Issues

 

  • If you are considering treatment you will need to prepare for the possible impact on your lifestyle and relationships.
  • You could also require time off work to deal with side effects and/or need to arrange a flexible work schedule with your employer.
  • Personal relationships may come under pressure from mood altering side effects and disruptions to routine. A big part of preparing for treatment is preparing those who will support you so they can help you through this time.

 


 

What about alternative / complementary treatments?

    • There is much interest in alternative treatments such as homeopathy, herbal medicine, dietary changes, and various therapies to decrease stress. Overall the results are disappointing.
    • It is important to be open and frank with your GP or specialist so that appropriate decisions are made.
    • The current treatment is so effective with very little risk that there is no need to delay treatment or consider "natural" alternatives
    • The best “alternative” treatment is to:
      • Stop alcohol.
      • Lose weight.
      • Have a balanced diet (low fat, fresh fruit and vegetables).
      • However there is minimal evidence to support any other sort of dietary restriction and no evidence for any herbal treatment.

    • Fatty liver has a negative influence on the outcome of Hepatitis C.  Therefore weight loss, a low fat diet and regular exercise and minimal or nil alcohol intake are all helpful measures in a more holistic approach because of a reduction in the degree of fatty liver.

 

  


 

Useful links

 

 

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