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What is hepatitis C?
Hepatitis C is inflammation of the liver caused by a virus. In men this virus is found in the blood and semen of an infected person. Contact with blood is the easiest way the virus spreads. There are lower amounts of the virus in semen. It’s not yet clear how likely it is for infected semen to spread the infection.
See also About hepatitis C.

What puts gay and bisexual men at risk of hepatitis C?
Unprotected anal sex, fisting, rimming or sharing sex toys all risk contact with tiny amounts of blood which can pass on hepatitis C. The more men this is done with, the more risk. It seems that sharing rolled up banknotes, straws or ‘bullets’ when snorting drugs like cocaine might also spread the virus.

Sharing injecting equipment (needles, syringes, filters, water, spoons, etc.) when taking drugs or steroids is another important way hepatitis C is passed on.

How serious is hepatitis C?
It’s much more serious than hepatitis A (which usually does no long term damage and you can only get once) and B (which most people recover totally from and also can only be caught once). You can protect yourself against these by being vaccinated. But no vaccine exists for hepatitis C and you can get infected again if cured.

Most people who get the infection don’t clear it from their body and will need treatment. Without treatment most people with hepatitis C remain infectious and risk getting serious liver disease which can end in cancer or the need for a transplant.

But hepatitis C can be treated?
Yes, and is best started before the liver suffers too much damage. But treatment takes up to 12 months, involves being injected once a week and has a failure rate of about 50%. Side effects of the treatment can include flu-like symptoms, aching joints and depression. Alcohol will need to be avoided. If treatment cures someone they can get infected again if they do something with a risk of infection. Sometimes a liver transplant is needed to keep someone alive. Hepatitis C is a leading cause of death among people with HIV.

How common is hepatitis C?
Few people in the general population in the UK have been infected: around 0.5% or over 200,000 people, most of who don’t realise they have it. But in certain groups rates can be much higher, especially among people who have injected drugs and shared equipment. People who had a lot of drug transfusions or drug products before screening began in 1991 also have high rates of hepatitis C.

Gay and bisexual men with HIV have quite high rates of infection too (close to 1 in 10 at some London hospitals), with low rates among HIV negative men. At particular risk are men who have unprotected sex or sex likely to involve contact with an arse that’s bleeding (fisting, rimming, using sex toys), especially if they do this with lots of partners.
People who share straws, rolled up bank notes, etc. when snorting drugs also seem more likely to get hepatitis C.

Is hepatitis C linked to being tattooed or pierced?
In the UK professional tattooists, piercers and acupuncturists must follow hygiene measures to prevent the spread of infections like hepatitis C. The only risk would come if an amateur, ‘do it yourself’ tattooist or piercer doesn’t take precautions to prevent infections. Or if someone is tattooed or pierced in a country with less strict hygiene controls.

How will I know if I have hepatitis C?
Usually people don’t have any symptoms for many years. A blood test from your doctor or a sexual health clinic can tell you if you’ve been infected. Signs of infection in your blood usually take 3-6 months to show. If the test is positive it might mean you’ve had the virus but cleared it from your body. Further tests will find out if you still have the infection and are infectious to others.

What are the effects of Hepatitis C?
See Symptoms & Effects

Where can I get tested for hepatitis C?
You can get a free blood test for hepatitis C from sexual health clinics. More information on testing for hepatitis C can be found at www.hepCuk.info

How do I get vaccinated against Hepatitis C?
There is currently no vaccine against Hepatitis C.

Where can I find out more about Hepatitis C?
Visit the website of the Hepatitis C Trust at www.hepCuk.info, the British Liver Trust at www.britishlivertrust.org.uk or get a hold of the booklet The risks of Hepatitis C – information for people with HIV from Terrence Higgins Trust.