HCV is a blood-borne pathogen. It is spread when the blood of a person with HCV comes in contact with the blood of someone else. The main way that HCV is spread in Canada is through injection drug use and sharing substance use equipment. It is less common, but HCV can also be spread through unprotected sex, unsterilized tattoo or piercing equipment, and occupational exposure (e.g., needle stick injuries). HCV can also be passed from mother to baby during pregnancy, in utero, or right before, during, or right after birth (called perinatal or vertical transmission).
The first 6 months of infection after exposure are referred to as acute HCV. Most people do not have symptoms during this time. When symptoms do occur, they include abdominal pain, nausea, jaundice, and generally feeling unwell. About 25% of people clear HCV on their own (spontaneous clearance, which means the virus leaves the body with no treatment). The remaining 75% of people develop chronic HCV. Chronic HCV often has no symptoms, but without treatment it can cause progressive liver damage with serious health consequences like cirrhosis (scarring of the liver), liver failure, and early death. Liver damage is affected by factors like alcohol use, age at the time of infection, and HIV co-infection. If a person is co-infected with both HCV and HIV, both diseases may have poorer outcomes.
HCV infection rates in Saskatchewan are almost double the national average. Unlike hepatitis A and hepatitis B, there is no vaccination against HCV, but treatment is available, and the infection is curable in over 95% of cases. Unfortunately, there are currently no available treatments that are considered safe to take during pregnancy. Risk reduction strategies are important because women can be infected with multiple strains of HCV.