Chapter 12 – Sexually Transmissible Infections (STIs)

Hepatitis C

More than 230, 000 Australians are chronically infected with hepatitis C virus (HCV) and are at long term risk of developing liver cirrhosis, liver failure and hepatocellular cancer.

Hepatitis C is transmitted through blood-to-blood contact. Chronic complications of HCV are the most common cause for liver transplantation in Australia. Many people with chronic hepatitis C infection are asymptomatic; thus, it is important to offer screening to potentially at-risk patients when doing serological testing as part of an STI screen. HCV is rarely sexually transmitted outside of the setting of unprotected anal sex in HIV positive MSM. Condoms are not routinely recommended to prevent heterosexual transmission unless blood is present (such as menstrual blood).

There is a national campaign to test at-risk persons for HCV as active infections can now be cured in the majority of people with intensive short courses of direct-acting antiviral agents (DAAs) which are available on the PBS and, since March 2016, can be prescribed by GPs, gastroenterologists and sexual health physicians.

Full details of the clinical presentation of Hepatitis C (when symptomatic), as well as testing and treatment recommendations, can be found in Australian STI management guidelines, see section on hepatitis C.

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History

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Examination

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Investigations

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Management

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