Specialists

Approximately half of the affected population do not know of their hepatitis C infection. New hepatitis B infections have been reduced by over 80 per cent since the systematic vaccination of adolescents starting in 1998. Because hepatitis infections develop over many years often causing no or only nonspecific symptoms, general practitioners need to be aware and suggest tests to those at high risk. Newly diagnosed viral hepatitis infections often show considerable damage to the liver already. Early testing and treatment can prevent severe secondary diseases.

When to test?

Hepatitis B

The hepatitis B virus is highly contagious and can be transmitted through bodily fluids when sharing needles, using non-sterile tattooing or piercing equipment or having sexual intercourse (see hepatitis B), and from mother to child during childbirth. Tests should be recommended to people who belong to high-risk groups and who have not been vaccinated, or to pregnant women who have not been vaccinated. Everyone who has not been vaccinated should be encouraged to do so.

Hepatitis C

Intravenous drug users (IDUs): Former and active users of drugs that are injected are particularly vulnerable. They make up for the majority of infected people. Many have been infected in the 1980s and early 1990s, before harm reduction measures were introduced. One single unsafe injection can be enough to get infected. 

People born between 1950 and 1985: The hepatitis C virus could not be detected before 1988. Before then, hepatitis C was called non-A/non-B hepatitis, that is hepatitis neither caused by hepatitis A nor hepatitis B viruses. Blood transfusions in the early 1990s, but also tattooing and piercing under inadequate hygienic conditions, are risk factors for an infection. People who were born between 1950 and 1985 show an above average infection rate, as evaluation of diagnoses shows.

People living with HIV: Because the transmission ways are similar, about a third of people diagnosed with HIV are co-infected with hepatitis C. People infected with HIV who are treated in a HIV cohort centre are routinely screened for HCV.

www.shcs.ch

Men who have sex with men (MSM): MSM make up the majority of newly diagnosed cases. The HIV cohort study shows an 18 times higher HCV rate in this group. Transmission probably takes place during sexual activities. A co-infection with HIV increases the risk further.

Hepatitis C Virus Infections in the Swiss HIV Cohort Study: A_Rapidly Enolving Epidemic

Migrants: People from countries with increased HCV prevalence are among those at high risk. These are apart from Central and East Asia and North Africa also Eastern European countries or France and Italy.

Global epidemiology and genotype distribution of the hepatitis C virus infection

Hepatitis  B and C in Switzerland – healthcare provider initiated testing for chronic  hepatitis B and C infection