Hepatitis virus carriers in Beijing will be able to work as kindergarten teachers in the future, as authorities have...
More >
Sharing of dirty needles by Victoria's injecting-drug users — a practice that contributes to the spread hepatitis C...
More >
Little Feat co-founder Richie Hayward has died after a long battle with liver disease. he was 64. Hayward played drums in...
More >
Other hep C issues
Pregnancy, babies and children
Can a father pass on hep C to a baby?
Telling children they have hep C
Partners, families and friends can play an important role in providing emotional and practical support to you but there is no guarantee that they will respond as supportively as you would like. It may be useful to have booklets or brochures on hand if you decide to tell others. There are only a small number of situations in which you are required by law to disclose that you have or ever had hep C:
- People must inform the blood bank in pre-blood donation questionnaires (because you cannot donate blood if you have hep C)
- Men must also disclose when they seek to donate sperm
- You have a responsibility to disclose your status if you are a healthcare worker in NSW who conducts exposure-prone procedures and is PCR positive (phone the Hepatitis Helpline for more information)
- Some insurance policies (particularly life insurance) require that you disclose any infections, disabilities, or illnesses that might influence the insurance company’s decision to insure you. Income protection insurance may also fall into this category
- If you are a member of the Australian Defence Force (Navy, Army, Air Force) and you have hep C, you will have to disclose this. You may be required to leave the forces if you have hep C, although this is determined on a case-by-case basis
Telling other people about your hep C may result in you being treated unfairly or rudely. It may be useful to talk to the Hepatitis Helpline before you tell others about your hep C.
Having hep C does not mean that you should treated differently from anyone else. This applies to all aspects of your everyday life, including maintaining privacy, buying or renting goods or services, obtaining healthcare services, applying for a job or getting a promotion at work. As a person with hep C you are covered by anti-discrimination laws. If something happens that seems discriminatory, you can usually access advice and help from legal or work-related organisations, for example an Equal Employment Opportunity officer, a community legal centre, the Anti-Discrimination Board of NSW or a workplace union.
Initially, you should discuss the discrimination with whoever you feel is discriminating against you. If this doesn’t solve the situation, the Anti-Discrimination Board may be able to investigate and determine whether you have been discriminated against. If so, they may be able to negotiate a solution.
When someone with hep C dies (for whatever reason), their family and loved ones should not be denied funeral services such as viewings or open casket services simply because the deceased had hep C. Speak to the Hepatitis Helpline for more information about this.
At work you are under no obligation to inform employers, work colleagues or customers about your hep C. The exception is if you are a healthcare worker who carries out exposure-prone procedures, in which case you have a responsibility to disclose (phone the Hepatitis Helpline for more information).
Your biggest workplace problem may be in taking time off due to hep C illness or combination treatment. If you don’t want your employer to find out about your hep C, ask your doctor to be vague when he or she fills in your time-off-work certificate (e.g. liver illness rather than hep C).
Because hep C is classed as a disability, your employer has a legal responsibility to make modifications to accommodate your hep C (as long as these changes are reasonable). They may be able to change your position from full-time to part-time, adopt flexi-time arrangements, allow you to work from home or reduce the physical activity required within your job. Of course, such changes would not be possible without you telling your employer about your hep C.
If you become too ill to continue working you may seek to withdraw some of your superannuation funds. This can usually only be done on compassionate grounds or in cases of severe financial hardship. For more information about this, you need to speak to your superannuation provider or Australian Prudential Regulation Authority (web link).
Superannuation funds usually provide default disability and death insurance cover, especially if your superannuation fund is employment related. Banks and other investment providers also offer these insurance products in addition to mortgage protection. Your medical history is not needed for the default level of disability or death cover but it may be required if you want higher or additional levels of cover (income protection) or if you want to make a claim.
It is not unlawful for superannuation funds to ask if you have hepatitis or other infectious diseases, or whether you inject recreational drugs, when they are considering your application for insurance cover. If you feel you have been treated unfairly in regard to superannuation or insurance cover, phone the Hepatitis Helpline for further information.
In pre-employment health checks, all questions should be relevant to the advertised job and employers have no valid legal reason to know about your hep C. The exception is if you are a healthcare worker who carries out exposure-prone procedures.
When filling out a pre-employment medical questionnaire, if you are asked about liver disease, hepatitis or hep C, you would probably need to decide which would be worse: mentioning hep C and possibly missing out on the job, or not mentioning it but having to explain at some later time why you didn’t. Phone the Hepatitis Helpline to talk more about this issue.
When seeking welfare support or employment assistance, you do not need to tell Centrelink or Job Network agencies about your hep C. However, if having hep C impacts on your ability to work, Centrelink, Job Network and your Job Capacity Assessor will need to know about it. In these cases, your information should be kept confidential and would not be passed on to potential employers. For assistance with Centrelink and welfare support difficulties, contact the Welfare Rights Centre (web link).
The risk of catching hep C through sex is so low that hep C is not classed as a sexually transmitted infection. In a monogamous relationship (a couple who do not have any other sexual partners) where one person is hep C positive and there is little risk of blood-to-blood contact during sex, there is no need to adopt safe sex practices. Aside from transmission via blood, transmission through sexual fluids is rare and is probably more likely to occur when the amount of hep C circulating in the blood is high. This may occur in the initial acute stage of infection or when the immune system is suppressed (e.g. coinfection with HIV). In such cases, safe sex practices should be adopted.
If blood-to-blood contact occurs during sex, hep C might be transmitted. To avoid blood-to-blood contact during sex, use condoms, dams or gloves:
- When you, or your partner, have cuts or lesions around the genitals (e.g. herpes or other sexually transmitted infections)
- During anal sex (because the anus lining is easily damaged and broken)
- During menstruation and during sexual practices that may involve trauma, bleeding or broken skin
Adopting safer sex practices in order to avoid catching hep C seems to be of particular importance for men who have sex with men – especially if one or more of the men are coinfected with HIV. For more information on this issue, phone the Hepatitis Helpline.
If you are unsure of a sex partner’s sexual health status or where you have multiple sexual partners, you should adopt safe sex practices to help prevent sexually transmitted infections (e.g. chlamydia, gonorrhoea, HIV, hep B, herpes or syphilis) being transmitted from one person to another.
Statistically, there are more men with hep C than women with hep C. This may be due to greater levels of injecting drug use among men. Another factor may be that men do not seem to fight off initial infection as well as women and have a greater chance of chronic infection.
Men don’t seem to respond to combination treatment as well as women. Men also seem to experience slightly more long term liver damage. Impotence is a common symptom in men with advanced cirrhosis. Men with cirrhosis are at five times the risk of developing liver cancer than are women who have cirrhosis.
In general, women seem to respond better than men to combination treatment. Women also seem to experience less long term liver damage.
Periods: Hep C is unlikely to cause problems for your periods if you don’t have significant liver damage (e.g. cirrhosis).
Birth control pill: Some contraceptive pills use oestrogen, which can cause problems with bile production (showing as itchiness and jaundice). For advice about contraception, speak to your hepatitis specialist or gynaecologist (women’s health specialist).
Menopause: Being female and having cirrhosis is associated with osteoporosis (thinning of the bone). Particular types of hormone replacement treatment may help lessen osteoporosis so speak to your specialist if you are thinking about this treatment.
Pregnancy: Aside from the low risk of transmission from mother to baby, hep C does not adversely affect a pregnant mother or her unborn child. Women with cirrhosis, however, may experience infertility and an increased rate of miscarriage.
Autoimmunity: If our antibodies (part of our immune system) get confused, instead of looking for foreign organisms, they can start targeting our own body cells. Confused antibodies are called autoantibodies. Studies have shown that people with hep C have greater levels of autoantibodies, and that among people with hep C, the condition is more common among women.
Pregnancy, babies and children
Having hep C will not generally affect your pregnancy, and being pregnant will not generally affect your hep C. Having cirrhosis, though, may involve complications. If you have cirrhosis, discuss your plans to have children with your liver specialist before you get pregnant.
Combination treatment and avoiding pregnancy - Because ribavirin has been shown to cause birth abnormalities, pregnancy must be avoided while on treatment. Women of child bearing age must not be pregnant or breastfeeding while on combination treatment. They, and any male sex partners, must use two effective forms of contraception during sex (e.g. she using the contraceptive pill and he using condoms). Additionally, the female sexual partners of men who are on combination treatment must avoid pregnancy.
Most babies are not at risk of catching their mother’s hep C. In fact, there is less than a one in 15 chance of your baby being born with hep C. If your baby is born with a hep C infection, there is a 45% chance that he or she will clear their infection naturally within the first 12 months.
Children with chronic hep C will benefit from seeing a paediatrician (children’s health specialist) who is familiar with monitoring and management of hep C. Childhood hep C appears to be mild with very little liver inflammation.
It is important that all children receive all the routine immunisations recommended on the National Immunisation Program. Hep B immunisation is included in this program. Children with chronic hep C should also be vaccinated against hep A to prevent the additional liver injury that could arise from a hep A infection.
Except in the case of some types of insurance policies, there is no need to tell other people about your child’s hep C status. This means you are not required to tell other family members, childcare staff, schools, baby sitters, friends of the child or sports and activity groups.
Can a father pass on hep C to a baby?
There is no evidence to show that hep C can be transmitted from a father, through his sperm, either at conception or in the womb. There is no increased risk that the baby will be born with the virus if both partners have hep C.
Having hep C does not negatively affect your fertility (unless you have cirrhosis). If you do have fertility problems you may choose to use ART (Assisted Reproductive Technology services). Initial screening questionnaires for men performed at the clinic will ask about hep C. If you have hep C, you will not be able to donate sperm unless it is to be used in artificial insemination of your spouse. Such restrictions do not apply to the collection of a woman’s eggs.
It is likely that you will be offered a range of blood tests during your pregnancy and these will probably include a hep C test. It is your decision whether to have a hep C test and your verbal consent should be obtained first. In this light, pre-test discussion with a healthcare worker should be provided so that you can make an informed decision.
If you test hep C antibody positive while pregnant, it is strongly recommended that the diagnosis be confirmed by having a PCR test. This is because false-positive test results can occur with the basic antibody tests, especially with women who are pregnant.
You do not have to disclose your hep C status to healthcare workers at your birthing clinic. However, it is advisable for the midwife and obstetrician to be aware of your status as they may be able to take some additional steps to prevent your baby being unnecessarily exposed to your blood. This relates to invasive testing such as foetal scalp sampling and/or electrodes for monitoring your baby during birth.
Mothers are encouraged to breastfeed whether or not they have hep C. Although small amounts of hep C virus have been found in breast milk it has not been linked to transmission. It is considered highly unlikely that your baby will catch the virus from breastfeeding. As a precaution, you should temporarily stop breastfeeding if a nipple is cracked or bleeding. For more information, phone the Hepatitis Helpline, MotherSafe or the Tresillian Parents HelpLine (web link).
In all cases, babies born to mothers with hep C will carry their mother’s hep C antibodies. As babies grow and strengthen their own immune systems, the maternal antibodies disappear. This process can take up to 18 months. With the small number of babies who do actually contract their mother’s hep C virus, the baby's own hep C antibodies will be detectable at 18 months of age and afterwards.
Telling children they have hep C
Research suggests that a parent tell their child that he or she has a chronic condition as soon as the child can understand the basic information. Around eight years old may be an appropriate age, or earlier if your child is asking specific questions.
Our website is always evolving. If you have ideas or feedback on how we can improve this page, or if you come across errors, please email us by clicking here (don't forget to tell us which page you are providing feedback on).
Stock photos used. People shown may have no actual connection with hepatitis C.
Top image by Paul Harvey.
This page last updated 12 May 2010
