What is hepatitis C?

Hepatitis C is an inflammation of the liver and, unlike hepatitis B, becomes chronic in the majority of cases, meaning it can lead to liver failure or liver cancer over years and decades. There is no vaccination against hepatitis C. Transmission through oral or vaginal intercourse has not been documented. In the case of anal intercourse, transmission appears to occur primarily via blood, e.g. via shared anal showers, shared sex toys or shared lubricant if the smallest amounts of blood adhere to it. Around 7 cases per 100,000 inhabitants are currently reported in Germany every year.

The main transmission routes for hepatitis C are:

• Shared injecting equipment (when injecting drugs into the vein or injecting anabolic steroids and the like into the muscle.
• Non-sterile tattooing or piercing (usually abroad or in prison).

In older people, non-sterile medical interventions in childhood or earlier blood transfusions are also possible. The virus was only discovered at the end of the 1980s and blood products were not tested for hepatitis C until the early 1990s (because there were no tests yet).

If you have or have had such risks, you should therefore have a hepatitis C test once in your life. Since 2021, people with statutory health insurance aged 35 and over have been entitled to this: as part of the Check-up 35, they can have a one-off hepatitis B and hepatitis C test at the health insurance company's expense.

What are the symptoms of hepatitis C?

Most people do not experience any symptoms when they become infected with the hepatitis C virus. If symptoms do occur, they are usually fatigue, nausea, upper abdominal discomfort or fever. A yellowing of the eyes and skin (“jaundice”) combined with dark urine and light-colored stools is rare. Chronic hepatitis C is usually only manifested by a slight increase in the liver enzymes.

What is hepatitis D and E?

The ABC of hepatitis almost ends here. However, there is still hepatitis E, which is mainly transmitted via undercooked game and other foods. It is similar to hepatitis A (also transmitted via feces, does not become chronic), but is milder and generally harmless except for pregnant women. There is currently no vaccination in the EU (but there is in China, for example). Sexual contact does not play a relevant role in the transmission of hepatitis E.

The hepatitis D virus is not a complete virus. It requires an infection with the hepatitis B virus in order to multiply in the liver cells. Hepatitis B is then more severe than without hepatitis D. But the good news is that the hepatitis B vaccination prevents hepatitis D from taking hold in the first place.

Why don't we have hepatitis tests at s.a.m health?

s.a.m health is a project for sexually active people who need regular tests. Hepatitis tests are not part of this: You should be vaccinated against hepatitis A and B. Hepatitis C can be easily prevented (hygiene, e.g. disinfecting shared sex toys before passing them on, avoiding blood-to-blood contact, safer use when using drugs) and is not an issue for the vast majority of people during sex. The free one-off test at Check-up 35 for people with statutory health insurance in Germany is completely sufficient for hepatitis C. A hepatitis test would make your test kit unnecessarily expensive.

We therefore offer you a test kit with the four most important sexual infections: HIV, syphilis, Gonorrhoe und Chlamydia.

This article was written by: Armin Schafberger - physician and health scientist, as well as former medical officer of the German AIDS service organization.