Blood Borne Viruses

There are three major blood borne viruses (viruses transmitted by blood-to-blood contact) that drug users, and especially injecting drug users, should be aware of.

They are

• Hepatitis B
• Hepatitis C, and
• HIV

Blood borne viruses can be passed on by:

• sharing of needles and syringes
• sharing other injecting kit - spoons, filters, etc
• having unprotected sex
• needlestick injuries
• sharing toothbrushes and razors
• tattooing, piercing or acupuncture needles which aren’t sterile
• an injection or transfusion of blood from an infected person
• a pregnant woman passing it to her child.

Snorting cocaine or other substances can damage the lining of the nostrils which can lead to bleeding, and there have been reports that sharing snorting kit (notes, straws etc) may allow for hepatitis to be transmitted. It isn’t known whether or not HIV can be transmitted by sharing snorting kit, but it’s better to avoid sharing to be safe.

Likewise, rubbing cocaine or other drugs into the gums or other parts of the body can cause ulcers which could allow blood borne viruses to be transmitted.

Hepatitis B and C

Hepatitis is the name for an infection of the liver. Hepatitis B (sometimes called Hep B or HBV) and Hepatitis C (Hep C or HCV) are quite common among injecting drug users.

Both are very infectious, and need only a tiny amount of blood-to-blood contact to cause infection. They are also very tough and have been shown to be infectious even in blood that has dried for up to six months - all the more reason to avoid using bank notes or other items that may have been used previously for snorting substances.

Your liver

Your liver is like a factory in your body, doing hundreds of jobs to keep you alive. You only have one liver, but it is tough. It can keep going when it is damaged and can repair itself.

Amongst its jobs are

• helping to fight infections filtering and cleaning the blood 
• making bile to break down food in the gut 
• destroying poisons and dealing with drugs 
• controlling cholesterol 
• making the chemicals – proteins and enzymes – that keep our body working

Differences between Hepatitis B and Hepatitis C

Probably the biggest difference is that most adults who get hepatitis B will clear it after a short illness and usually become immune for life. Those that don’t clear it can be infectious for a long time afterwards.

Hepatitis C is a chronic illness for most people who catch it because it lasts for a long time, possibly throughout a person’s life. It does affect people differently though - some people have no symptoms and so don’t know that they have the virus.

Symptoms

Symptoms for Hep B and Hep C are similar. They can include:

• pain in the liver area of the body 
• mild to severe tiredness 
• losing weight quickly 
• losing appetite 
• not able to drink much alcohol 
• problems concentrating 
• feeling sick 
• flu-like symptoms like fever, chills, night sweats, headaches 
• jaundice – a yellowy skin colour

BUT some of these symptoms may never appear in some people, or may come and go, or may be caused by something else. The only way to know whether or not you have hepatitis is to be tested for it.

Protecting yourself

The best way to protect yourself against Hepatitis B and C is to never share any equipment that comes into contact with blood (like needles, syringes and so on) and avoid the other risk factors at the top of this page.

It is also possible to be immunised against Hepatitis B. For more information or to arrange an appointment contact the service on (01204) 525690.

Young people under the age of 18 can get information about Hep B immunisation from 360º on (01204) 337330.

Testing for Hepatitis C (HCV) is also available, along with advice and pre- and post-test counselling, and referral for treatment if necessary.

The central needle exchange at Trident House can arrange for a test for the presence of Hepatitis C, this involves taking a blood sample. You can phone up on (01204) 388962 to find out more information.

HIV

HIV stands for Human Immunodeficiency Virus. Having HIV does not mean that a person has AIDS.

HIV damages the body’s immune system which means that people with the virus are less able to fight certain infections. It can take years for HIV to damage the immune system so much that a person becomes unwell.

AIDS stands for Acquired ImmunoDeficiency Syndrome - this is when the immune system is so damaged that the person is unable to fight off many common infections which in healthy people would only be minor. AIDS can take many years to develop from HIV, and can be effectively delayed by treatment, but once it reaches this stage it is fatal.

The HIV virus is not as strong as the hepatitis virus and cannot survive as long outside the body.

Symptoms

Severe symptoms of HIV and AIDS can take many years, even over a decade, to appear. It is not unusual for infected people to have no symptoms at all for a long time. However, even with no symptoms it is still possible to pass on the virus to other people.

Once AIDS develops, the symptoms of a severely weakend immune system can include:

• extreme weakness or tiredness
• rapid weight loss
• frequent fevers lasting several weeks with no obvious explanation
• swollen lymph glands
• white spots in the mouth or throat
• frequent / constant minor infections that cause rashes or sores on the skin
• chronic diarrhoea
• chronic cough
• trouble remembering things

Treatment

Anti-HIV therapy is treatment with drugs that attack the HIV virus itself. These drugs interfere with the way that the virus tries to reproduce, but they can’t kill it completely.

Anti-HIV drugs are usually prescribed in combinations of 3 or more, and this is called “combination therapy”. These treatments have helped a lot of people by controlling the HIV and delaying the onset of AIDS, but it doesn’t work for everyone.

Treatments also have side effects which can be severe. Also, the longer a treatment is taken for, the more likely it is that the virus will be able to resist it. If one type of treatment fails, another can be tried but it will get more difficult to find the right combination of drugs.

Testing for HIV

The central needle exchange at Trident House can arrange for a test for the presence of HIV antibodies, which show the presence of the virus. This involves taking a blood sample. You can phone up on (01204) 388962 to find out more information.

Where can I find out more online?

www.mainliners.org.uk - Advice and information about blood borne viruses specifically for injecting drug users
www.hepCuk.info - The UK Hep C Trust
www.britishlivertrust.org.uk - A national charity working to reduce the impact of liver disease
www.livernorth.org.uk - A North of England support group for liver patients

www.avert.org - Avert, an HIV and AIDS charity giving advice and information
www.tht.org.uk - The Terrence Higgins Trust
www.fpa.org.uk - Straightforward information, advice and support about sex and sexual health
www.nat.org.uk - The National AIDS Trust