Counselling and support are extremely important for anyone with hepatitis C, both during and after the testing process. Ideally it is best for IDUs to talk to a professional, such as a drug worker, specialist nurse, doctor or counsellor.
Clinical nurse specialists, based at some hospitals, are specially trained to help people cope with hepatitis C and its symptoms, and are a good source of information and support.
Insurance/mortgages
Most insurance companies ask applicants if they have been tested for HIV, hepatitis B and hepatitis C. A positive test result may mean a life insurance policy or mortgage linked to a life policy could be refused or the premium loaded. If appropriate, many consultants are willing to write to a mortgage or insurance company stating health and life expectancy.
Who to tell
Who to tell is often a difficult decision. The only people affected by a positive result are the person’s immediate family and injecting and sexual partner(s). Close family members and partners might like to consider being tested.
It is worth bearing in mind that there is still a level of ignorance about the disease among the general public. There have been cases in which people have lost their jobs, been refused medical and dental treatment and their children stigmatised at school. It should always be possible to arrange for medical and dental treatment elsewhere if this happens. Simple protective measures (using gloves, new and/or sterile equipment, basic sensible medical practices, etc.) are enough to protect healthcare workers and contacts from infection.
Case reporting
Hepatitis C, like all viral forms of hepatitis, is a notifiable disease and doctors have a statutory duty to notify their ‘proper office’ of the local authority of suspected and confirmed cases, who in turn pass the information to the local health protection unit. Anonymised data on individuals who test positive for hepatitis C are also reported from laboratories and collated at local and national level in each UK country. Information on who is getting the infection is vital to ensuring that preventive services are in place, and to help with planning local services for treatment. Staff at these agencies work under the strictest levels of confidentiality, collecting only the information essential for monitoring and control.
Most drug agencies and GUM (genito-urinary medicine) clinics offer an anonymised testing service. If a test is positive, they will forward on the result to the patient’s GP so they can arrange on-going care and treatment. Dried blood spot (DBS) testing is increasingly being offered to people with an injecting history to make testing more accessible in a variety of settings. DBS tests are diagnostic and can provide full range of HCV tests, markers of HBV and HIV antibody.