Laura’s Story

Name: Laura

Gender: Female

Age: 30

Who is Laura?

Laura lives with her four children in Melbourne, Australia. She is thinking of joining the military but was not working at the time of her interview. She describes her ethnic background as ‘Australian’: like both of her parents, Laura was born in Australia. She acquired hepatitis C after sharing injecting equipment with a previous partner. As Laura explains, she is ‘going to have to hold off [on treatment] until [she] is in that right kind of headspace’.

Brief Outline:

Laura decided to get tested for hepatitis C in the middle of 2020, because she had shared injecting equipment with a previous partner who had the virus. The positive diagnosis wasn’t a surprise to her as it confirmed what she already thought. She hasn’t had treatment yet, because she is concerned about potential side effects, especially depression. While she recently learnt about the new treatment without the side effects that worry her, she is still waiting for the right time to start.

Laura's Story:

At the time of her interview in 2020, Laura had recently left an abusive relationship. On leaving the relationship, she decided that she wanted to ‘get tested for STIs […] hep C […and] everything that [her previous partner] could have passed on’ to her.

She recalls being especially motivated to have these tests because she knew that her partner had hepatitis C and, towards the end of their relationship, they had shared injecting equipment: ‘I want[ed] to get tested, because I knew for a fact that he has [hep C] and he would inject himself and then inject me, so there [was] a strong possibility that I’d have it [too].’ She says that her positive diagnosis confirmed what she already thought.

Laura remembers she had a very strong reaction to her diagnosis as it indicated that her previous partner didn’t show enough care for her when they were together. ‘So this is my reaction [to the diagnosis]: ‘Fucking dog, I knew it.’ That was my reaction […] It goes to show how much he actually loved me when, you know, he started doing [injecting] himself and then doing [injecting] me.’

Given she doesn’t take drugs now, Laura says that she’s not too ‘worried about passing [hep C] onto anyone else’. However, as she explains, she is careful with her blood in other contexts, especially in relation to her children: ‘When I’m cooking dinner, I make sure I clean up my blood, or if I get it on the food, it goes straight in the bin. So, I am sort of worried, but I know [hep C is only passed on through] blood-to-blood contact. But you know what kids are like, they hurt themselves, and sometimes they cut themselves and [blood and hep C] can go into the body.’

Laura explains she hasn’t had treatment for her hepatitis C yet because she’s worried about the potential side effects of treatment and their impact on her parenting: ‘I heard that it can send you into a really deep depression, and I’m not in that really good headspace right now […] I don’t want my kids taken [away from me] because I’m that depressed that I can’t clean my house.’

Laura had very recently heard about the new treatments that don’t cause the side effects that she says worry her. She explains that even though she has been told that the new treatment doesn’t have the same risks, she is still worried about the ‘deep depression’ often connected to the older, interferon-based treatment. As a result, Laura still wants to wait for the right time to have treatment. ‘I’m going to have to hold off until I’m in that right kind of headspace.’

Hepatitis C Quick Reference

While the new direct-acting antiviral (DAA) treatment for hepatitis C is generally straight forward, the personal experiences of people affected by it can be more complex. Below are a few key points about testing, treatment and health after cure.

Acquiring hepatitis C

Hepatitis C is a ‘blood-borne virus’. This means it is acquired through blood-to-blood contact. This can happen in several different ways. In some countries such as Australia, hepatitis C is commonly acquired through sharing injecting equipment. In other countries, hepatitis C is more commonly acquired through medical procedures or forms of skin penetration such as tattooing, body piercing or acupuncture, when unsterilised equipment has been used.

Hepatitis C testing

Two tests are used to diagnose hepatitis C. The first is an ‘antibody test’. This is used to identify exposure to hepatitis C. A positive antibody test shows that exposure has occurred, but not whether hepatitis C is still in the body. The presence of hepatitis C is determined with a PCR test. A PCR test looks for hepatitis C in the bloodstream by detecting the genetic material specific to the virus. A negative PCR test means the body has ‘cleared’ hepatitis C without treatment. A positive PCR test means hepatitis C is still present and medical advice is needed to discuss the possibility of future tests and treatment.

Treatment

The current form of hepatitis C treatment is called direct-acting antiviral (DAA) treatment. It is taken in tablet form, with around 95% of people cured on completion. This treatment replaced the old interferon-based treatment. The new treatment was a significant improvement for people with hepatitis C because it is relatively short (cure usually results within eight to 12 weeks) and has minimal side effects. The old treatment by comparison was much longer, less likely to result in cure and had many debilitating side effects. Because the old treatment was unreliable and debilitating, many people with hepatitis C chose not to have it, and instead waited for the development of better treatment. Many of these people have now been cured using the new treatment.

After treatment

After hepatitis C cure it is still possible to test positive for hepatitis C antibodies (see the two tests described above). This is because the antibody test only determines whether hepatitis C has ever been in the body. Only a PCR test can determine whether hepatitis C is still active in the body. Importantly, it is possible to acquire hepatitis again after cure. There are no limits to how many times testing or treatment for hepatitis C can be accessed in Australia. This means that treatment is always an option even for people who have had it in the past.