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Counselling Guidelines for Hepatitis C

Health Care Provider Counselling Guidelines for Hepatitis C Positive Individuals

These guidelines are intended for health care providers to use on a one-to-one basis with their patients to provide education and counselling on hepatitis C.

Ways to Stay Healthy with Viral Hepatitis:

Assess smoking status and provide tobacco cessation intervention to all clients. Smoking increases the risk of liver cancer in HCV-positive individuals. Ideally the individual should avoid alcohol. Individuals can help to avoid illness by eating healthy, reducing stress, being active and getting adequate sleep. Consult with health care provider before taking any medication to be sure that it is safe.

Testing and Treatment:

HCV-RNA testing should be done to check for active virus. If active virus is present, HCV viral load and HCV genotype testing will be completed in preparation for possible treatment and referral to a liver or hepatitis C specialist. Other blood work could include liver enzymes, hepatitis A, B, and HIV testing.


Hepatitis A, hepatitis B and Pneu-P-23 vaccinations are recommended for all HCV-positive individuals and are provided free of charge. The combined hepatitis A and B vaccine (Twinrix™) is not publicly funded. Vaccine can be ordered through the Health Unit online form found here or by email ([email protected]).

Household Transmission:

Personal care items that could be contaminated with blood (toothbrushes, scissors, razors, nail clippers, etc.) should NOT be shared. Sores or breaks in skin should be covered. Hepatitis C is not spread by casual contact such as hugging, kissing, shaking hands, or exposure to sneezing or coughing.

Sexual Transmission:

Discuss safer sex practices and the need to inform potential sexual partners that there could be a risk of transmission. Risk is increased by high risk sexual practices involving trauma, menstrual blood, or anal intercourse. In monogamous long-term relationships, transmission is rare.

Injection and Drug Equipment/Needle Syringe Program:

Individuals should not share needles, syringes or other drug paraphernalia such as spoons, straws, filters or cookers. Sharps containers and harm reduction supplies are available through the Smart Works Needle Syringe Program at all of the Health Unit office locations.

Blood Donations/Transfusions:

Individuals cannot donate blood, organs, tissues, or semen.

Contact Notification:

Those infected with HCV in the last 24 months should be counselled about contact notification. Contacts include household and intimate contacts that are likely to have blood to blood exposure to the client including: shared drug equipment and/or personal care items; sexual partners with known high risk sexual practices; long term sexual partners; others with potential exposures to the client’s blood.


  • Canadian Liver Foundation, Healthy Living with Viral Hepatitis, March 2010.
  • CATIE, Hepatitis C: An In-Depth Guide, 2014.
  • Leeds, Grenville and Lanark District Health Unit, Reportable Disease Toolkit, 2018