🦠 Men's Health

Hepatitis C in Nigeria

Diagnosis, treatment and cure of hepatitis C in Nigerian adults

Hepatitis C is a viral liver infection affecting an estimated 3–4% of Nigerians (approximately 6–8 million people), though most do not know they are infected. Unlike hepatitis B, hepatitis C is now CURABLE — highly effective direct-acting antivirals (DAAs) cure over 95% of infections in 8–12 weeks. Without treatment, chronic infection leads to cirrhosis, liver failure, and liver cancer over 20–30 years. Testing and treatment are now more accessible in Nigeria.

Signs and Symptoms

✓ Acute infection (first 6 months): usually mild or asymptomatic; some have fatigue, jaundice, nausea

✓ Chronic infection (years to decades): usually no symptoms until liver damage is advanced

✓ Advanced cirrhosis: jaundice, abdominal swelling (ascites), leg swelling, confusion (hepatic encephalopathy), vomiting blood (varices)

✓ Fatigue and reduced exercise tolerance — often dismissed as 'tiredness'

✓ Joint pain, skin rashes, dry eyes/mouth (extrahepatic manifestations)

Risk Factors

Blood transfusion before 2000 (before universal screening in Nigeria)
Reuse of injection needles and syringes — a major transmission route in Nigeria
Traditional practices: tattooing, scarification, female genital cutting with shared instruments
Sharing sharp objects (razors, clippers)
People who inject drugs
Healthcare workers with needlestick injuries
Sexual transmission (lower risk than hepatitis B, but increased with HIV co-infection)

When to Seek Help

Test if at riskAnyone who received blood transfusions before 2000, has a history of injections in poorly regulated settings, or has liver disease of unknown cause should be tested

Annual testingPeople who inject drugs or have high-risk exposures should test annually

UrgentAnyone with jaundice, abdominal swelling, or vomiting blood — these indicate advanced liver disease needing immediate assessment

Tests & Diagnosis

🧪 Anti-HCV antibody test

Screening test — positive means exposure; does not distinguish active from cleared infection; rapid tests available in Nigeria

🧪 HCV RNA (PCR)

Confirms active infection — quantifies viral load; essential before starting treatment

🧪 HCV genotype

Identifies which of 6 strains — some DAAs are pangenotypic (work for all types), making genotyping less critical now

🧪 Liver function tests

ALT, AST, bilirubin, albumin, INR — assess degree of liver damage

🧪 Liver fibrosis assessment

FIB-4 score (calculated from blood tests) or Fibroscan (ultrasound-based liver stiffness measurement) — guides treatment urgency

Treatment Options

Direct-acting antivirals (DAAs)

Current gold-standard treatment: sofosbuvir + daclatasvir (12 weeks) or sofosbuvir/velpatasvir (12 weeks) — cure rates >95% for all genotypes

Availability in Nigeria

Generic DAAs are available in Nigeria at significantly reduced cost (₦50,000–₦200,000 for full course at government treatment centres); some NGOs provide subsidised or free treatment

No interferon needed

Old regimens using weekly interferon injections (poorly tolerated) are no longer necessary — modern DAAs are oral tablets taken once daily

SVR12 (cure confirmation)

HCV RNA undetectable 12 weeks after completing treatment = CURED; test again at 12 weeks post-treatment

Liver monitoring after cure

Cured patients with cirrhosis still need 6-monthly liver ultrasound and AFP test to screen for liver cancer — cure removes ongoing damage but cancer risk remains elevated

Lifestyle support

Avoid alcohol completely; hepatitis A and B vaccines if not immune; review all medications for hepatotoxicity

Frequently Asked Questions

Is hepatitis C really curable?

Yes — with 8–12 weeks of once-daily oral tablets, over 95% of people are cured. This is one of medicine's great recent successes.

If I feel well, do I still need treatment?

Yes — most people feel well until cirrhosis develops. By then, the liver is severely damaged. Treating early prevents cirrhosis, liver failure, and liver cancer.

Where can I get hepatitis C treatment in Nigeria?

Treatment is available at PEPFAR-supported sites, federal teaching hospitals, and through organisations like MSF (Doctors Without Borders) in some states. Contact your nearest tertiary hospital's hepatology or infectious disease unit.

Can I transmit hepatitis C to my partner?

Sexual transmission is possible but the risk is low with a single long-term partner (about 1% per year). Risk increases with multiple partners, HIV co-infection, or if there are sores or bleeding. Barrier protection is advised.

Do I need a liver transplant?

Only if liver failure is advanced and irreversible. Early diagnosis and DAA treatment before cirrhosis develops avoids this need in the vast majority of patients.