What Is Hepatitis C
Hepatitis C is a liver infection that can lead to serious liver damage. Itâs caused by the hepatitis C virus. About 2.4 million people in the U.S. have the disease. But it causes few symptoms, so most of them don’t know. The virus spreads through an infected personâs blood or body fluids.
There are many forms of the hepatitis C virus, or HCV. The most common in the U.S. is type 1. None is more serious than any other, but they respond differently to treatment.
What Do Hepatitis C Symptoms Look Like
Hepatitis C infection can go through two stages: acute and chronic. In the early, or acute stage, most people don’t have symptoms. If they do develop symptoms, these can include:
- flu-like symptoms, tiredness, high temperature and aches and pains
- loss of appetite
- tummy pain
- jaundice, meaning your skin and the whites of your eyes turn yellow
While for some people, the infection will clear without treatment, in most cases, acute infection will develop into long-term chronic infection. Chronic infection may not become apparent for a number of years until the liver displays signs of damage. These symptoms can include:
- mental confusion and depression these are specific to hepatitis C
- constantly feeling tired
- nausea, vomiting or tummy pain
- dark urine
- feeling bloated
- joint and muscle pain
Without treatment, chronic hepatitis C can cause scarring of the liver , which can cause the liver to stop working properly. A small number of people with cirrhosis develop liver cancer and these complications can lead to death. Other than a liver transplant, theres no cure for cirrhosis. However, treatments can help relieve some of the symptoms.
It’s Tricky Because Hep C Doesn’t Often Present Symptoms At All
Lanla Conteh, M.D., clinical associate professor of hepatology and gastroenterology at The Ohio State University Wexner Medical Center, in Columbus, OH, discusses the symptoms of hepatitis C.
One of the problems with hepatitis C virus is that we do not tend to see early symptoms when people get the virus. Unfortunately, when many people get infected with the virus, they oftentimes do not know, because it does not cause any symptoms.
If and when people do get symptoms with hepatitis C, which again, is not common, some of those symptoms tend to be yellowing of the skin or the eyes, something called jaundice. They can also experience nausea, vomiting, pain in the abdomen that tends to be on the right upper side.
Again, these signs of early hepatitis C are not very common, because most people do not have any symptoms when they get the virus.
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Who Is More Likely To Get Hepatitis C
People more likely to get hepatitis C are those who
- have injected drugs
- had a blood transfusion or organ transplant before July 1992
- have hemophilia and received clotting factor before 1987
- have been on kidney dialysis
- have been in contact with blood or infected needles at work
- have had tattoos or body piercings
- have worked or lived in a prison
- were born to a mother with hepatitis C
- are infected with HIV
- have had more than one sex partner in the last 6 months or have a history of sexually transmitted disease
- are men who have or had sex with men
In the United States, injecting drugs is the most common way that people get hepatitis C.13
Who Should Get Tested
You should consider getting tested for hepatitis C if you’re worried you could have been infected or you fall into one of the groups at an increased risk of being infected.
- Hepatitis C often has no symptoms, so you may still be infected if you feel healthy.
- The following groups of people are at an increased risk of hepatitis C:
- ex-drug users and current drug users, particularly users of injected drugs
- people who received blood transfusions before September 1991
- recipients of organ or tissue transplants before 1992
- people who have lived or had medical treatment in an area where hepatitis C is common high risk areas include North Africa, the Middle East and Central and East Asia
- babies and children whose mothers have hepatitis C
- anyone accidentally exposed to the virus, such as health workers
- people who have received a tattoo or piercing where equipment may not have been properly sterilised
- sexual partners of people with hepatitis C
If you continue to engage in high-risk activities, such as injecting drugs frequently, regular testing may be recommended. Your doctor will be able to advise you about this.
Hepatitis C Antibody Test
Certain foreign substances that enter your body trigger your immune system to make antibodies. Antibodies are specifically programmed to only target the foreign substance they were made to fight.
If youve ever had a hepatitis C infection, your body will make hepatitis C antibodies as part of its immune response.
Your body only makes these antibodies if you have hepatitis C or had it in the past. So the hepatitis C antibody test can confirm whether you have the virus by testing for these specific antibodies.
If the antibody test is positive, an HCV RNA test can show whether the infection is current.
While people of any gender experience the same hepatitis C symptoms, 2014 research suggested some effects of the virus may differ, depending on the sex you were assigned at birth.
Researchers noted that:
- women have a higher chance of clearing the virus without treatment
- liver disease may progress more rapidly in men
- men have a higher chance of developing cirrhosis
How Are Hepatitis B And C Treated
- Antiviral medications, interferon injections and a liver transplant are options for treatment of ongoing infections. Not everyone will need these treatments.
- Medicines known as direct-acting antiviral agents are now available that can lead to a cure in 8 to 12 weeks in many patients with hepatitis C, but hepatitis B may require long-term treatment.
- There is a vaccine that is used to prevent hepatitis B infection in both adults and newborns, but there is no vaccine yet for hepatitis C.
The newer direct-acting antiviral agents medications to treat HCV include:
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How Do Doctors Treat The Complications Of Hepatitis C
If hepatitis C leads to cirrhosis, you should see a doctor who specializes in liver diseases. Doctors can treat the health problems related to cirrhosis with medicines, surgery, and other medical procedures. If you have cirrhosis, you have an increased chance of liver cancer. Your doctor may order an ultrasound test to check for liver cancer.
If hepatitis C leads to liver failure or liver cancer, you may need a liver transplant.
How Is Viral Hepatitis Prevented
Prevention of hepatitis involves measures to avoid exposure to the viruses, using immunoglobulin in the event of exposure, and vaccines. Administration of immunoglobulin is called passive protection because antibodies from patients who have had viral hepatitis are given to the patient. Vaccination is called active protection because killed viruses or non-infectious components of viruses are given to stimulate the body to produce its own antibodies.
Avoidance of exposure to viruses
Prevention of viral hepatitis, like any other illness, is preferable to reliance upon treatment. Taking precautions to prevent exposure to another individual’s blood , semen , and other bodily secretions and waste will help prevent the spread of all of these viruses.
Use of immunoglobulins
Immune serum globulin is human serum that contains antibodies to hepatitis A. ISG can be administered to prevent infection in individuals who have been exposed to hepatitis A. ISG works immediately upon administration, and the duration of protection is several months. ISG usually is given to travelers to regions of the world where there are high rates of hepatitis A infection and to close or household contacts of patients with hepatitis A infection. ISG is safe with few side effects.
Individuals at increased risk of acquiring hepatitis A are:
Some local health authorities or private companies may require hepatitis A vaccination for food handlers.
Hepatitis B vaccine is recommended for:
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Hepatitis C Symptoms & Treatment
Hepatitis C is found in infected blood. It is also rarely found in semen and vaginal fluids.
Hepatitis C is mainly passed on through using contaminated needles and syringes or sharing other items with infected blood on them. It can also be passed on through unprotected sex, especially when blood is present.
You can prevent hepatitis C by never sharing needles and syringes, practising safer sex, and avoiding unlicensed tattoo parlours and acupuncturists.
Hepatitis C will often not have any noticeable symptoms, but a simple blood test carried out by a healthcare professional will show whether you have hepatitis C.
In the early stages, some peoples bodies can clear a hepatitis C infection on their own, others may develop chronic hepatitis C and will need to take antiviral treatment to cure the infection.
Without treatment, chronic hepatitis C can lead to permanent liver damage.
Hepatitis C is part of a group of hepatitis viruses that attack the liver.
Its mainly passed on through contaminated needles, either from injecting drugs or from needle stick injuries in healthcare settings. It can also be transmitted sexually, especially during anal sex or other types of sex that may involve blood.
Some groups are more at risk of getting hepatitis C than others, including people who use drugs, people in prisons, men who have sex with men, health workers and people living with HIV.
Symptoms Of Hepatitis C Virus
Symptoms for HCV may not appear for 20 to 30 years, and that is why it is so important to get tested. The U.S. Centers for Disease Control now recommends that all adults 18 years and older are tested at least once for HCV. Some high risk groups may need more frequent testing, and all pregnant women should be tested during every pregnancy.
HCV can actually clear itself from the body in about 15% of people, but most people become infected with the virus chronically.
Early symptoms of acute HCV occur within 1 to 3 months and may last several weeks. These may include:
- yellow-colored skin or eye sclera
- nausea and stomach pain
- joint or muscle pain
Chronic, long-term symptoms of HCV can include weight loss, fluid build-up and swelling, poor appetite, fatigue, easy bruising and bleeding, itchy skin, jaundice, dark-colored urine, confusion, drowsiness and slurred speech , and spider-like blood vessels on the skin .
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What Is Acute Fulminant Hepatitis
Rarely, individuals with acute infections with HAV and HBV develop severe inflammation, and the liver fails . These patients are extremely ill with the symptoms of acute hepatitis already described and the additional problems of confusion or coma , as well as bruising or bleeding . In fact, up to 80% of people with acute fulminant hepatitis can die within days to weeks therefore, it is fortunate that acute fulminant hepatitis is rare. For example, less than 0.5% of adults with acute infection with HBV will develop acute fulminant hepatitis. This is even less common with HCV alone, although it becomes more frequent when both HBV and HCV are present together.
Articles On Hepatitis C
Hepatitis C is a sneaky virus. You may not have any symptoms at all. Most people donât. This is one if the reasons, along with treatability now, that all adults are recommended to get tested. Your doctor could check your liver and see only a little damage. You’re usually not diagnosed until they spot a problem with your liver enzymes after a routine blood test.
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Effective Treatments Are Available For Hepatitis C
New medication to treat for HCV have been approved in recent years. These treatments are much better than the previously available treatment because they have few side effects and do not need to be injected. There are several direct-acting antiviral HCV treatments that cure more than 95% of people who take them in 8 to 12 weeks. HCV treatment dramatically reduces deaths among people with HCV infection, and people who are cured of HCV are much less likely to develop cirrhosis or liver cancer.
Take Action! CDCs National Prevention Information Network Service Locator helps consumers locate hepatitis B and hepatitis C prevention, care, and treatment services.
How Common Is Hepatitis C
There are approximately 30,000 new cases of acute hepatitis C every year in the United States as estimated by the CDC. In 2015, it was estimated that approximately 3.5 million Americans were infected with hepatitis C.
On a global scale, the prevalence of hepatitis C is greatest in Central and East Asia, North Africa, and the Middle East. In 2016, it was estimated that 177 million people worldwide had antibodies to hepatitis C virus.
- exposure to other people who do or might have hepatitis C.
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Questions For Your Doctor
When you visit the doctor, you may want to ask questions to get the information you need to manage your hepatitis C. If you can, have a family member or friend take notes. You might ask:
How Do Women Get Hepatitis C
Hepatitis C spreads from person to person through contact with infected blood. If you work in an industry where you might come in contact with blood, theres an increased risk of exposure. These personal care industries include:
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Hcv Infection And Cerebrovascular Events
In chronic HCV infection, cerebrovascular acute and chronic events have been reported with a higher prevalence than that observed in the general population in many cases, such neurologic conditions were associated with the presence of mixed cryoglobulinemia. Enger et al, in the largest retrospective study to date, including 21919 HCV-positive subjects and 67109 HCV-negative control subjects, reported a strict association between HCV and stroke, with a higher adjusted estimated risk of stroke for anti-HCV positive subjects . Gutierrez et al showed a close association between HCV infection and stroke in a retrospective study of subjects from the NHANES cohort during the period 2005-2010. However, it should be underscored that the two above studies have thus far been published only in an abstract form. Nonetheless, in a prospective study, involving a large population cohort from Taiwan, Liao et al established an association between HCV infection and stroke . Recently, in a large retrospective cohort from Taiwan, Hsu et al also found a higher risk of stroke in HCV infected subjects. Likewise, we recorded a higher prevalence of HCV infection in patients with stroke when compared with a large age- and gender-matched control group . In addition, HCV infection turned out to be an independent risk factor for stroke .
When To Seek Medical Advice
See your GP if you persistently have any of the later symptoms listed, or if they keep returning. They may recommend having a blood test that can check for hepatitis C.
Read more about diagnosing hepatitis C
None of these symptoms mean you definitely have hepatitis C, but it’s important to get them checked out.
You should also speak to your GP about getting tested if there’s a risk you’re infected, even if you don’t have any symptoms. This particularly includes people who inject drugs or have done so in the past.
Read about the causes of hepatitis C for more information about who’s at risk of having the infection.
Page last reviewed: 27 October 2021 Next review due: 27 October 2024
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What Are The Treatment Guidelines For Hepatitis C
Hepatitis C treatment is best discussed with a doctor or specialist familiar with current and developing options as this field is changing, and even major guidelines may become outdated quickly.
The latest treatment guidelines by the American Association for the Study of Liver Disease and Infectious Disease Society of America recommends use of DAAs as first-line treatment for hepatitis C infection. The choice of DAA varies by specific virus genotype, and the presence or absence of cirrhosis. In the U.S., specific insurance providers also might influence the choice due to the high cost of DAAs. Although the individual, public health, and cost benefits of treating all patients with hepatitis C is clear, the most difficult barrier to treating all people with HCV is the very high cost of the drug regimens. Patients are encouraged to discuss options with their health care professional.
Treatment is recommended in all patients with chronic hepatitis C unless they have a short life expectancy that is not related to liver disease. Severe life-threatening liver disease may require liver transplantation. Newer therapies with DAAs have allowed more and more patients to be treated.
What are the goals of therapy for hepatitis C infection?
The ultimate goals of antiviral therapy are to
- prevent transmission of hepatitis C,
- prevent progression to cirrhosis and liver cancer, and
- improve survival and quality of life.