Understanding The Difference Between Acute Hepatitis C And Chronic Hepatitis C
Similar to other forms of hepatitis, infected individuals may have acute Hepatitis C or chronic Hepatitis C. All chronic Hepatitis C infections begin with acute Hepatitis C, becoming chronic Hepatitis C after being infected for more than six months. However, not all acute Hepatitis C infections become chronic Hepatitis C as a result of spontaneous viral clearance. Both forms can be treated with proper medication.
Is Hepatitis Testing Recommended For People With Hiv
Yes. Everyone living with HIV should be tested for HBV and HCV when they are first diagnosed with HIV and begin treatment. People living with HIV who have ongoing risk factors for getting hepatitis B or hepatitis C should be tested annually.
In addition, new HCV screening recommendations from the Centers for Disease Control and Prevention call for:
- One-time screening for all adults 18 years and older
- Screening of all pregnant women during every pregnancy
- Testing for all persons with risk factors, with testing continued periodic testing those with ongoing risk.
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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Stages Of Hepatitis C
The hepatitis C virus affects people in different ways and has several stages:
- Incubation period. This is the time between first exposure to the start of the disease. It can last anywhere from 14 to 80 days, but the average is 45
- Acute hepatitis C. This is a short-term illness that lasts for the first 6 months after the virus enters your body. After that, some people who have it will get rid of, or clear, the virus on their own.
- Chronic hepatitis C. For most people who get hepatitis C — up to 85% — the illness moves into a long-lasting stage . This is called a chronic hepatitis C infection and can lead to serious health problems like liver cancer or cirrhosis.
- Cirrhosis. This disease leads to inflammation that, over time, replaces your healthy liver cells with scar tissue. It usually takes about 20 to 30 years for this to happen, though it can be faster if you drink alcohol or have HIV.
- Liver cancer. Cirrhosis makes liver cancer more likely. Your doctor will make sure you get regular tests because there are usually no symptoms in the early stages.
Learn more about the stages and progression of hepatitis C.
How Can You Prevent The Spread Of Hepatitis C
Now that you know how you get hepatitis C, you can take steps to protect yourself from the virus. For instance:
- Avoid sharing needles or other paraphernalia related to intravenous drugs.
- Wear gloves if youre a health care worker or otherwise exposed to needles or potentially infected blood.
- Use barrier methodsaka condomsoutside of sexually monogamous relationships.
- Dont share toothbrushes or other dental equipment, nail clippers, or shaving tools.
- If youre getting a tattoo or piercing, make sure the artist or piercer uses sterile ink and needles.
If you have the hepatitis C virus, you can prevent passing it along to others by following those same steps, in addition to:
- Covering any open sores or wounds.
- Telling all your health and dental care providers you have the virus.
- Avoiding donating blood.
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What Are The Signs & Symptoms Of Hcv Infection
Most people with HCV have no symptoms. But even without symptoms, they can develop health problems decades later and can still pass the disease to others.
If symptoms do happen, it’s usually when the disease is very advanced. Symptoms can be similar to those of hepatitis A and hepatitis B and include:
- jaundice
- fever
- darker than usual urine or gray-colored stools
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.
It may take 2 to 3 months after exposure for the test to detect antibodies. If needed, your healthcare professional may order an HCV RNA test, which can detect the virus after just 1 or 2 weeks.
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
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How Do You Prevent Hepatitis C
Researchers have yet to develop a vaccine that prevents hepatitis C .
Just as you might not know you have hepatitis C, other people with the condition may not know they have it, either. But you can take a few key precautions to avoid contracting it:
- Avoid sharing needles.
- When getting piercings or tattoos, check to make sure the piercer or tattoo artist uses only sterile, unopened needles and ink.
- Avoid sharing nail clippers, razors, and toothbrushes.
- Use sterile gloves when caring for someone elses wound.
Since hepatitis C is transmitted through blood, you wont get it by sharing food and drinks with someone who has the condition or by hugging, touching, or holding hands.
Hepatitis C is not commonly transmitted through sexual contact. But using a condom or another barrier method when having sex can always help lower your chances of contracting a sexually transmitted infection.
Keep in mind that you can contract hepatitis C again, even if youve had it already.
Diagnosis Of Hepatitis C
If you are at risk of hepatitis C infection, or think you may have been exposed to hepatitis C in the past, see your doctor for an assessment of your liver health. This will include blood tests and possibly a non-invasive test for liver damage .
There are 2 blood tests used to diagnose hepatitis C. Usually these can be done at the same time but sometimes they will be done separately.
The first test known as a hepatitis C antibody test can tell you whether you have ever been exposed to hepatitis C.
It may take 2 to 3 months from the time of infection until a blood test can detect antibodies to hepatitis C, so there is a window period during which you cannot tell if you are or have been infected. In this time, take precautions to prevent the potential spread of the virus.
The second test is called hepatitis C PCR, which will be done if the antibody test is positive. This determines if the virus is still present in your blood or liver or if you have already cleared the infection.
If you have cleared the virus or had successful treatment to cure it, the PCR test will be negative.
A liver ultrasound or Fibroscan can also be performed to assess if you have any liver damage.
If your doctor is inexperienced in diagnosing hepatitis C you can call the LiverLine on for information, and to find a GP who can help you.
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What Are The Types Of Hepatitis C Infection
There are two types of hepatitis C infection:
- Acute: a short-term infection that occurs within 6 months after a person is exposed to the virus. However, about 75 to 85 percent of people with the acute form go on to develop the chronic form.
- Chronic: a long-term illness that can continue throughout a persons life. It can lead to cirrhosis of the liver and other serious problems, such as liver failure or cancer. About 15,000 people a year die from liver disease associated with hepatitis C.
What To Do If The Hcv Antibody Test Is Reactive
If the antibody test is reactive or positive, you need an additional test to see if you currently have hepatitis C. This test is called a nucleic acid test for HCV RNA. Another name used for this test is a PCR test.
If the NAT for HCV RNA is:
- Negative you were infected with hepatitis C virus, but the virus is no longer in your body because you were cured or cleared the virus naturally.
- Positive you now have the virus in your blood.
If you have a reactive antibody test and a positive NAT for HCV RNA, you will need to talk to a doctor about treatment. Treatments are available that can cure most people with hepatitis C in 8 to 12 weeks.
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Medications For Hepatitis C
Many different medications can treat hepatitis C. Treatments most often include antivirals, with Riboviria sometimes prescribed if previous treatments were ineffective.
Medications called direct-acting antivirals work to fully remove the hepatitis C virus from your body while helping prevent liver damage at the same time.
A few brand names of these medications include:
- Zepatier
6 different genotypes , or strains, of hepatitis C.
Once your doctor or other healthcare professional knows your genotype, theyll have a better idea of which medication will work best for you. Some strains have developed a resistance to some medications, so your genotype can affect your treatment options.
Sharing Toothbrushes Scissors And Razors
There’s a potential risk that hepatitis C may be passed on through sharing items such as toothbrushes, razors and scissors, as they can become contaminated with infected blood.
Equipment used by hairdressers, such as scissors and clippers, can pose a risk if it has been contaminated with infected blood and not been sterilised or cleaned between customers. However, most salons operate to high standards, so this risk is low.
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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
- 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
Hepatitis C And Injecting Drugs
If you inject drugs, avoid sharing needles, syringes or other equipment such as tourniquets, spoons, swabs or water.
Where possible, always use sterile needles and syringes. These are available free of charge from needle and syringe programs and some pharmacists. To find out where you can obtain free needles, syringes and other injecting equipment, contact DirectLine
Try to wash your hands before and after injecting. If you cant do this, use hand sanitiser or alcohol swabs from a needle and syringe program service.
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How Do People Get Hepatitis C
Hepatitis C virus is found in the blood of people with HCV infection. It enters the body through blood-to-blood contact.
Until reliable blood tests for HCV were developed , people usually got hepatitis C from blood products and blood transfusions. Now that blood and blood products are tested for HCV, this is no longer the typical means of infection.
Currently, people usually get hepatitis C by sharing needles for injection drug use. An HCV-infected woman can pass the infection to her baby during birth. It is also possible to get hepatitis C from an infected person through sexual contact, an accidental needlestick with a contaminated needle, or improperly sterilized medical, acupuncture, piercing, or tattooing equipment.
What Hepatitis C Does To Your Liver
Hepatitis C causes inflammation in the liver that leads, very slowly, to damage which eventually forms scars. This is called fibrosis and in most people with hepatitis C it takes many years to develop without symptoms so people often dont know it is happening. Over time, usually up to 30 years, this can lead to cirrhosis of the liver. With cirrhosis, the liver becomes scarred, hard and bumps form. The shape of the liver changes and this changes the way blood flows through the liver, which can lead to bleeding into the gut. Cirrhosis can also lead to liver cancer. When cirrhosis develops, your liver starts to run out of normal cells and can stop working also known as liver failure.
If there is a small to medium amount of damage the liver can repair itself. However, if there is a large amount of damage from severe cirrhosis or cancer, the liver cannot repair itself. When there is a large amount of irreversible liver damage, a liver transplant may be an option this would be discussed with your doctor or nurse.
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How Do You Get Hepatitis C
The hepatitis C virus is usually spread through blood-to-blood contact.
Some ways the infection can be spread include:
- sharing unsterilised needles particularly needles used to inject recreational drugs
- sharing razors or toothbrushes
- from a pregnant woman to her unborn baby
- through unprotected sex although this is very rare
In the UK, most hepatitis C infections happen in people who inject drugs or have injected them in the past.
It’s estimated around half of those who inject drugs have been infected with the virus.
Symptoms Of Hepatitis A Include Fatigue And Tummy Pain
Hepatitis A is a liver infection caused by the highly contagious Hepatitis A virus. Most people are vaccinated against the virus, and don’t need any treatment if they come in contact with it.
The CDC recommends that unvaccinated people who encounter it to get a hepatitis A shot, and possibly an antibody drug, within two weeks of exposure.
Symptoms usually start within 15 to 50 days of coming into contact with the virus.
For most people, symptoms of hepatitis A include fatigue, loss of appetite, tummy pain, nausea, vomiting, yellow skin, dark urine, and pale poop.
Symptoms range in severity and usually last between a few weeks to about two months, without any long-term liver damage.
But in rare cases, the condition can become chronic and lead to liver failure and death. Older people and those with weakened immune systems are at higher risk of severe illness.
Kids younger than 6 years old with hepatitis A don’t tend to get symptoms.
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How Do Doctors Treat Hepatitis C
Doctors treat hepatitis C with antiviral medicines that attack the virus and can cure the disease in most cases.
Several newer medicines, called direct-acting antiviral medicines, have been approved to treat hepatitis C since 2013. Studies show that these medicines can cure chronic hepatitis C in most people with this disease. These medicines can also cure acute hepatitis C. In some cases, doctors recommend waiting to see if an acute infection becomes chronic before starting treatment.
Your doctor may prescribe one or more of these newer, direct-acting antiviral medicines to treat hepatitis C:
You may need to take medicines for 8 to 24 weeks to cure hepatitis C. Your doctor will prescribe medicines and recommend a length of treatment based on
- which hepatitis C genotype you have
- how much liver damage you have
- whether you have been treated for hepatitis C in the past
Your doctor may order blood tests during and after your treatment. Blood tests can show whether the treatment is working. Hepatitis C medicines cure the infection in most people who complete treatment.
Hepatitis C medicines may cause side effects. Talk with your doctor about the side effects of treatment. Check with your doctor before taking any other prescription or over-the-counter medicines.
For safety reasons, talk with your doctor before using dietary supplements, such as vitamins, or any complementary or alternative medicines or medical practices.
What You Should Know
In the United States, hepatitis C virus is the most common chronic blood-borne infection, the most common cause of chronic liver disease contributing to progressive liver fibrosis, cirrhosis and liver cancer, and is the most frequent cause for liver transplantation. Learn more
HCV infection can be detected by anti-HCV screening tests 4-10 weeks after infection. Anti-HCV can be detected in > 97% of persons by 6 months after exposure. Learn more
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Other Hepatitis C Tests
After an individual has received a reactive or positive result from a hepatitis C antibody test, they will need to have two follow-up tests.
The first test checks to see whether a person still has the virus the other measures the amount of the virus in the blood.
The first test is the hep C RNA qualitative test, also known as the PCR test. A positive result means that a person has the hepatitis C virus. A negative result means that the body has cleared the virus without treatment.
The second test is the hep C RNA quantitative test. The result of this test is given as a number rather than a positive or negative. This is because the test compares the amount of the virus in the body before, during, and after treatment.
The number given as a result of this test is known as the viral load. The lower amount of the hepatitis C virus in the blood, the better the chances that a person can eliminate the virus from their body.
After hepatitis C virus is diagnosed, other tests may be needed:
Certain behaviors, experiences, and medical procedures increase the risk of getting the hepatitis C virus, which is transmitted by contact with blood.
The following are risk factors for contracting the virus:
The Centers for Disease Control and Prevention advise all baby boomers get tested for hepatitis C. Baby boomers are people born between 1945 and 1965. They are five times more likely to have the virus than other adults.