How Is It Spread
Hepatitis A is spread when a person ingests fecal mattereven in microscopic amountsfrom contact with objects, food, or drinks contaminated by feces or stool from an infected person.
Hepatitis B is primarily spread when blood, semen, or certain other body fluids- even in microscopic amounts from a person infected with the hepatitis B virus enters the body of someone who is not infected. The hepatitis B virus can also be transmitted from:
- Birth to an infected mother
- Sex with an infected person
- Sharing equipment that has been contaminated with blood from an infected person, such as needles, syringes, and even medical equipment, such as glucose monitors
- Sharing personal items such as toothbrushes or razors
- Poor infection control has resulted in outbreaks in health care facilities
Hepatitis C is spread when blood from a person infected with the Hepatitis C virus even in microscopic amounts enters the body of someone who is not infected. The hepatitis C virus can also be transmitted from:
- Sharing equipment that has been contaminated with blood from an infected person, such as needles and syringes
- Receiving a blood transfusion or organ transplant before 1992
- Poor infection control has resulted in outbreaks in health care facilities
- Birth to an infected mother
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 the infection.
How Common Is Hepatitis C In The United States
In the United States, hepatitis C is the most common chronic viral infection found in blood and spread through contact with blood.14
Researchers estimate that about 2.7 million to 3.9 million people in the United States have chronic hepatitis C.13 Many people who have hepatitis C dont have symptoms and dont know they have this infection.
New screening efforts and more effective hepatitis C treatments are helping doctors identify and cure more people with the disease. With more screening and treatment, hepatitis C may become less common in the future. Researchers estimate that hepatitis C could be a rare disease in the United States by 2036.17
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What Are The Symptoms
Most people who have HCV infection feel well, have no symptoms, and may not know they have the disease. Some people may have a brief illness with symptoms around 6 weeks after being infected with HCV.
Symptoms of acute HCV infection may include:
- Nausea and vomiting
Most people will have no symptoms and may not know that they have the virus. People with HCV infection may feel tired, have a low mood or stomach pains. About 75% of people living with HCV infection will develop a chronic infection.
What Can People Do To Help The Medications Work Best
- Take the medications every day
- Stay in touch with pharmacy to be sure that all refills are ready on time
- Take the medications exactly as prescribed
- Do not skip doses
- Get all blood tests done on time
- Go to all visits with providers as recommended
- Tell the provider about all other medications that are being taken – including over-the-counter medicines, vitamins, herbs, and supplements
- Complete the entire course of medication
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Progress Being Made Worldwide
All types of viral hepatitis can be controlled or prevented.
- Hepatitis C can be cured a once-daily medication taken by mouth for 8-12 weeks can cure most people who are infected with hepatitis C. In 2019, 9.4 million people were receiving treatment for chronic HCV infection, greater than a nine-fold increase since 2015 .
- Medications to manage hepatitis B are available to help prevent liver damage and slow progression of the disease.
- Hepatitis A and hepatitis B can both be prevented with safe and effective vaccines. Efforts to increase the number of children vaccinated against hepatitis B around the world have dramatically reduced the number of new hepatitis B virus infections.
Hepatitis A and hepatitis E can also be prevented, and cases reduced with improvements in sanitation, because these infections are transmitted from infected feces either person-to-person or through contaminated food and drinking water.
Global Immunization Strategic Framework 2021
In 2021, CDC released the Global Immunization Strategic Framework 2021-2030, which provides a roadmap to achieving progress toward a world where everyone is protected from vaccine-preventable diseases , such as hepatitis A and hepatitis B.
Three Goals are core immunization program capacities that CDC seeks to strengthen:
- Prevent VPDs by strengthening immunization services.
- Detect VPDs by supporting and improving disease surveillance systems.
- Respond to and prepare for VPD outbreaks.
Two Goals are cross-cutting capacities:
- Sustain immunization program capacities over time.
- Innovate to increase immunization program impact through research and evaluation.
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Living With Hepatitis C Infection
Many people are living with hepatitis C. If you have hepatitis C, there are several important things that you can do to help yourself and others such as:
- Eat a healthy diet and get plenty of rest.
- To avoid further liver damage:
- Do not drink alcohol.
- Do not take medicine that can cause liver damage .
- Get vaccinated against hepatitis A & B if you are not already immune.
- Do not to pass the infection to anyone else by taking the following precautions, such as:
- Do not share toothbrushes or razors with others.
- Do not to let anyone else come into contact with your blood, urine or feces.
- Use condoms during sexual activity.
- Limit the number of sex partners you have.
- If you use injection drugs, do not share needles or syringes with anyone else.
- It is best to not get tattoos or body piercings.
Although often uncomfortable, you should notify your partner of your hepatitis C prior to having sex. You also must notify all your health care professionals of your infection, so they can take precautions.
What Other Tests Diagnose Hepatitis C
Once the diagnosis of hepatitis C is established, other tests may be done to determine whether the patient has developed liver fibrosis or scarring . This can be done with a needle biopsy of the liver, and examining the biopsied liver tissue under the microscope. Liver biopsy is less commonly done today because noninvasive tests are more readily available, more easily accomplished and less costly.
Liver imaging can evaluate fibrosis using ultrasound and MRI scans. Additionally, calculations using a variety of blood tests also can predict the degree of inflammation and fibrosis present. Genotype testing will typically be done to determine what subtype of hepatitis C the patient has, as this will impact what drugs are used for treatment. Testing for other infections including HIV, hepatitis A, and hepatitis B is typically done to determine if the patient might have other conditions that could impact patient’s treatment and prognosis.
With the newest forms of antiviral treatment, the most common types of chronic hepatitis C can be cured in most individuals.
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What Are The Signs And Symptoms Of Hepatitis C
Most people who contract hepatitis C do not have any symptoms, especially in the early stages. However, some people do develop early symptoms, which may include:
- Painful joints
But 3 out of 4 cases result in a chronic infection. In these people, symptoms may develop years, even decades later, when liver damage occurs. Others develop symptoms from 2 weeks to 6 months after infection. The average time to develop symptoms is 6 to 7 weeks after acquiring the virus. Those newly infected with hepatitis C may experience mild-to-severe fever, fatigue, abdominal pain, loss of appetite, nausea, vomiting, joint pain, dark urine, clay-colored stool, and yellowing of the skin . A person who has hepatitis C infection but isn’t exhibiting any symptoms can still pass the virus on to others.
Hepatitis C And Blood Spills
When cleaning and removing blood spills, use standard infection control precautions at all times:
- Cover any cuts or wounds with a waterproof dressing.
- Wear single-use gloves and use paper towel to mop up blood spills.
- Clean the area with warm water and detergent, then rinse and dry.
- Place used gloves and paper towels into a plastic bag, then seal and dispose of them in a rubbish bin.
- Wash your hands in warm, soapy water then dry them thoroughly.
- Put bloodstained tissues, sanitary towels or dressings in a plastic bag before throwing them away.
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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.
You Can Have It And Not Know It
What is Hepatitis C?
Hepatitis C is a liver disease caused by the hepatitis C virus . HCV is far more infectious than HIV. Presently, there is no vaccine to prevent HCV infection.
In 2011, it is estimated that over 220,000 people in Canada were infected with HCV. In 2012, 10,180 new cases of hepatitis C were reported in Canada. It has been estimated that over 40% of people living with chronic hepatitis C don’t even know they are infected.
About 15 to 25 percent of adults will recover within 6 months of becoming infected . The remaining 75 to 85 percent are unable to clear the virus and will become chronically infected. Chronic hepatitis C is treatable and in some instances can be cured.
Why is hepatitis C a health concern?
Many people infected with HCV do not know they have the virus because symptoms can take two to six months to appear and the majority of people will not develop symptoms. During this time, they can spread the infection to others. You may not know you have this infection until damage has already been done to your liver. Potential complications from chronic hepatitis C include cirrhosis of the liver, liver failure, liver cancer and premature death.
Why do I need my liver?
How is hepatitis C virus spread?
The most common risk factors for HCV infection include:
What are the symptoms of hepatitis C?
How can I find out if I have hepatitis C?
How can I protect myself and others against HCV?
What if I have hepatitis C?
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Protease Inhibitor Antiviral Medications
Protease inhibitors work by preventing the spread of infection within the body by stopping viruses from multiplying.
Grazoprevir is a protease inhibitor for hepatitis C genotypes 1 and 4. Its only available in combination with elbasvir and sold as grazoprevir/elbasvir.
The drug combination is sold under the brand name Zepatier.
Who Should Be Vaccinated
- All children aged 1223 months
- All children and adolescents 218 years of age who have not previously received hepatitis A vaccine
People at increased risk for hepatitis A
- International travelers
- Men who have sex with men
- People who use or inject drugs
- People with occupational risk for exposure
- People who anticipate close personal contact with an international adoptee
- People experiencing homelessness
People at increased risk for severe disease from hepatitis A infection
- People with chronic liver disease, including hepatitis B and hepatitis C
- People with HIV
Other people recommended for vaccination
- Pregnant women at risk for hepatitis A or risk for severe outcome from hepatitis A infection
Any person who requests vaccination
There is no vaccine available for hepatitis C.
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How Does Hepatitis C Spread
Hepatitis C is spread only through exposure to an infected person’s blood.
High-risk activities include:
- Sharing drug use equipment. Anything involved with injecting street drugs, from syringes, to needles, to tourniquets, can have small amounts of blood on it that can transmit hepatitis C. Pipes and straws to smoke or snort drugs can have blood on them from cracked lips or nosebleeds. Get into a treatment program if you can. At the very least, don’t share needles or equipment with anyone else.
- Sharing tattoo or piercing tools. Nonsterile items and ink can spread contaminated blood.
- Blood transfusions in countries that donât screen blood for hepatitis C.
- Nonsterile medical equipment. Tools that arenât cleaned properly between use can spread the virus.
- Blood or cutting rituals. Sharing the tools or exchanging blood can transmit hepatitis C.
Medium-risk activities include:
What Does It Mean To Have A Successful Treatment What Is A Sustained Virologic Response
In an untreated state, the hepatitis C virus infects the cells of the liver and then continuously lives there, making copies of itself that circulate in the bloodstream. Antiviral medications can destroy the ability of the virus to reproduce, so the amount of virus in the bloodstream then decreases. The amount of virus in the blood is measured by aviral load.
Treatment is successful when the viral load drops toundetectablelevels, which means the virus cannot be detected in the bloodstream at all. The viral load becomes undetectable during treatment and remains undetected after treatment has ended. If there is still no detectable virus in the blood 12 weeks after the end of the treatment, the treatment was successful. This is called a Sustained Virologic Response .
A patient who has achieved an SVR is considered to be cured of the hepatitis C virus.
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Acute Phase Of Hepatitis C
Acute means ‘new’ or ‘for a short time’. This phase lasts for the first six months. When first infected with the virus, most people have no symptoms, or only mild ones. If symptoms do occur, they develop about 7-8 weeks after being exposed to the virus and may include feeling sick , being sick and feeling generally unwell. Some people go ‘yellow’ . This is due to a build-up of the chemical bilirubin which is made in the liver and spills into the blood in some liver conditions. It is unusual to have severe symptoms.
Following the initial infection:
- In about one quarter to one half of cases the virus is cleared from the body by the immune system within 2-6 months. If this happens then you will have no long-term effects from the virus. Younger people and women are more likely to clear the virus in this way.
- In 5 to 8 out of 10 cases, the virus remains active in the liver and bloodstream long-term. This is called chronic infection with hepatitis C.
Are Hepatitis B And C Preventable
Hepatitis B is a vaccine-preventable disease.
There is a three-shot vaccination series that is very effective in protecting people against the virus if theyre exposed. In the United States, all newborns are vaccinated for hepatitis B and all pregnant women are screened for hepatitis B during pregnancy. This way, mothers infected with hepatitis B can take protective steps to decrease the risk of transmission of the virus to the child.
There is no vaccine for hepatitis C.
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Liver Assessment Before Treatment
Blood tests can assess the state of your liver. Your healthcare provider can calculate an APRI score, which can rule out the presence of liver damage in many people. These people can be treated immediately by their GPs. Some people will need to be referred to their local hepatitis C service for a fibroscan.
Everyone should have a fibroscan before starting hepatitis C treatment. It’s important to know how much scar tissue or damage is present. If you have mild or moderate scarring in the liver, your GP can supervise your treatment. After successful treatment no further follow-up is needed. Scar tissue in the liver will reduce over time.
If severe scar tissue is present in the liver, you should be cared for by a specialist clinic. After treatment you should stay under specialist follow-up because there is a risk of liver cancer , even many years after the virus has been cured.
What happens after treatment?
Being cured of the hepatitis C virus means having a sustained virological response , which is when the virus can’t be detected three months after treatment.
This is a complete cure from hepatitis C, as being free of the virus three months after treatment means it is unlikely the virus will return. However, you are not immune to hepatitis C and you can be reinfected if you’re exposed to the virus again.
How Is Hepatitis C Spread
Hepatitis C spreads through contact with the blood of someone who has HCV. This contact may be through
- Sharing drug needles or other drug materials with someone who has HCV. In the United States, this is the most common way that people get hepatitis C.
- Getting an accidental stick with a needle that was used on someone who has HCV. This can happen in health care settings.
- Being tattooed or pierced with tools or inks that were not sterilized after being used on someone who has HCV
- Having contact with the blood or open sores of someone who has HCV
- Sharing personal care items that may have come in contact with another person’s blood, such as razors or toothbrushes
- Being born to a mother with HCV
- Having unprotected sex with someone who has HCV
Before 1992, hepatitis C was also commonly spread through blood transfusions and organ transplants. Since then, there has been routine testing of the U.S. blood supply for HCV. It is now very rare for someone to get HCV this way.
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