Hepatitis C

What Is Hepatitis C?

Hepatitis C is inflammation of the liver, caused by a specific variant of the hepatitis virus. It is spread through direct contact with the blood of someone who has it.

According to the CDC, some people experience hepatitis C only for a short time, but more than half of those infected will develop a chronic hepatitis C infection with the potential for serious complications.

What is the difference between hepatitis A, B, and C?

Hepatitis A is primarily spread through contaminated food or water. There is an effective vaccine for hepatitis A.

Hepatitis B is spread through contact with blood or bodily fluids. It can spread through sexual contact or sharing drug-injection tools. There is an effective vaccine for it.

Hepatitis C spreads through blood only. There is no vaccine to prevent hepatitis C, so the best protection is to avoid behaviors that put you at risk for exposure.

Causes of hepatitis C

Hepatitis C is a virus that causes inflammation of the liver (“hepatitis”). More than half of people with hepatitis C are unaware that they have it, because it can take years (even decades) for symptoms to appear, according to the Mayo Clinic.

How common is hepatitis C?

Around 2.7 to 3.9 million people in the United States have hepatitis C. Many of these people are unaware that they have this illness.

Hepatitis C is the most common chronic viral infection that is spread through blood contact, according to the NIH. Hepatitis C is particularly high among people who misuse opioids.

How is Hepatitis C transmitted?

Hepatitis C is transmitted through contact with blood from someone who has it. According to the CDC, this happens often in situations like:

• Sharing drug-injection tools (needles, syringes)
• Accidental needlestick in a healthcare or caregiving setting
• Non-sterile items used for piercing or tattooing
• Rituals that involve blood sharing or cutting
• From mother to child during childbirth

Hepatitis C risk factors

In the United States, an uptick in opioid abuse has caused a rise in hepatitis C since 2006, according to the CDC. Risk factors of hepatitis C include:

• Using intervenous drugs
• Sharing needles, syringes, or other drug-injection tools with others
• Having HIV
• Getting tattoos or piercings where tools haven’t been sanitized correctly
• Born to a mother with a hepatitis C infection
• Born between 1945 and 1965
• Received a blood transfusion before 1992
• Are in or have been in prison

Signs and symptoms of hepatitis C

In the early stages of a hepatitis C infection, symptoms range from nothing to flu-like symptoms. More than half of people with hepatitis C are unaware that they have it, according to the Mayo Clinic. This is why the CDC recommends being tested if you have any risk factors.

What are the early warning signs of hepatitis C?

In the acute (“new”) stage of a hepatitis C infection, you may experience flu-like symptoms, such as

• Fever
• Fatigue
• Body aches and chills
• Loss of appetite

The CDC reports that in some cases, symptoms of sudden liver failure may occur. These symptoms include

• Jaundice (yellowing of the skin and eyes)
• Abdominal pain
• Nausea
• Vomiting
• Dark-colored pee and light-colored poop

What are the symptoms of advanced liver disease?

Advanced liver disease can occur during a chronic (long-term) hepatitis C infection. This can happen years (even decades) into the infection. Symptoms, according to the Mayo Clinic, include:

• Swelling in the arms, legs, and abdomen
• Unexplained weight loss
• Easy bruising and bleeding
• Trouble with memory or thought process
• Itchy skin

Is hep C contagious?

Yes, hepatitis C is contagious through blood contact. Currently, in the United States, hepatitis C is most commonly spread through shared drug-injection tools, according to the CDC.

Complications of hepatitis C

Hepatitis C will sometimes resolve itself or respond to some new treatment options. However, in over half the cases, hepatitis C becomes a chronic condition that can lead to complications, such as

• Liver cirrhosis
• Liver cancer
• Death

Over 15,000 people died from complications of hepatitis C in 2018, according to the CDC.

Liver cirrhosis

Liver cirrhosis (severe scarring of the liver) is a complication of chronic hepatitis. According to the CDC symptoms of liver cirrhosis are

• Fatigue
• Loss of appetite / weight loss
• Nausea and vomiting
• Pain or tenderness in the upper right abdominal region
• Itchy skin
• Jaundice (yellowing of the skin and eyes)

Liver cancer

Hepatitis infections pose the greatest risk for liver cancer. In the United States, nearly 50% of liver cancer cases are caused by a chronic hepatitis C infection, according to the CDC.

Diagnosing and testing for hepatitis C

Hepatitis C testing involves a blood test that looks for the presence of antibodies in the blood. If antibodies are found, additional testing will be done to determine if the antibodies are from a previous infection or a current infection.

It takes 8-11 weeks after exposure for testing to be positive if you have a hepatitis c infection, according to the CDC.

How is hepatitis C diagnosed?

If your blood test confirms the presence of antibodies, additional testing may be necessary to confirm a diagnosis and to determine the severity of the infection. According to The Cleveland Clinic, additional tests may include

• Liver function tests
• MRI
• Ultrasound
• Liver biopsy

Getting tested for hepatitis C

Getting tested for hepatitis C is usually done in a healthcare setting, such as at a

• Walk-in clinic
• Urgent care clinic
• Primary care clinic
• Public health clinic

There are rapid tests available in some places, which can yield results in as little as 30 minutes. However, not every healthcare provider offers rapid testing. In some cases, test results can take days to weeks to come back, according to the CDC.

Who should get tested for hep C?

Every adult should be tested for hepatitis C at least once in their life, according to the recommendations of the CDC. Additionally, women should be tested during each pregnancy, and people with risk factors should be tested more frequently. This includes people who

• Inhale or inject drugs
• Receive maintenance hemodialysis

Treating hepatitis C

There is currently no vaccine to help prevent hepatitis C, however, there are some antiviral medications that can help treat symptoms and in some cases cure the infection.

Because of the ongoing research in hepatitis C treatments, medication and treatment regimens change rapidly according to the CDC.

What are the treatments for hepatitis C?

Common treatments for hepatitis C include

• Antiviral medication
• Liver transplant (in the case of advanced liver disease)
• Avoiding alcohol and certain medications to prevent further damage to the liver

Does hepatitis C go away?

Hepatitis C can go away on its own in some cases, though this is rare. According to studies published by the NIH, a hepatitis C infection will spontaneously clear itself in about 25% of cases.

It is much more likely to clear a hepatitis C infection with antiviral treatment.

Is hepatitis C curable?

There are several antiviral medications that can be used to treat hepatitis C. The treatment regimens frequently change, due to evolving research. However, the CDC notes that hepatitis C treatment can cure more than 90% of cases.

Preventing hepatitis C

Preventing hepatitis C involves avoiding risk factors, such as

• Avoiding drug use, especially drugs that involve injection
• Avoiding blood contact with people who may have hepatitis C
• Careful PPE and sharps handling if you work in a healthcare setting
• Getting tattoos and piercings from reputable businesses that use proper sterilization techniques and PPE

Is there a hepatitis C vaccine?

Currently, there is no vaccine for hepatitis C.

Hepatitis C—CDC Fact Sheet, (February 28, 2023)
https://www.cdc.gov/hepatitis/hcv/

Hepatitis C—Cleveland Clinic, (February 28, 2023)
https://my.clevelandclinic.org/health/diseases/15664-hepatitis-c

Hepatitis C—Mayo Clinic, (February 28, 2023)
https://www.mayoclinic.org/diseases-conditions/hepatitis-c/symptoms-causes/syc-20354278

Hepatitis C—NIH, (February 28, 2023)
https://www.niddk.nih.gov/health-information/liver-disease/viral-hepatitis/hepatitis-c

Hepatitis C virus clearance, reinfection, and persistence, with insights from studies of injecting drug users: towards a vaccine, (February 28, 2023)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3608418/

2014-2020 Hepatitis C Treatment Estimates, (February 28, 2023)
https://www.cdc.gov/nchhstp/newsroom/2021/2014-2020-hepatitis-c-treatment-estimates.html#