The Ohio State University: College of Public Health

Hepatitis C

Information obtained directly from the Center for Disease Control

Hepatitis C is a liver infection caused by the Hepatitis C virus (HCV). Hepatitis C is a blood-borne virus. Today, most people become infected with the Hepatitis C virus by sharing needles or other equipment to inject drugs. For some people, hepatitis C is a short-term illness but for the majority of people who become infected with Hepatitis C, it becomes a long-term, chronic infection. Chronic Hepatitis C is a serious disease than can result in long-term health problems, even death. The majority of infected persons might not be aware of their infection because they are not clinically ill. There is no vaccine for Hepatitis C.

What is hepatitis? 

Hepatitis means inflammation of the liver. When the liver is inflamed or damaged, its function can be affected. Heavy alcohol use, toxins, some medications, and certain medical conditions can all cause hepatitis. However, hepatitis is often caused by a virus. In the United States, the most common hepatitis viruses are hepatitis A virus, hepatitis B virus, and hepatitis C virus.

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

Hepatitis A, Hepatitis B, and Hepatitis C are liver infections caused by three different viruses. Although each can cause similar symptoms, they are spread in different ways and can affect the liver differently. Hepatitis A is usually a short-term infection. Hepatitis B and hepatitis C can also begin as short-term infections but in some people, the virus remains in the body, and causes chronic (lifelong) infection. There are vaccines to prevent hepatitis A and hepatitis B; however, there is no vaccine for hepatitis C.

Statistics

  • In 2016, a total of 2,967 cases of acute hepatitis C were reported to CDC. Since many people may not have symptoms or don’t know they are infected, their illness is often not diagnosed or reported and therefore can’t be counted. CDC estimates the actual number of acute hepatitis C cases was almost 41,200 in 2016.
  • In 2016, there were an estimated 2.4 million people living with hepatitis C in the United States.

Transmission/Exposure

How is hepatitis C spread?

Hepatitis C is usually spread when blood from a person infected with the hepatitis C virus enters the body of someone who is not infected. Today, most people become infected with the hepatitis C virus by sharing needles or other equipment to prepare or inject drugs.

People can become infected with the hepatitis C virus during such activities as:

  • Sharing needles, syringes, or other equipment to prepare or inject drugs
  • Needlestick injuries in health care settings
  • Being born to a mother who has hepatitis C

Less commonly, a person can also get hepatitis C virus through

  • Sharing personal care items that may have come in contact with another person’s blood, such as razors or toothbrushes
  • Having sexual contact with a person infected with the hepatitis C virus
  • Getting a tattoo or body piercing in an unregulated setting

Hepatitis C virus is not spread by sharing eating utensils, breastfeeding, hugging, kissing, holding hands, coughing, or sneezing. It is also not spread through food or water.

Can I be re-infected with hepatitis C virus if I have cleared the virus? 

Yes. If you have been infected with the hepatitis C virus and cleared the virus, or if you have been successfully treated and cured, you can be re-infected with the hepatitis C virus.

What is the risk of a pregnant woman passing hepatitis C to her baby? 

About 6 in 100 infants born to mothers with hepatitis C become infected with the hepatitis C virus. However, the risk becomes greater if the mother has both HIV and hepatitis C

Symptoms

What are the symptoms of acute hepatitis C?

People with new (acute) hepatitis C virus infection usually do not have symptoms or have mild symptoms. When symptoms do occur, they can include:

  • Fever
  • Fatigue
  • Dark urine
  • Clay-colored bowel movements
  • Abdominal pain
  • Loss of appetite
  • Nausea
  • Vomiting
  • Joint pain
  • Jaundice (yellow color in the skin or eyes)

How soon after exposure to hepatitis C virus do symptoms appear?

In those people who develop symptoms from acute infection, the average time from exposure to symptoms ranges from 2 to 12 weeks. However, most people who are infected with the hepatitis C virus do not develop symptoms.

Can a person spread hepatitis C without having symptoms? 

Yes, even if a person with hepatitis C has no symptoms, he or she can still spread the hepatitis C virus to others.

What are the symptoms of chronic hepatitis C?

Most people with chronic hepatitis C virus infection do not have any symptoms or have general, or common symptoms such as chronic fatigue and depression. Many people eventually develop chronic liver disease, which can range from mild to severe, including cirrhosis (scarring of the liver) and liver cancer. Chronic liver disease in people with hepatitis C usually happens slowly, without any signs or symptoms, over several decades. Chronic hepatitis C virus infection is often not recognized until people are screened for blood donation or from an abnormal blood test found during a routine examination.

How serious is chronic hepatitis C?

Chronic hepatitis C can be a serious disease resulting in long-term health problems, including liver damage, liver failure, liver cancer, or even death. It is a major cause of cirrhosis and liver cancer and the most common reason for liver transplantation in the United States. There were 18,153 deaths related to hepatitis C virus reported to CDC in 2016, but this is believed to be an underestimate.

What are the long-term effects of hepatitis C?

Of every 100 people infected with hepatitis C virus:

  • 75-85 will develop chronic infection
  • 10-20 will develop cirrhosis over 20-30 years

Among 100 people with hepatitis C and cirrhosis, with each passing year:

  • 3-6 will develop liver failure
  • 1-5 will develop liver cancer

Developing cirrhosis is more likely if you are male, age 50 years and older, use alcohol, have nonalcoholic fatty liver disease, hepatitis B virus or HIV coinfection, or take immunosuppressive drugs

Tests

Who should get tested for hepatitis C?

CDC recommends hepatitis C testing for:

  • Current or former injection drug users, including those who injected only once many years ago
  • Everyone born from 1945  to 1965
  • Anyone who received clotting factor concentrates made before 1987
  • Recipients of blood transfusions or solid organ transplants prior to July 1992
  • Long-term hemodialysis patients
  • People with known exposures to the hepatitis C virus, such as
    • health care workers or public safety workers after needle sticks involving blood from someone infected with hepatitis C virus
    • recipients of blood or organs from a donor who tested positive for the hepatitis C virus
  • People with HIV infection
  • Children born to mothers with hepatitis C

What blood tests are used to test for hepatitis C? 

The only way to know if you have hepatitis C is to get tested and you may need more than one type of test. A blood test, called a hepatitis C antibody test, can tell if you have ever been infected with the hepatitis C virus. Antibodies are chemicals released into the bloodstream when someone gets infected. Another test, called a hepatitis C virus RNA test, can tell if you have a current infection with the hepatitis C virus. RNA is the virus’ genetic material.

How do I interpret the results of hepatitis C anti-body test?

There are two possible antibody test results:

  • Non-reactive, or a negative, means that a person has never had hepatitis C. However, if a person has been recently exposed to the hepatitis C virus, he or she will need to be tested again.
  • Reactive, or a positive, means that hepatitis C antibodies were found in the blood and a person has been infected with the hepatitis C virus at some point in time. A reactive antibody test does not necessarily mean a person has hepatitis C. Once someone has been infected, they will always have antibodies in their blood. This is true if even if they have cleared the hepatitis C virus.

A reactive antibody test requires an additional test, called a hepatitis C virus RNA test (or PCR), to confirm whether the virus is still present in the person’s bloodstream.

How soon after exposure to the hepatitis C virus can the antibody test tell if someone is infected?

For most people exposed to the hepatitis C virus, the HCV antibody blood test will be positive in 4–10 weeks. About 97% of people infected will have a positive HCV antibody test 6 months after exposure.

Treatment

What is the treatment for acute hepatitis C?

There is not a recommended treatment for acute hepatitis C. People with acute hepatitis C virus infection should be followed by a doctor and only considered for treatment if their infection remains and becomes a chronic infection.

What is the treatment for chronic hepatitis C?

There are several medications available to treat chronic hepatitis C. Hepatitis C treatments have gotten much better in recent years. Current treatments usually involve just 8-12 weeks of oral therapy (pills) and cure over 90% of people with few side effects. For a complete list of currently approved FDA treatments for hepatitis C, please visit http://www.hepatitisc.uw.edu/page/treatment/drugsExternal.

 

Source:  Center for Disease Control. (2018, November 2). Hepatitis C Questions and Answers for the Public. Retrieved from https://www.cdc.gov/hepatitis/hcv/cfaq.htm#overview