Hepatitis C is a viral infection that causes liver inflammation, sometimes leading to serious liver damage. The hepatitis C virus (HCV) spreads through contaminated blood.
Hepatitis C Symptoms
Long-term infection with the hepatitis C virus is known as chronic hepatitis C. Chronic hepatitis C is usually a "silent" infection for many years, until the virus damages the liver enough to cause the signs and symptoms of liver disease.
Signs and symptoms include:
- Bleeding easily
- Bruising easily
- Fatigue
- Poor appetite
- Yellow discoloration of the skin and eyes (jaundice)
- Dark-colored urine
- Itchy skin
- Fluid buildup in your abdomen (ascites)
- Swelling in your legs
- Weight loss
- Confusion, drowsiness and slurred speech (hepatic encephalopathy)
- Spider-like blood vessels on your skin (spider angiomas)
Every chronic hepatitis C infection starts with an acute phase. Acute hepatitis C usually goes undiagnosed because it rarely causes symptoms. When signs and symptoms are present, they may include jaundice, along with fatigue, nausea, fever and muscle aches. Acute symptoms appear one to three months after exposure to the virus and last two weeks to three months.
Acute hepatitis C infection doesn't always become chronic. Some people clear HCV from their bodies after the acute phase, an outcome known as spontaneous viral clearance. In studies of people diagnosed with acute HCV, rates of spontaneous viral clearance have varied from 15% to 25%. Acute hepatitis C also responds well to antiviral therapy.
Causes
Hepatitis C infection is caused by the hepatitis C virus (HCV). The infection spreads when blood contaminated with the virus enters the bloodstream of an uninfected person. It can be passed through:
- organ transplants
- sharing items like razors or toothbrushes
- sharing needles
- childbirth (passing from a mother with hepatitis C to her baby)
- sexual contact if blood is exchanged
- getting a tattoo or a piercing with non-sterile equipment
Risk factors
Your risk of hepatitis C infection is increased if you:
- Are a health care worker who has been exposed to infected blood, which may happen if an infected needle pierces your skin
- Have ever injected or inhaled illicit drugs
- Have HIV
- Received a piercing or tattoo in an unclean environment using unsterile equipment
- Received a blood transfusion or organ transplant before 1992
- Received clotting factor concentrates before 1987
- Received hemodialysis treatments for a long period of time
- Were born to a woman with a hepatitis C infection
- Were ever in prison
- Were born between 1945 and 1965, the age group with the highest incidence of hepatitis C infection
Hepatitis C can’t be transmitted via:
- hugging
- kissing
- sharing food or eating utensils
- coughing
- a mosquito bite
Complications
Hepatitis C infection that continues over many years can cause significant complications, such as:
1. Scarring of the liver (cirrhosis)
After decades of hepatitis C infection, cirrhosis may occur. Scarring in your liver makes it difficult for your liver to function.
2. Liver cancer
A few people with hepatitis C infection may develop liver cancer.
3. Liver failure
Advanced cirrhosis may cause your liver to stop functioning.
Diagnosis and tests
Doctors can diagnose hepatitis C using blood tests:
- First, the doctor will perform a simple blood test to look for hepatitis C antibodies in the blood. A positive test means that the person has had exposure to the virus, but does not necessarily prove ongoing infection.
- If the antibody test is positive, the person may then have a second blood test called a hepatitis C RNA test. This will check whether the virus is still present in the blood.
- A third blood test — called a genotype test — can work out which type of hepatitis C virus is present, as there are at least six types.
If the person has had hepatitis C for a long time, a doctor may recommend further tests to look for liver damage, measure the severity of any existing damage, and rule out other causes of damage.
These tests usually involve blood tests and ultrasound scans. Doctors only use a liver biopsy — which involves taking a small sample of liver tissue — when the other tests do not provide enough information.
Treatment
1. Antiviral medications
Hepatitis C infection is treated with antiviral medications intended to clear the virus from your body. The goal of treatment is to have no hepatitis C virus detected in your body at least 12 weeks after you complete treatment.
Researchers have recently made significant advances in treatment for hepatitis C using new, "direct-acting" antiviral medications, sometimes in combination with existing ones. As a result, people experience better outcomes, fewer side effects and shorter treatment times — some as short as eight weeks. The choice of medications and length of treatment depend on the hepatitis C genotype, presence of existing liver damage, other medical conditions and prior treatments.
Due to the pace of research, recommendations for medications and treatment regimens are changing rapidly. It is therefore best to discuss your treatment options with a specialist.
Throughout treatment, your care team will monitor your response to medications.
2. Liver transplantation
If you have developed serious complications from chronic hepatitis C infection, liver transplantation may be an option. During liver transplantation, the surgeon removes your damaged liver and replaces it with a healthy liver. Most transplanted livers come from deceased donors, though a small number come from living donors who donate a portion of their livers.
In most cases, a liver transplant alone doesn't cure hepatitis C. The infection is likely to return, requiring treatment with antiviral medication to prevent damage to the transplanted liver. Several studies have demonstrated that new, direct-acting antiviral medication regimens are effective at curing post-transplant hepatitis C. At the same time, treatment with direct-acting antivirals can be achieved in appropriately selected patients before liver transplantation.
3. Vaccinations
Although there is no vaccine for hepatitis C, your doctor will likely recommend that you receive vaccines against the hepatitis A and B viruses. These are separate viruses that also can cause liver damage and complicate the course of chronic hepatitis C.
Prevention
Protect yourself from hepatitis C infection by taking the following precautions:
- Stop using illicit drugs, particularly if you inject them. If you use illicit drugs, seek help.
- Be cautious about body piercing and tattooing. If you choose to undergo piercing or tattooing, look for a reputable shop. Ask questions beforehand about how the equipment is cleaned. Make sure the employees use sterile needles. If employees doesn't answer your questions, look for another shop.
- Practice safer sex. Don't engage in unprotected sex with multiple partners or with any partner whose health status is uncertain. Sexual transmission between monogamous couples may occur, but the risk is low.
Lifestyle and home remedies
If you receive a diagnosis of hepatitis C, your doctor will likely recommend certain lifestyle changes. These measures will help keep you healthy longer and protect the health of others as well:
- Stop drinking alcohol. Alcohol speeds the progression of liver disease.
- Avoid medications that may cause liver damage. Review your medications with your doctor, including over-the-counter medications you take as well as herbal preparations and dietary supplements. Your doctor may recommend avoiding certain medications.
- Help prevent others from coming in contact with your blood. Cover any wounds you have, and don't share razors or toothbrushes. Don't donate blood, body organs or semen, and advise health care workers that you have the virus. Also tell your partner about your infection before you have sex, and always use condoms during intercourse.
Conclusion
Hepatitis C is transmitted through blood-to-blood contact with someone who has an HCV infection. Your body may clear the infection on its own, but in most cases, hepatitis C will develop into a chronic condition.
Hepatitis C can usually be cured, but it may eventually lead to severe liver damage if left untreated.
If you’re at higher risk for getting an HCV infection than the general population, it’s important to get regular hepatitis C screenings.
If you contract the hepatitis C virus, the sooner you know, the better your chances are for avoiding complications.
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