Hepatitis C

Hepatitis C is a viral infection that causes inflammation that damages your liver. It usually doesn’t go away without treatment, and it can cause serious liver damage over time. New medications can now cure hepatitis C infection. But many people don’t have symptoms and don’t know they have it.

Hepatitis C spreads primarily through blood. You get it by coming into contact with blood from someone infected with the hepatitis C virus (HCV). Transmission often occurs when people share needles for injecting drugs. Researchers estimate between 2 and 4 million people in the U.S. have hepatitis C.

Symptoms of hepatitis C

Most people don’t have any symptoms of hepatitis C. If you do have symptoms, you might have them when your body first begins to recognize and fight the virus. This is the “acute” phase of the infection.

It can cause:

• Abdominal pain
• Dark-colored pee and/or light-colored poop
• Flu-like symptoms (like fever, fatigue, nausea and body aches)
• Jaundice (a yellow tint in your skin or the whites of your eyes)

If you don’t have acute symptoms, you might begin to have symptoms after many years of chronic (long-term) hepatitis C infection. These are signs that the infection is starting to affect your liver function.

You might have all the symptoms above, and also:

• Blood in your poop or bloody vomit
• Frequent or excessive bleeding and bruising
• Itchy skin all over
• Reddish or dark-colored palms
• Small, spiderlike blood vessels showing in your skin
• Swollen belly from fluid buildup in your belly

How do you get hepatitis C?

You can get hepatitis C if you have contact with blood from someone else who has the virus. In the U.S., the most common cause of hepatitis C transmission is sharing needles to inject intravenous drugs.

Other possible causes of transmission include:

• Being born to a mother with hepatitis C
• Exposure to infected blood or needles in healthcare settings
• Getting a tattoo or body piercing with unsterilized equipment
• Sharing a razor or toothbrush with somebody who might have bled while using it

It’s important to know that hepatitis C is contagious even if you don’t have symptoms or know that you have it. However, it only spreads through blood, not through other bodily fluids or casual contact.

How will hepatitis C affect me?

Up to 30% of people who get hepatitis C may be able to fight it off naturally when it’s still new (acute). It can take several months for your body to defeat the virus. Most people who get hepatitis C can’t fight it off naturally. When your body surrenders after months of fighting, it becomes a chronic infection.

What are the complications of chronic hepatitis C infection?

Chronic hepatitis C infection means long-term, ongoing inflammation in your liver (hepatitis). This is a form of chronic liver disease. Inflammation slowly damages your liver over many years, causing scarring that interferes with its functioning (cirrhosis). The end-stage of this process is chronic liver failure.

Cirrhosis and liver failure bring risks of other complications, including:

• Portal hypertension
• Liver cancer

How doctors diagnose hepatitis C

If you think you might have hepatitis, or you have symptoms of liver disease, a healthcare provider will examine you to look for physical signs. These may include swelling in your body or yellowing in your eyes.

They’ll follow up with blood tests. These may include:

• Antibody test. This shows whether your blood contains antibodies to the HPC virus.
• RNA test. This test shows if the virus is still active in your body.
• Genotype test. There are at least six strains or genotypes of hepatitis C. This test shows which strain you have. Your provider will use test results to recommend treatment.
• Liver function tests. These tests check on your liver’s overall health.

If blood tests show your liver is struggling, your provider might want to do other tests to check for liver damage. A transient elastography is a type of ultrasound that measures the scarring in your liver.

What is the treatment for hepatitis C?

Direct-acting antiviral (DAA) medications are the primary treatment for hepatitis C. These are tablets that you swallow. There are at least a dozen DAAs that treat different strains (genotypes) of the virus.

Commonly prescribed medications include:

• Elbasvir/grazoprevir (Zepatier^®)
• Glecaprevir/pibrentasvir (Mavyret^®)
• Ledipasvir/sofosbuvir (Harvoni^®)
• Sofosbuvir/velpatasvir (Epclusa^®)
• Sofosbuvir/velpatasvir/voxilaprevir (Vosevi^®)

If you’ve had hepatitis C for a long time and have a lot of liver damage, you may need other treatments. Some damage is reversible, but some isn’t. You might need treatment for the effects of liver disease.

What is the recovery time?

Most people take DAAs for two to six months, but some people might need to take them for longer.

What are the side effects of the treatment?

Common DAA side effects include:

• Abdominal pain
• Diarrhea
• Fatigue
• Headache
• Nausea
• Shortness of breath

What else can I do to take care of myself?

When you have liver disease, it’s important to do what you can to protect your liver from further harm. That might mean:

• Quitting or cutting back on alcohol
• Quitting smoking
• Getting vaccinated against hepatitis A and B
• Keeping up with your regular healthcare checkups

Can hepatitis C be prevented?

The only way to prevent infection is to avoid contact with infected blood. There’s no vaccine yet for hepatitis C, although scientists continue to work on one. The virus has many variations and mutates very quickly. That makes it challenging to develop a vaccine that’s effective against all the variations.

What’s the prognosis for hepatitis C?

Some people who get hepatitis C can fight it off naturally during the acute phase. But for most people, it becomes a chronic infection. Chronic hepatitis C will continue to damage your liver over time, even if you don’t have symptoms and don’t know you have it. This is why routine screenings are important.

Once you know that you have it, you can treat it with antivirals. Research shows these medications cure most cases of hepatitis C, no matter how long you’ve had it. But even after curing hepatitis C, some people have irreversible liver damage (cirrhosis). This happens in about 20% of people after 20 to 30 years.