What is hepatitis C?
Hepatitis C is an infection of the liver that is caused by a virus. Hepatitis C is caused by a different virus than hepatitis A or hepatitis B. Hepatitis C is spread through contact with the blood of an infected person. Some people can have hepatitis C for years without feeling sick, or just experience minor symptoms. If the infection is not treated, it can cause the liver to swell and become inflamed. As the disease progresses, symptoms of liver damage may appear.
What are the strains of hepatitis C?
There are several different strains of the hepatitis C virus. The most common strain is type 1. About 75% of patients with hepatitis C in the United States have type 1. Another 10 to 20% of patients have type 2 or 3. The less common types are hepatitis C 4, 5 and 6.
What are the forms of hepatitis C?
There are two forms of hepatitis C:
Acute –this is short-term infection that occurs within 6 months after exposure to the virus. However, about 75-85% of people with the acute form go on to develop the chronic form.
Chronic—this is a long-term illness that can persist throughout a person’s life. It can lead to cirrhosis (scarring) of the liver and other serious problems, such as liver failure or cancer. About 15,000 people per year die from liver disease associated with hepatitis C.
Early symptoms of hepatitis C may be similar to those of flu. Infected people often do not experience any symptoms. If symptoms do occur, it takes from 2 weeks to 6 months after exposure before they occur.
What are the symptoms of hepatitis C?
Symptoms of acute hepatitis C may include:
Achiness in the joints or muscles
Loss of appetite
Tenderness in the area of the liver
Symptoms of liver damage associated with chronic hepatitis may include:
Jaundice (yellowing of the skin and whites of the eyes)
Low-grade fever up to 102 degrees F
How common is hepatitis C?
About 3.2 million people in the United States have hepatitis C. An estimated 16,000 acute cases were reported in 2009. Hepatitis C is the leading cause of cirrhosis of the liver and liver cancer. It is the most common cause for liver transplants in the United States. Over 75% of adults infected with hepatitis are baby boomers (people born from 1945 through 1965). Baby boomers are five times more likely to have hepatitis C than the general population. It is unclear why the rate of infection is so much higher for people in this age group.
What causes hepatitis C?
The disease is caused when blood from an infected person enters the body of an uninfected person. The infection is most often transmitted when an infected person shares needles or syringes used to inject intravenous drugs. Even people who have used intravenous drugs infrequently may be at risk for infection.
Patients who received donated blood or blood products or had organ transplants before 1992 are at higher risk for hepatitis C. After that, biological products were routinely screened for hepatitis C so the risk of transmission declined dramatically.
Health care workers who accidentally stick themselves with needles used on infected patients are at risk of getting hepatitis C.
Less common routes of transmission include sexual contact with an infected person. Although the risk of contracting hepatitis C through sexual intercourse is low, the probability increases for people who have multiple sex partners or those with HIV infections. Sharing a razor, toothbrush or other personal item that may have come into contact with the blood of an infected person can also cause hepatitis C infections, although the risk is low. There is some risk of becoming infected through body piercing or tattooing, if the facility does not use sterile equipment or does not follow infection control practices. Babies born to mothers with hepatitis C might also become infected, although this is rare.
How is hepatitis C diagnosed?
There are several blood tests that may be used to test for the disease. Usually, a person’s blood will be tested to see whether it contains any antibodies to the hepatitis C virus. The body makes antibodies in response to an infectious substance, such as a virus. If antibodies are detected, that means the person was exposed to hepatitis C at some point in time. A blood test called an RNA test (or PCR test) can be done to see whether the blood is still infected with the active virus. If the result is positive, it means that the person is currently infected with hepatitis C.
Even if the initial antibody test is negative, a person should be tested again within 6 months.
People with hepatitis C may have to undergo liver function tests to tell if their livers are damaged and how much damage has occurred.
How is hepatitis C treated?
Various drugs are used to treat hepatitis C. There is no cure for hepatitis C. The aim of treatment is to reduce the amount of the virus in the blood to an undetectable level. The type and length of treatment may vary. Some strains are more resistant to antiviral medications than other strains. Some medications may not be suitable for all patients with hepatitis C, due to their side effects or the presence of other medical conditions.
Drugs to treat hepatitis C include:
Harvoni (ledipasvir and sofosbuvir)—This is a once-a-day pill that has been approved by the FDA as the first combination pill for the treatment of chronic HCV genotype 1 infection. The course of treatment is between 12 and 24 weeks, depending on the severity of the disease.
Pegylated alpha interferon—This drug is given by injection every week, over a period from 6 months up to 1 year. It can only be used by adult patients.
Ribavirin—This medication is available in tablet form. It is taken twice per day for 6 months to 1 year, along with alpha interferon.
Boceprevir and Tlaprevir—These antiviral medications are relatively new. They were approved by the Food and Drug Administration for the treatment of hepatitis C in 2011. Either boceprevir or telaprevir can be taken along with alpha interferon and ribavirin, but they cannot both be used at the same time.
These medications may cause birth defects, so women who are pregnant should not take them. Patients should be monitored by their doctors when using these drugs.
How can hepatitis C be prevented?
Unfortunately, no vaccine against hepatitis C is currently available. The only way to prevent infection is to avoid contact with infected blood. Hepatitis C cannot be spread by coughing, sneezing or sharing eating utensils. People should not be excluded from school, work or other environments because they have hepatitis C.
Here are some precautions that may prevent transmission of hepatitis C.
Not sharing personal care items, such as toothbrushes or razors, with others
Practicing safe sex by using condoms
Not sharing needles or syringes
Wearing gloves when handling another person’s blood
Using sterile equipment for body piercings or tattoos
Health care workers should follow recommended safety measures. People who are at greater risk for contracting hepatitis C should have their blood tested. The Centers for Disease Control recommends that Baby Boomers be screened at least once for the disease.
What is the prognosis for hepatitis C?
You can continue to lead an active life even if you are diagnosed with hepatitis C. People with the disease can work and continue their regular daily activities.
To maintain a healthy lifestyle, patients should
Follow a regular exercise routine
Eat nutritious meals
Limit alcohol consumption
Check with a doctor before taking over-the-counter medications, such as acetaminophen
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