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Diseases & Conditions

Hepatitis C

What is hepatitis C?

Hepatitis C is an infection of the liver that is caused by a virus. 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 may just have 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 forms of hepatitis C?

There are two forms of hepatitis C:

  • Acute – a short-term infection that occurs within six months after a person is exposed to the virus. However, about 75 to 85 percent of people with the acute form go on to develop the chronic form.
  • Chronic – a long-term illness that can continue 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 have any symptoms. If symptoms do occur, it takes from two weeks to six 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
  • Mild fatigue (feeling tired)
  • Nausea (feeling sick to the stomach)
  • 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).

What causes hepatitis C?

Hepatitis C is caused when blood from an infected person enters the body of an uninfected person. The infection is most often spread when an infected person shares needles or syringes that are used to inject intravenous (IV) drugs. Even people who have used IV 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. Health care workers who accidentally stick themselves with needles used on infected patients are also at risk of getting hepatitis C.

Less common ways of spreading hepatitis C include:

  • Sexual contact with an infected person. Although the risk of getting hepatitis C through sexual intercourse is low, the risk increases for people who have several 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, although the risk is low.
  • 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 who have hepatitis C might also become infected, although this is rare.

Additionally, “baby boomers,” born in the United States between 1945 and 1965, are at increased risk of having hepatitis C. If you are part of this group you should be screened for hepatitis C even in the absence of the risk factors listed above.

How common is hepatitis C?

About 3.2 million people in the U.S. have hepatitis C. Hepatitis C is the leading cause of cirrhosis of the liver and liver cancer. It is the most common reason for liver transplants in the U.S.

How is hepatitis C diagnosed?

Several blood tests may be used to test for hepatitis C. 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 found, that means the person was exposed to hepatitis C at some point. 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 first antibody test is negative, a person should be tested again within six months.

A person with hepatitis C may have to have a liver biopsy or liver scan (fibroscan) to tell if the liver is damaged, and how much damage has occurred.

How is hepatitis C treated?

Several drugs are available to treat hepatitis C. The aim of treatment is to reduce the amount of the virus in the blood to a level where it can’t be found. The type and length of treatment may vary. Some hepatitis strains do not respond to antiviral medications as well as others. Some medications may not be suitable for all patients with hepatitis C, because of the side effects or the patient’s other medical conditions.

Drugs to treat hepatitis C today include:

  • Sofosbuvir (Sovaldi®) – tablet taken once a day
  • Ledipasvir/sofosbuvir (Harvoni®) – pill taken once a day for 12 to 24 weeks, depending on how serious the disease is
  • Ribavirin (CoPegus®, Rebetol®, Ribasphere®, Virazole®) – tablet taken twice a day. Ribavirin may cause birth defects, so pregnant women should not take them. Patients should be monitored by their doctors when using these drugs.
  • Simeprevir (Olysio®) – capsule taken once a day with peginterferon alfa and ribavirin Combination of parita previr/ombitasvir/ritonavir/dasabuvir (Viekira Pak)

Can hepatitis C be prevented?

Unfortunately, no vaccine against hepatitis C is currently commercially 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 kept away from school, work, or other social settings because they have hepatitis C.

Here are some precautions that may prevent the spread of hepatitis C:

  • Do not share personal care items, such as toothbrushes or razors, with others.
  • Practice safe sex by using condoms.
  • Don’t share needles or syringes.
  • Wear gloves when handling another person’s blood.
  • Use 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. As noted above, the Centers for Disease Control recommends that Americans born between 1945 and 1965 be screened at least once for the disease.

What is the prognosis (outlook) for someone who has 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:

  • Exercise regularly.
  • Eat balanced, nutritious meals.
  • Limit how much alcohol they drink.
  • Check with a doctor before taking over-the-counter medications, such as acetaminophen.

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 5/22/2015...#15664

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