Hepatitis C

Hepatitis C

What Is Hepatitis C (HCV)?

Hepatitis C (HCV) is a virus that causes inflammation of the liver. It is a member of the family of viruses that include hepatitis A and hepatitis B. The viruses behave differently and have different modes of transmission. Hepatitis C can cause serious liver damage, liver failure, liver cancer, and even death.

How Is Hepatitis C Transmitted?

Hepatitis C is a blood-borne illness, meaning it is transmitted via contact with infected blood. Usually the virus enters the body through a puncture wound on the skin. The most common way hepatitis C is transmitted is via injection drug use. Sharing dirty needles with someone who is infected can transmit hepatitis C. Health care professionals may contract the virus via needlestick injury. Prior to 1992, the U.S. blood supply was not screened the way it is today, so some people contracted hepatitis C from infected blood transfusions. Rarely, babies born to hepatitis C-infected mothers acquire the virus. Hepatitis C can also be spread by having sex with an infected person or sharing personal items (for example, a razor or toothbrush) with someone who has the virus, but these cases are rare.

How Common Is Hepatitis C?

About 3.2 million people in the U.S. currently live with chronic hepatitis C infection. The virus is most common in baby boomers who represent 75% of infected adults. The rates of hepatitis C were the highest in the 1970s and 1980s, the time when many baby boomers were likely infected. Many people who have hepatitis C don't know they have it because the virus may not produce symptoms until decades after infection.

What Are the Signs and Symptoms of Hepatitis C?

About 70% to 80% of people with hepatitis C infection do not have any symptoms, especially in the early stages. In these people, symptoms may develop years, even decades later, when liver damage occurs. Others develop symptoms between 2 weeks to 6 months after infection. The average time to develop symptoms is 6 to 7 weeks after acquiring the virus. Those newly infected with hepatitis C may experience mild-to-severe fever, fatigue, abdominal pain, loss of appetite, nausea, vomiting, joint pain, dark urine, clay-colored stool, and yellowing of the skin (jaundice). A person who has hepatitis C infection but isn't exhibiting any symptoms can still pass the virus on to others.

• Acute vs. Chronic Hepatitis Infection

  Acute hepatitis C infection refers to symptoms that appear within 6 months of newly acquiring the virus. About 20% to 30% of those who acquire hepatitis C experience acute illness. After this, the body either clears the virus or goes on to develop chronic infection. Chronic hepatitis C infection refers to long-lasting infection. The majority of people who have acute hepatitis C infection (75% to 85%) go on to develop the chronic form of the illness.
  

• How Is Hepatitis C Diagnosed?

  Hepatitis C infection is diagnosed with several blood tests. The hepatitis C antibody test checks for antibodies (immune particles) that fight the virus. A "non-reactive" result means that antibodies to the virus are not detected. A "reactive" result means antibodies to the virus are present, but the test is unable to indicate whether the infection is current or in the past. Another blood test assessing the presence of hepatitis C genetic material (HCV RNA test) is available. The results of this test can help doctors determine whether hepatitis C infection is current or not. Additional blood tests can be used to determine the amount of virus in the body, known as a titer.
  
  When someone has confirmed hepatitis C infection, the doctor will order more tests to assess the degree of liver damage. A liver biopsy may be performed. There are several different strains of hepatitis C virus that respond to different treatments. For this reason, the doctor will order a test to determine the genotype(s) of the hepatitis C infection to help determine the course of treatment.

• Potential Complications of Hepatitis C

  Chronic hepatitis C infection is a long-lasting illness with potentially serious complications. About 75% to 85% of those with acute hepatitis C infection go on to develop chronic illness. Of those in the chronic illness group, mo
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  re than two-thirds will develop liver disease. Up to 20% will develop cirrhosis, or scarring of the liver, within 20 to 30 years. Cirrhosis affects liver function and causes elevated blood liver enzymes. Up to 5% of people with chronic hepatitis C infection will die from liver cancer or cirrhosis. Chronic hepatitis C infection is the most common reason for liver transplantation in the U.S.

• What Is the Treatment for Hepatitis C?

  Treatment for hepatitis C is available. The course of treatment depends on whether the infection is acute or chronic, the strain (genotype) of the virus, how much virus is in the body (viral load), the degree of liver damage, response to previous treatment, and the health of the patient. Hepatitis C treatment is highly individualized, so it's important to be under the care of a doctor with expertise in this area. Medications used to treat hepatitis C include interferon (Infergen, Roferon, Intron A), peglyated interferon (Pegasys, Pegintron), ribavirin (CoPegus, Rebetol), boceprevir (Victrelis), telaprevir (Incivek), simprevir (Olysio), and sofosbuvir (Sovaldi). The goal of treatment is to achieve sustained virologic response (SVR), which means there is no detectable virus in the blood 6 months after treatment. While it's not a cure, achieving SVR is the next best thing. Many people with hepatitis C infection can achieve SVR with treatment.

• Is Hepatitis C Curable?

  About 15% to 25% of people who are infected with the hepatitis C infection clear the virus on their own. Scientists are still trying to determine why some people clear hepatitis C infection and others go on to develop symptoms. There is no cure for an active or chronic hepatitis C infection, but sustained virologic response (SVR) - which means there is no detectable virus in the blood 6 months after treatment - is the next best thing. Hepatitis C infection rarely recurs in those who have achieved SVR.