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.
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.
