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Hepatitis C

What Is Hepatitis C?

Hepatitis C is an infection of the liver caused by the hepatitis C virus (HCV). It can lead to liver failure, liver cancer, or chronic liver disease (cirrhosis), and is a leading reason for liver transplants in the United States.

Some people with HCV have just a short-term illness because their bodies can get rid of the virus. But most infected people develop a chronic (long-term) infection.

How Do People Get Hepatitis C?

HCV spreads by direct contact with an infected person's blood and other body fluids. This can happen through:

  • sharing drug needles and intranasal (snorting) drug devices
  • getting a tattoo or body piercing with unsterilized tools
  • sexual contact (although this is less common)
  • passing of the infection from a pregnant woman to her unborn child

Children who have hepatitis (heh-puh-TYE-tus) C most often got the infection as newborns from their mothers.

Thanks to blood screening and other health care precautions, the spread of HCV from hemodialysis, blood transfusions, or organ transplants is now rare.

It's also rare, but possible, for someone to get infected by sharing household items that might have had contact with an infected person's blood, such as razors, toothbrushes, or scissors.

Hepatitis C is more common in adults than in children. Infection rates in the United States almost tripled from 2010 to 2015, according to the Centers for Disease Control and Prevention (CDC). Most of these new infections are in young people (20 to 29 years old) who inject drugs — many of whom moved from abusing prescription pain relievers (opioids) to injecting heroin, which often is cheaper and easier to get.

Because women of reproductive age are part of this group, experts worry that more newborns will be at risk for hepatitis C.

How Do Acute Hepatitis C and Chronic Hepatitis C Differ?

Doctors refer to hepatitis C infections as either acute or chronic:

  • Acute hepatitis C is a short-term illness that happens within 6 months of when a person is exposed to the virus.
  • Chronic hepatitis C is when a person still has the virus in their body after 6 months. This means the virus stays in the body and can cause lifelong illness.

What Are the Signs & Symptoms of Hepatitis C?

Hepatitis C can be a "silent but deadly" infection. Most people with an infection have no symptoms. But they can still get health problems decades later and can pass the disease to others.

When symptoms of acute hepatitis C do happen, they can be like those of hepatitis A and hepatitis B and include:

  • jaundice (when the skin and whites of the eyes look yellow)
  • fever
  • nausea, vomiting, and lack of appetite
  • belly pain (on the upper right side)
  • joint pain
  • darker than usual urine (pee) or gray-colored stools

People with chronic hepatitis C might sometimes have vague general symptoms, like feeling very tired or depressed. Most children have no symptoms, and only start to feel some of the acute disease symptoms when they develop advanced liver disease many years later.

What Problems Can Hepatitis C Cause?

Hepatitis C is the most serious type of hepatitis. It's now one of the most common reasons for liver transplants in adults.

Fortunately, medicines can now treat people with hepatitis C and cure them in most cases.

How Is Hepatitis C Diagnosed?

Doctors do a blood test to look for antibodies to HCV. The CDC recommends the diagnostic blood test for:

  • all Americans born between 1945–1965 (baby boomers)
  • anyone who has ever injected drugs
  • patients who received donated blood or organs before 1992
  • people receiving hemodialysis
  • people who have conditions such as HIV or chronic liver disease
  • newborns born to mothers with hepatitis C
  • people exposed to the blood of someone with hepatitis C

How Is Hepatitis C Treated?

Great progress has been made in treating and even curing hepatitis C. Oral medicines now can cure HCV for many people within 3 months. These medicines were very expensive at first, but their prices have come down, a trend that health experts hope will continue as the incidence of HCV rises and increased screening finds more cases.

These medicines successfully cure about 90% of HCV patients. A new oral medicine under development looks promising for the 10% who don't respond to the standard treatment. This new antiviral combination pill is currently under review by the U.S. Food and Drug Administration (FDA).

What Happens After a Hepatitis C Infection?

Anyone who has ever tested positive for hepatitis C cannot be a blood donor.

Health experts caution that people who had hepatitis C due to drug use should get counseling or further treatment to help them overcome their addiction. Otherwise, they could become reinfected.

Can Hepatitis C Be Prevented?

Unfortunately, there's no vaccine to protect against hepatitis C. Prevention means avoiding risky behaviors that can spread HCV, especially injecting drugs.

Reviewed by: Elana Pearl Ben-Joseph, MD
Date reviewed: May 2022