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Hepatitis C

Definition

Hepatitis C is an infection of the liver. The hepatitis C virus (HCV) causes it.

Hepatitis
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Causes

The hepatitis C virus is spread through contact with the blood of an infected person.

A woman with hepatitis can pass the virus on to her baby during birth. The hepatitis C virus is not spread through food or water.

Risk Factors

Factors that increase your chance of this infection:

  • Injecting illicit drugs, especially with shared needles
  • Receiving a blood transfusion before 1992—this risk is very low in the United States.
  • Receiving blood clotting products before 1987
  • Receiving an HCV-infected organ transplant
  • Long-term kidney dialysis treatment
  • Sharing toothbrushes, razors, nail clippers, or other personal hygiene items that have HCV-infected blood on them
  • Being accidentally stuck by an HCV-infected needle—a concern for healthcare workers
  • Frequent contact with HCV-infected people—a concern for healthcare workers
  • Tattooing
  • Body piercing
  • Having sex with partners who have hepatitis C or other sexually transmitted diseases—this is most common in men who have sex with men.

Symptoms

Eighty percent of people with hepatitis C have no symptoms. Over time, the disease can cause serious liver damage.

Symptoms may include:

  • Fatigue
  • Loss of appetite
  • Jaundice (yellowing of the eyes and skin)
  • Darker colored urine
  • Loose, light, or chalky colored stools
  • Abdominal pain
  • Aches and pains
  • Itching
  • Hives
  • Joint pain
  • Cigarette smokers may suddenly dislike the taste of cigarettes
  • Nausea
  • Vomiting

Chronic hepatitis C may cause some of the above symptoms, as well as:

  • Weakness
  • Severe fatigue
  • Loss of appetite

Serious complications of hepatitis C include:

  • Chronic infection that will lead to cirrhosis (scarring) and progressive liver failure
  • Increased risk of liver cancer

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. You will also discuss your risk factors.

Tests may include:

  • Blood tests—to look for hepatitis C antibodies or genetic material from the virus (antibodies are proteins that your body has made to fight the hepatitis C virus)
  • Liver function studies— to initially determine and follow how well your liver is functioning
  • Ultrasound of the liver—to assess liver damage
  • Liver biopsy —removal of a sample of liver tissue to be examined

Treatment

Hepatitis C is usually treated with combined therapy, consisting of:

  • Interferon—given by injection
  • Ribavirin —given orally
  • Protease inhibitor
  • Nucleotide analog inhibitor—to treat chronic hepatitis C

These medicines can cause difficult side effects. They also have limited success rates.

You will be advised to stop drinking alcohol and smoking, which can further damage your liver, especially when undergoing treatment. If you have problems stopping alcohol, your doctor can refer you to counseling or a treatment program. There are several ways to successfully quit smoking.

In unsuccessful cases, chronic hepatitis C can cause cirrhosis and serious liver damage. A liver transplant may be needed, although it does not typically cure hepatitis C.

Prevention

To prevent becoming infected with hepatitis C:

  • Do not inject illicit drugs. Shared needles have the highest risk. Seek help to stop using drugs .
  • Do not have sex with partners who have sexually transmitted diseases (STDs).
  • Practice safe sex (using latex condoms ) or abstain from sex.
  • Limit your number of sexual partners.
  • Do not share personal items that might have blood on them, such as:
    • Razors
    • Toothbrushes
    • Manicuring tools
    • Pierced earrings
  • Avoid handling items that may be contaminated by HCV-infected blood.
  • Donate your own blood before elective surgery to be used if you need a blood transfusion.

To prevent spreading hepatitis C to others if you are infected:

  • Tell your dentist and physician before receiving check-ups or treatment.
  • Get both a hepatitis A and hepatitis B vaccination.
  • Do not donate blood or organs for transplant.

Revision Information

  • American Liver Foundation

    http://www.liverfoundation.org

  • Hepatitis Foundation International

    http://www.hepfi.org

  • Canadian Liver Foundation

    http://www.liver.ca

  • Health Canada

    http://www.hc-sc.gc.ca

  • Chang MH, Gordon LA, Fung HB. Boceprevir: A protease inhibitor for the treatment of hepatitis C. Clin Ther. 2012 Sep 10. pii: S0149-2918(12)00490-0. doi: 10.1016/j.clinthera.2012.08.009. [Epub ahead of print]

  • Hepatitis C. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/hepatitis/HCV/index.htm. Updated March 14, 2011. Accessed October 15, 2012.

  • Hepatitis C. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. September 10, 2012. Accessed October 15, 2012.

  • Sexual transmission of hepatitis C virus among HIV-infected men who have sex with men—New York City, 2005-2010. MMWR Morb Mortal Wkly Rep. 2011 Jul 22;60:945-50.

  • Sexually transmitted diseases. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/std/default.htm. Updated August 31, 2012. Accessed October 15, 2012.

  • What is a blood transfusion? National Heart Lung and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/bt/. Updated January 30, 2012. Accessed October 15, 2012.

  • What I need to know about hepatitis C. National Digestive Diseases Information Clearinghouse website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/hepc%5Fez/. Published April 2009. Updated May 10, 2012. Accessed October 15, 2012.

  • 12/9/2013 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: US Food & Drug Administration. FDA news release: FDA approves new treatment for hepatitis C virus. Food & Drug Administration website. Published November 22, 2013. Accessed December 9, 2013.

  • 4/29/2014 12/9/2013 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: American Association for the Study of Liver Diseases/Infectious Diseases Society of America (AASLD/IDSA) recommendations on testing, managing, and treating hepatitis C. Available at: http://www.hcvguidelines.org/fullreport. Updated March 21, 2014. Accessed April 29, 2014.

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