Definition

Hepatitis C is an infection of the liver with the hepatitis C virus (HCV).

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 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

Symptoms

Most people with hepatitis C do not have symptoms. Over time, the disease can cause serious liver damage.

Symptoms may include:

• Fatigue
• Loss of appetite
• Yellowing of the eyes and skin
• Darker colored urine
• Loose, light, or chalky colored stools
• Abdominal pain
• Aches and pains
• Itching
• Rash
• 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

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

Your bodily fluids and tissues may be tested. This can be done with:

• Blood tests
• Liver biopsy

Your liver function may be evaluated. This can be done with liver function studies.

Images may be needed of your liver. This can be done with an ultrasound.

Treatment

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

• Medication to boost the immune system
• Antiviral medications

These medications 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 illegal 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.
• Go to regular check ups and get tested for hepatitis C and other STDs as advised.

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.

Hepatitis Foundation International http://www.hepfi.org

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

Hepatitis C. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed
Updated September 25, 2014. Accessed September 30, 2014

Hepatitis C information for the public. Centers for Disease Control and Prevention website. Available at:
http://www.cdc.gov/hepatitis/C/index.htm
Updated May 6, 2014. Accessed September 30, 2014.

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 September 11, 2014. Accessed September 30, 2014.

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 September 30, 2014.

What I need to know about hepatitis C. National Digestive Diseases Information Clearinghouse website. Available at:
http://digestive.niddk.nih.gov/ddiseases/pubs/hepc_ez/
Published April 2009. Updated December 19, 2012. Accessed September 30, 2014.

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 September 30, 2014.

10/8/2014 DynaMed’s Systematic Literature Surveillance
http://www.ebscohost.com/dynamed:
British Association of Sexual Health and HIV (BASHH) recommendations on testing for sexually transmitted infections in men who have sex with men. Available at: http://www.bashh.org/documents/BASHH%20Recommendations%20for%20testing%20for%20STIs%20in%20MSM%20-%20FINAL.pdf. Updated 2014. Accessed October 8, 2014.