According to the Centers for Disease Control and Prevention (CDC), about 2.2 million adults in the United States have hepatitis C. However, thanks to newer antiviral medications, hepatitis C is highly curable if treated, so it’s important to be tested if you’re at risk. Here’s what you should know about this viral infection, including its symptoms, how it’s transmitted and its treatments.
Hepatitis C is a viral infection that affects the liver, a vital organ that filters blood, fights infections and processes nutrients. The infection causes the liver to become inflamed.
Of all bloodborne chronic infections, hepatitis C is the most common in the U.S., according to the U.S. Food and Drug Administration (FDA).
In some people, hepatitis C is a short-term illness and lasts only a few weeks.
However, in more than half of those infected with the hepatitis C virus, it may lead to a long-term, chronic condition, according to the CDC. If not treated, chronic hepatitis C may be life-threatening, causing health problems such as liver damage, liver failure, cirrhosis (scarring of the liver) and liver cancer.
You can get hepatitis C when you are exposed to the blood of someone who is infected with it. Most of the time, people become infected when they share needles, syringes or other paraphernalia that they use to prepare and inject drugs.
Hepatitis C transmission and other ways of becoming infected include:
Exposure during a medical procedure: It is rare, but infection is possible should your healthcare provider not take the precautions needed to prevent the spread of bloodborne infections when drawing blood or injecting you for some other reason.
During blood transfusions or organ transplants: Since the early 1990s, the blood supply is well screened for hepatitis C, so the risk of exposure to hepatitis C from blood transfusions or organ transplants is extremely low. However, it is still possible.
Sex with someone who is infected: This too is rare, but it could happen. It is most likely to occur when men have sex with other men. Also, the risk is greater for people who have multiple sexual partners, engage in sex that is rough or who are infected with HIV.
During birth: Babies born to mothers who have hepatitis C may get it from them. According to the CDC, about 6% of babies born to infected mothers get it. The risk is higher if mom has both HIV and hepatitis C.
Sharing personal items: You may get infected if you use personal items from someone who is infected that has their blood or blood products on it in amounts too small to see. Such items include nail clippers, razors, toothbrushes and glucose monitors.
Getting a tattoo or body piercing: The virus may spread when getting tattoos or body piercings, especially in facilities that are not licensed or if anyone uses instruments that haven’t been sterilized properly. Consider the risks if you are interested in getting a tattoo or body piercing, and look for places that follow good health practices.
Hepatitis C is NOT spread by:
Using someone’s silverware or drinking glasses
Hugging and kissing
Holding hands
Coughing or sneezing
Mosquito or other insect bites
Remember, people with hepatitis C may be symptom-free. However, if they are infected, they may still spread the virus to another person if blood is exposed. The New York State Department of Health notes that most people with acute hepatitis C are contagious for one or more weeks before they notice symptoms.
Symptoms of acute hepatitis C usually develop two to 12 weeks after being exposed to the virus, the CDC says. Symptoms may include:
Yellow skin or eyes
Lack of appetite
Stomach pain
Stomach upset
Urine that is dark in color
Light-colored stools
Joint pain
Fatigue
Some people with chronic hepatitis C don’t have symptoms and don’t feel sick until their disease is advanced.
People with chronic hepatitis C also may experience symptoms such as chronic fatigue and depression. They might only find out that they have hepatitis C when they go to donate blood or they undergo blood testing for some other reason.
People who have been exposed to the hepatitis C virus should get tested because the disease is highly curable if it is treated.
According to the World Health Organization, newer direct-acting antiviral medications may cure as many as 95% of people with hepatitis C. However, throughout the world, many do not have access to diagnosis and treatment.
A small number of people with acute hepatitis C will clear it from their bodies without any treatment. More research is needed to explain why this happens.
Most people need treatment. Antiviral medicines are used to treat acute and chronic hepatitis C in patients older than three years old. The newer medicines are given as a pill for eight to 12 weeks.
The goal of the medication is to have no hepatitis C virus in the body after 12 weeks from the end of treatment. The newer antiviral medicines have fewer side effects and are taken for less time than earlier medications, which were given as injections.
The medications for hepatitis C that have been approved by the FDA include:
Elbasvir-grazoprevir (Zepatier)
Glecaprevir-pibrentasvir (Mavyret)
Ledipasvir-sofosbuvir (Harvoni)
Ribavirin (Copegus, Moderiba, Ribasphere)
Sofosbuvir (Sovaldi)
Sofosbuvir-velpatasvir (Epclusa)
Sofosbuvir-velpatasvir-Voxilaprevir (Vosevi)
A liver transplant may be an option for those whose hepatitis C has caused serious liver damage. Livers may come from living donors who donate a part of their liver or from a cadaver. Transplant is a surgical procedure where the damaged liver is removed and replaced with a new organ.
A liver transplant may not cure hepatitis C, and patients may have to be on antiviral medicines afterward to prevent further liver damage. Research has shown that the newer antiviral medicines may cure hepatitis C after a transplant or possibly before, the Mayo Clinic says.
There is a vaccine for hepatitis A and hepatitis B, but there is no vaccine for hepatitis C. However, it is important to get the hepatitis A and B vaccines because these viruses may cause liver damage and worsen hepatitis C.
You can make lifestyle changes that will help you manage hepatitis C. These include:
Eliminating alcohol. Alcohol may damage the liver and speed disease. Stop drinking, even in moderation.
Avoiding liver-damaging medications. Talk to your healthcare provider about all the medicines you take. Certain medications may damage your liver and should be avoided. This includes acetaminophen, especially in higher doses than recommended. Cholesterol-lowering medications known as statins may elevate liver tests when they are started. Some natural products such as chaparral, comfrey tea, kava, skullcap and yohimbe may also be harmful to the liver.
It is equally important that you protect those living with you by making sure they don’t come into contact with your blood.
Keep any wounds you may have covered.
Never let anyone use your toothbrush or razor.
Use condoms during sex.
Don’t give blood or donate body organs or semen.
Treatments may change quickly thanks to ongoing research. Discuss treatment options with your healthcare provider.
It is possible to get hepatitis C more than once. If you inject drugs or receive treatments such as kidney dialysis on a regular basis, have multiple sexual partners or other risk factors, you should be tested for hepatitis C on a regular basis.
Centers for Disease Control and Prevention (CDC): Hepatitis C.
CDC: Q&As for the Public.
New York Department of Health: Hepatitis C.
Mayo Clinic: Hepatitis C.
World Health Organization: Hepatitis C.
U.S. Food and Drug Administration (FDA): Hepatitis C treatments give patients more options.
University of Washington: HCV Medications.
American College of Gastroenterology: Medications and the Liver.