Acute hepatitis C may resolve on its own, while chronic cases have different outcomes depending on the degree of liver damage. Cirrhosis and liver cancer are possible complications that may have a life expectancy of 2–12 years.

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Some people may live with the hepatitis C virus (HCV) without knowing they have it. Hepatitis C, caused by HCV, may damage the liver and cause serious complications.

Sometimes, cases of hepatitis C resolve on their own without treatment. This is called acute hepatitis C. It’s rarely associated with life threatening conditions.

The life expectancy and outlook of chronic hepatitis C may depend on different factors.

HCV is rarely fatal itself. The outlook and life expectancy for people with chronic hepatitis C depend on the existence and severity of complications. It also depends on how well a person responds to early treatment.

Chronic hepatitis C usually has no symptoms. People with chronic hepatitis C may not even know they have it. But once symptoms appear, it may mean complications have developed.

Complications from untreated hepatitis C include cirrhosis (liver scarring) and liver cancer.

The 5-year survival rate for liver cancer is about 22%, while the life expectancy of someone with early-stage cirrhosis is about 9–12 years.

According to the Centers for Disease Control and Prevention (CDC), people with hepatitis C have a 5–25% increased chance of developing cirrhosis within 20 years. Those who develop cirrhosis from HCV have a 1–4% chance of also developing liver cancer.

Hepatitis C is the most common reason for liver transplants. Treating cirrhosis and liver cancer typically requires a liver transplant.

Symptoms or no symptoms?

Chronic hepatitis C usually has no symptoms. People with chronic hepatitis C may not even know they have it. But once symptoms appear, it means that damage to the liver has already begun.

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Cases of hepatitis C in the United States

The CDC reports that in 2018, a total of 15,713 U.S. death certificates had hepatitis C as an underlying or contributing cause of death. This is likely lower than the actual numbers since many infections go undocumented.

Studies show that baby boomers (born between 1946 and 1964) are more likely than other groups to have been exposed to HCV. Most of them contracted infections between 1970 and 1990 during a peak of new infections.

And since people with an HCV infection might not show symptoms, they may unknowingly transmit the virus to others.

Today, the most common risk factor for hepatitis C in the United States is injection drug use.

Since an HCV infection can show no symptoms, the number of new cases is likely higher than reported, according to the CDC.

Treatment

Chronic hepatitis C is often treatable. It usually involves taking a combination of medications to reduce the viral load to undetectable levels. These drugs work to keep the virus from multiplying and eventually kill off the virus.

Drug regimens for hepatitis C are always changing and getting better. Your healthcare team may know more about the latest treatments available at the moment.

After treatment, your healthcare professional may want to ensure the virus is gone. Being clear of the virus, also called sustained virologic response (SVR), means it likely won’t come back. But reinfection is still possible.

In the United States, older drug regimens included interferon injection and ribavirin, an oral medication. Newer oral medications called direct-acting antivirals (DAAs) may be more effective and better tolerated by most people.

More than 90% of cases have a positive outlook after 8–12 weeks of therapy. This depends on the:

  • DAA used
  • HCV genotype
  • viral load
  • severity of liver damage before treatment

It’s important to include routine HCV screening for certain populations to identify infection before severe damage occurs. A delayed diagnosis can affect the treatment’s effectiveness.

Genotype

The outlook of chronic hepatitis C cases also depends on the virus genotype. Genotypes are variations of the virus that have evolved over the years. Some genotypes may be more difficult to treat than others.

Currently, the most common HCV genotypes in the United States are genotypes 1a, 1b, 2, and 3.

In June 2016, the Food and Drug Administration (FDA) approved the combination medication Epclusa (sofosbuvir/velpatasvir). This is the first drug approved to treat six genotypes of hepatitis C.

In 2019, the FDA approved the antiviral drug Mavyret (glecaprevir/pibrentasvir) for an 8-week treatment period for all genotypes. This was 4 weeks shorter than most other treatments and had similar results.

Instead of liver biopsies, newer imaging tests, magnetic resonance elastography (MRE), and transient elastography are now used to measure the stiffness of the liver to determine the extent of the damage.

As of 2020, researchers are still working on a vaccine for hepatitis C. The virus is unique because it has at least 7 distinct forms and 67 subtypes. This variability and immunological challenges are hurdles to vaccine success.

Can you fully recover from hepatitis C?

According to the World Health Organization (WHO), it is possible to recover from hepatitis C and live a healthy life. The prognosis of chronic hepatitis C cases depends on the extent of liver damage, individual responses to treatment, virus genotype, and other personal factors.

Can you drink alcohol if you have hepatitis C?

Although alcohol does not cause hepatitis C, it may cause or worsen liver damage. If you’re living with hepatitis C, which already has a risk of progressing to liver damage, you may want to abstain from drinking alcohol. Asking your healthcare professional about dietary changes, including alcohol intake, may be a good idea.

Is it safe to live with someone with hepatitis C?

Hepatitis C may be spread from person to person, although this is rare, so living in the same household as someone with hepatitis C is considered safe in general.

Hepatitis C may be transmitted by sharing needles and other injection equipment as well as personal objects (like toothbrushes or razors) that come into contact with the blood of a person with the virus.

Transmission of hepatitis C during sexual intercourse, via blood transfusions, and tattoo and body piercing is possible but highly uncommon.

The outlook for hepatitis C depends on different factors, like treatment response, genotypes, and complications.

Drug therapies for chronic hepatitis C can clear the virus, and newer therapies are frequently improving the success rates of these treatments. Overall, the outlook improves with early diagnosis and intervention.