Chronic hepatitis C infection is caused by the hepatitis C virus (HCV). As the virus enters the body, it causes an infection in the liver. Over time, the infection can scar the liver and prevent it from working normally.

According to the Centers for Disease Control and Prevention (CDC), around 2.4 million people in the United States were estimated to have chronic hepatitis C between 2013 and 2016.

Many people with chronic hepatitis C don’t even know they have it.

Hepatitis C is a manageable condition, but it can be fatal if it isn’t treated and you develop complications. There’s currently a vaccine for hepatitis A and hepatitis B but not for hepatitis C.

Chronic hepatitis C is often difficult to diagnose because most people have no early symptoms.

Early symptoms can include:

  • fatigue
  • muscle aches
  • loss of appetite

Most symptoms of chronic hepatitis C don’t appear until cirrhosis (severe scarring of the liver) develops and the liver begins to fail. These symptoms can include:

  • weakness
  • weight loss
  • blood clotting problems

Fluid can sometimes collect in the abdomen. Jaundice, or yellowing of the skin, only appears in people with advanced cirrhosis.

Hepatitis C can be passed from person to person. Most people with HCV get it through direct contact with blood containing the virus.

People with hepatitis C can pass on the virus to others by sharing needles and syringes. Hepatitis C is easily transmitted among people who use intravenous drugs.

It’s also possible, but much less common, to acquire the HCV by:

  • sharing a razor with a person who has the virus
  • sharing a toothbrush with a person who has the virus at the same time that you have bleeding gums
  • having sexual contact with a person who has the virus

The most common treatment for chronic hepatitis C is a combination of highly active antiviral agents known as direct-acting antivirals (DAAs).

These medications target specific components in the HCV replication cycle, preventing further infection and leading to viral clearance.

Examples of DAAs include:

  • elbasvir-grazoprevir (Zepatier)
  • ledipasvir-sofosbuvir (Harvoni)
  • sofosbuvir-velpatasvir (Epclusa)
  • sofosbuvir-velpatasvir-voxilaprevir (Vosevi)

You may need to take these medications for anywhere from 8 to 24 weeks, depending on the health of your liver and your exposure to prior treatments for HCV infection.

Side effects are rare, but may include:

  • fatigue
  • anxiety
  • anemia
  • itching
  • insomnia
  • rash

The only way to confirm a hepatitis C infection is through a blood test.

The most common test is an HCV antibody test. A positive result means you’ve been exposed to the virus, but you may not have an infection.

To confirm an HCV infection, you must undergo an HCV viral load test to check for genetic material (RNA). Your doctor can use this test to confirm whether you’re carrying the virus in your body.

Your doctor can also order a third test to check which type of hepatitis C virus you have. There are seven different genotypes of hepatitis C. Treatment for each type is slightly different.

Cirrhosis is the most common complication of hepatitis C. Less common complications of hepatitis C include liver failure and cancer.

According to a 2017 study, 23.9 percent of people who registered for liver transplants and 27.2 percent of people who received liver transplants in 2015 did so because they’d developed hepatocellular carcinoma, the most common liver cancer.

This made hepatocellular carcinoma the leading diagnosis for people seeking liver transplants. Hepatocellular carcinoma is associated with conditions including hepatitis B and hepatitis C.

For liver transplant registrants with HCV, the ratio of people who had hepatocellular carcinoma to people who didn’t increased by 5.6 times from 2004 to 2015.

Receiving a liver transplant won’t get rid of an active HCV infection. However, with the introduction of DAAs, there are many options for treatment and cure of HCV infection after receiving a transplant.

Acute and chronic hepatitis C are caused by the same virus.

Acute hepatitis C develops after initial infection with the HCV. This stage can last up to 6 months. Many people have no symptoms during the acute stage and never find out that they have the infection.

According to the CDC, over half of people with acute hepatitis C develop chronic hepatitis C.

The World Health Organization (WHO) states that 15 to 45 percent of people with acute hepatitis C spontaneously clear the virus within 6 months. This means that the virus goes away even though it hasn’t been treated.

The 55 to 85 percent of people who don’t clear the virus will develop a chronic HCV infection.

Chronic hepatitis C can be managed with medications and even cured, but it’s still a serious condition.

According to the CDC, 5 to 25 percent of people with HCV will develop cirrhosis over the course of 10 to 20 years.

Each year, 1 to 4 percent of the people with cirrhosis will develop hepatocellular carcinoma. Of those people with cirrhosis, 3 to 6 percent will develop hepatic decompensation, or advanced liver disease.

The best thing you can do to protect your liver from hepatitis C is to get an early diagnosis. The earlier you start medication, the higher your chances are for preventing liver failure.

If you have chronic hepatitis C, you should also try to avoid alcohol. Maintaining a moderate weight and avoiding excessive fat in your diet is also important.

After your treatment course is over, you should still have your liver enzymes checked regularly to make sure your liver is healthy.