The hepatitis C virus (HCV) is a liver disease caused by a viral infection. If left untreated, the virus can lead to serious liver damage.
HCV is a bloodborne disease, meaning it’s transmitted from person to person through contact with blood. The most common way people contract the virus is from sharing needles used to prepare or inject drugs.
Before 1992, blood transfusions were a common cause of HCV transmission. Since then, stricter screenings of the blood supply have greatly reduced this risk of transmission.
The majority of HCV cases are chronic (or long-term). This means they’ll persist until treatment knocks out the virus completely. However, cure rates for chronic HCV are improving.
Acute (or short-term) HCV appears much sooner with obvious symptoms. Unlike chronic HCV, the acute version of the illness is more responsive to traditional treatments. However, because new treatments are so effective and well tolerated, traditional treatments are not recommended.
The new preferred treatment method for HCV involves watchful waiting to see if acute HCV resolves without treatment. This occurs in up to 25 percent of acute HCV cases. If the virus progresses to chronic HCV, doctors will administer new drugs called direct-acting antivirals.
One of the challenges of HCV is that it can take months before the virus is discovered through testing. That’s because the incubation period for HCV varies greatly from person to person.
Incubation refers to the time between your first contact with the virus and the first signs of the disease.
Unlike the flu virus, which has an incubation period of less than a week, incubation for acute HCV can take between 14 to 180 days. The hepatitis C infection is considered chronic after 180 days.
The incubation period of HCV differs from that of other types of hepatitis. The incubation period for hepatitis A (HAV) is 15 to 50 days. The incubation period for hepatitis B (HBV) is 45 to 160 days.
Part of the reason for the differences in incubation periods may be the nature of the diseases and the way they’re transmitted.
HAV, for example, is transmitted through the ingestion of fecal matter. A microscopic bit of fecal matter can be transmitted through close contact or sexual contact with an infected person. It can also be transmitted through the consumption of food or beverages that are contaminated.
HBV travels through contact with bodily fluids, including blood and semen. It can be transmitted by sharing needles or having sexual contact with a person who has the virus. A baby born to a mother living with HBV is also at a high risk of contracting the virus.
Symptoms of hepatitis C
A small percentage of people with HCV develop noticeable symptoms within a few months after incubation. These include:
- dark urine
- muscle pain
- abdominal pain
- itchiness of the skin
If the virus remains undetected and untreated, those symptoms plus others are more likely to appear years after incubation. Other signs and symptoms include:
- fluid retention in the abdomen
- swelling in the legs
- bleeding problems
- bruising problems
- weight loss
- mental confusion
Unfortunately, by the time these signs appear, liver damage may be severe. That’s why it’s important to get screened for hepatitis C as soon as possible.
The drug interferon has long been the primary treatment for HCV. It requires several injections for up to a year. Interferon also tends to produce flu-like side effects. An oral drug, ribavirin, was also available to treat HCV, but it had to be taken along with interferon injections.
Newer oral medications are proving to be very effective at treating HCV and have replaced interferon. Among them is sofosbuvir (Sovaldi), which doesn’t require interferon injections to be effective.
Additional drugs for this condition have been approved by the U.S. Food and Drug Administration (FDA) since that time. This includes:
- sofosbuvir and ledipasvir (Harvoni)
- ombitasvir, paritaprevir, ritonavir, and dasabuvir (Viekira Pak)
- simeprevir (Olysio), which is to be used in combination with sofosbuvir (Sovaldi)
- daclatasvir (Daklinza), which is also used in combination with sofosbuvir (Sovaldi)
- ombitasvir, paritaprevir, and ritonavir (Technivie)
- sofosbuvir and velpatasvir (Epclusa)
- sofosbuvir, velpatasvir, and voxilaprevir (Vosevi)
- glecaprevir and pibrentasvir (Mavyret)
- elbasvir and grazoprevir (Zepatier)
How to prevent hepatitis C
Without treatment, HCV can lead to cirrhosis of the liver and even liver failure. But it’s a preventable illness. Here are three ways to prevent getting hepatitis C:
- If you have a history of illicit drug use, get help in trying to quit. Avoiding contact with needles used by others is the biggest single step you can take to prevent infection or reinfection.
- If you’re a healthcare worker, always practice universal precautions when handling used needles, syringes, and blades.
- Avoid getting a tattoo or piecing in an unregulated setting, as any infected needle can transmit the virus.
When to see a doctor
You should get tested for HCV if:
- you think there’s any chance you may have been exposed to the virus
- you were born between 1945 and 1965
- you have used injected drugs, even if it was a long time ago
- you’re HIV-positive
- you received a blood transfusion or organ transplant before July 1992
This is especially important because you may have the virus without any obvious symptoms. The long incubation period for HCV can make it difficult to tell if you have the virus.
Talk with your doctor about getting tested, especially if you have symptoms. A simple blood test can screen you for hepatitis C and ensure you get proper treatment if needed.