Hepatitis C is a viral infection that can attack and damage the liver. It’s one of the most serious hepatitis viruses, and can lead to various complications including liver transplant. In some cases, it can even lead to death. However, new treatments for hepatitis C over the past few years mean that the virus today is much more manageable than it was in the past. In most cases, hepatitis C is curable, so it’s important to seek treatment early if you may have an infection.

What are the symptoms of hepatitis C?

Every hepatitis C infection begins as an acute infection. It occurs a few weeks after exposure. For many people, this stage of the virus has no symptoms. If you do experience symptoms, they can begin weeks or months after exposure to the virus. Possible symptoms include:

  • fever
  • fatigue
  • nausea
  • vomiting
  • dark urine
  • clay-colored bowel movements
  • joint pain
  • yellow skin

Most cases of acute hepatitis C will develop into a chronic infection. Chronic hepatitis C usually has no symptoms until it begins to cause liver scarring, or cirrhosis, and other liver damage. Over many years, the virus attacks the liver and causes damage. This can lead to liver failure or even death.

Since hepatitis C doesn’t always cause symptoms, the only way to be sure whether you have an infection is to be tested for it. A simple blood screening test can tell your doctor whether you have antibodies to hepatitis C in your blood. The presence of antibodies means you’ve been exposed to hepatitis C. A second test for virus levels will tell your doctor whether you have a hepatitis C infection.

Does everyone need treatment?

The Centers for Disease Control and Prevention (CDC) reports that up to one out of four people who contract the hepatitis C virus will eventually be cured from the condition without treatment. For these people, hepatitis C will be a short-term acute infection that goes away without treatment.

For most people, however, acute hepatitis C will develop into a chronic infection that does require treatment. Since the virus often doesn’t have symptoms until after liver damage has taken place, it’s important to get tested for it if you think you might have been exposed. 

Are there medicines to cure hepatitis C?

In the past, chronic hepatitis C was treated with a combination of ribavirin and interferon. Rather than directly attacking the virus, these drugs worked by strengthening your immune system. The immune system would then kill the virus. The goal of treatment was to rid your body of the virus.

However, since 2011, the Food and Drug Administration has approved many antivirals that attack hepatitis C more directly. These drugs have much better success rates than older treatments. Some of the most recommended treatments for different genotypes of hepatitis C include:

All of these drug combinations are protease inhibitors. This means they prevent the virus from getting the proteins it needs to reproduce. Over a period of time, usually 12 to 24 weeks, this causes the virus to die out and clear from your system.

For all of the protease inhibitor drugs, the goal of hepatitis C treatment is sustained virologic response, or SVR. SVR means that the amount of hepatitis virus in your system is so low that it can’t be detected 12 weeks after you finish treatment. If you achieve SVR after treatment, you can say that your hepatitis C infection is cured.

Is there a way to prevent hepatitis C?

There is currently no vaccine to help protect people from getting hepatitis C. However, there are vaccines for other hepatitis viruses, including hepatitis A and hepatitis B. According to the CDC, researchers are working toward developing a vaccine for hepatitis C as well.

If you are diagnosed with hepatitis C, your doctor may advise you to get vaccinated against hepatitis A and hepatitis B. This is because these viruses can also lead to liver damage and complications during treatment of hepatitis C.

Since you can’t prevent hepatitis C by getting vaccinated, the best prevention is to avoid exposure. Hepatitis C is a bloodborne pathogen, so you can limit your chances of exposure by avoiding risky behavior. This means never sharing needles and practicing proper protocol if you ever need to be exposed to bodily fluids. Hepatitis C is usually not transmitted through sexual contact, but it’s possible. So you can also limit your exposure by using condoms, unless you and your partner are monogamous and have both been recently tested.

Can a transplant cure hepatitis C?

If you develop chronic hepatitis C and it leads to liver cancer or liver failure, you may need a liver transplant. Hepatitis C is one of the most common reasons for liver transplants.

A liver transplant removes a damaged liver and replaces it with a healthy organ. However, the National Digestive Diseases Information Clearinghouse notes that it’s possible for hepatitis C to return even after a transplant. The virus lives in your bloodstream, not your liver, so removing your liver won’t cure the disease. If you have an active infection of hepatitis C, continued damage to your new liver is very likely. However, if you have achieved SVR before the transplant, you are unlikely to develop a second infection.

Are alternative medicines available?

Certain forms of alternative medicine are believed by some to help cure hepatitis C. However, Mayo Clinic reports that there are no research-proven forms of alternative treatment or complementary medicine for hepatitis C.

Milk thistle is an herb commonly suggested to help cure liver disease. But a study published in JAMA found that milk thistle was no more effective than a placebo in treating patients with hepatitis C.

What is the outlook?

According to the National Institutes of Health, it’s definitely possible to have a positive response to treatment of hepatitis C. Depending on the genotype of hepatitis C, approximately 90 percent of people who are treated with protease inhibitors will achieve SVR and be cured of the infection. According to a 2015 study published by Jayne Smith-Palmer, people who achieve SVR have a 1-2 percent relapse rate and a very low likelihood of liver-related mortality.