Hepatitis C basics

Hepatitis C is an infection caused by the hepatitis C virus (HCV) that causes inflammation of the liver. The illness can be mild or it can become chronic. The main method of transmission is contact with blood that contains HCV. Diagnosis is made through blood testing.

Hepatitis C can be successfully treated with antiviral medications, but chronic hepatitis C can severely damage the liver over time. Currently, there’s no vaccination for hepatitis C.

There are five main types of hepatitis virus. They all attack the liver, but there are distinct differences.

Hepatitis C (HCV)

HCV, one of the more serious types of hepatitis, spreads through exposure to blood that contains the virus. Sharing needles can spread HCV.

Contaminated medical products during transfusions or other medical procedures can also transmit HCV. However, it’s rarely contracted this way in the United States due to strict screening protocols.

Rarely, HCV can be transmitted through sexual contact. HCV can be short-term (acute) or long-term (chronic). There’s currently no vaccine to prevent HCV.

Hepatitis A (HAV)

HAV can be found in the feces of those with the virus. It usually spreads through contaminated food or water. It may also be transmitted through sexual contact. It’s fairly common in areas with poor sanitation.

Most of the time, illness caused by HAV is mild. It can become life-threatening, but this is rare. It’s an acute infection that doesn’t become chronic.

There are often no symptoms of HAV, so the number of cases may be underreported. In the United States, there were about 4,000 new cases in 2016, according to the Centers for Disease Control and Prevention (CDC). Vaccination can prevent HAV.

Hepatitis B (HBV)

HBV is spread through body fluids that contain the virus, including blood and semen. It can be transmitted from mother to baby during childbirth. Shared needles and contaminated medical supplies can also transmit HBV.

The CDC estimates that 800,000 to 2.2 million people in the United States have chronic HBV. There’s a vaccine to help prevent it.

Hepatitis D (HDV)

You can only get HDV if you already have HBV. The HBV vaccine protects you from HDV infection.

Hepatitis E (HEV)

HEV is transmitted via contaminated food or water. It’s quite common in areas where sanitization is a problem. There’s a vaccine to prevent HEV, but according to the World Health Organization (WHO), it’s not yet widely available.

According to the CDC, in 2016 there were about 3,000 reported cases of acute HCV. The CDC estimates the actual number of acute HCV cases to be 41,000. Approximately 3.5 million people in the United States are living with chronic HCV.

HCV can be found throughout the world. Regions with the highest rates of HCV include Central and East Asia and Northern Africa. According to the WHO, types C and B cause chronic illness for hundreds of millions of people around the world.

According to the WHO:

  • 15 to 45 percent of people infected with HCV get better within six months without ever receiving treatment.
  • Many people are unaware they’re infected.
  • 55 to 85 percent will develop chronic HCV infection.
  • For people with chronic HCV, the chance of developing cirrhosis of the liver is 15 to 30 percent within 20 years.
  • 71 million people around the world are living with chronic HCV.
  • Treatment with antiviral medications can cure HCV in many cases, but in some parts of the world, access to necessary medical care is lacking.
  • Antiviral treatment can reduce risk for cirrhosis of the liver and liver cancer.
  • Antiviral treatment works for over 95 percent of people treated.
  • 350,000 to 500,000 people die from HCV-related complications each year.

Some groups of people have an increased risk for HCV. Certain behaviors can also increase the risk of developing HCV. Groups and behaviors with increased risks include those:

  • who share contaminated needles
  • who have received contaminated blood products (since new screening procedures were implemented in 1992, this is a rare occurrence in the United States)
  • who get body piercings or tattoos with instruments that have not been properly sterilized
  • who work in healthcare and may be accidentally stuck with contaminated needles
  • living with HIV
  • newborns whose mothers are HCV-positive

It happens infrequently, but it’s also possible to transmit HCV through sexual contact or sharing personal items like razors or toothbrushes if they touch blood.

It’s possible to have HCV and not know it. According to the CDC, 70 to 80 percent of people with acute HCV don’t show symptoms. You can be infected for years before the first symptoms appear, or you can begin to show symptoms between one and three months after infection.

Symptoms can include:

  • yellowing skin and eyes
  • dark urine
  • light-colored stool
  • nausea, vomiting, abdominal pain, and discomfort
  • loss of appetite
  • extreme fatigue

Among those infected with HCV, 75 to 85 percent will go on to develop chronic illness. According to CDC, of those with chronic HCV:

  • 60 to 70 percent will develop chronic liver disease
  • 5 to 20 percent will develop cirrhosis of the liver in 20 to 30 years
  • 1 to 5 percent will die from cirrhosis or liver cancer

In about 15 to 25 percent of cases, acute HCV infection clears up without treatment. It’s unclear why this happens.

Early treatment can lower your risk for developing chronic HCV. Antiviral medications work to eradicate the virus. You’ll need to take them for several months.

If you have HCV, you should see your doctor regularly so they can monitor your condition. Blood tests will help your doctor assess the health of your liver over time.

You can help keep your liver healthy by avoiding alcohol. Some medications — even those sold over the counter — can damage your liver. You should check with your doctor before taking medication or dietary supplements. Ask your doctor if you should be vaccinated for hepatitis A and B.

You should also take care to lower your chances of transmitting HCV to others:

  • Keep cuts and scrapes covered.
  • Don’t share personal items like your toothbrush or nail clippers.
  • Don’t donate blood or semen.
  • Tell all your healthcare providers that you have HCV before they treat you.

If you have severe liver damage, you may need a liver transplant. However, this isn’t a cure. HCV in your blood can attack your new liver, so you’ll still need antiviral medication.

HCV can be transmitted from mother to baby during birth, though it’s rare. It’s much more likely to be transmitted this way if the mother also has HIV. About 4 out of every 100 babies born to an HCV-positive mother will contract HCV.

Other surprising facts:

  • 25 percent of people with HIV also have HCV.
  • 2 to 10 percent of people with HCV also have HBV.
  • HCV tends to progress faster in people with HIV.
  • HCV is one of the top causes of liver disease, liver transplants, and the leading cause of death from liver disease.
  • About 75 percent of adults with HCV are baby boomers.
  • Chronic liver disease, which is often due to HCV, is a leading cause of death for African-Americans.
  • Rates of chronic HCV are higher for African-Americans than for people of other ethnicities.
  • HCV is not transmitted through coughing, sneezing, or being in close proximity to someone with HCV.
  • HCV can’t be transmitted through breast milk.