Hepatitis C is one of five types of hepatitis infections and is caused by the hepatitis C virus (HCV). It causes inflammation of the liver. It can be mild, or it can become chronic.

Hepatitis C can be successfully treated with antiviral medications, but chronic hepatitis C can severely damage the liver over time.

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Is hepatitis C curable?

Hepatitis C is curable with treatment. In less than half of cases, an acute HCV infection clears up without treatment. It’s unclear why this happens.

Early treatment can lower your risk for acquiring HCV. Antiviral medications work to eradicate the virus. You’ll need to take them for about 8 to 12 weeks or longer.

If you’ve contracted HCV, you should connect with your doctor regularly, so they can monitor your condition. Your doctor will order blood tests to help them assess the health of your liver over time.

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.

Is hepatitis C an STD/STI?

HCV is primarily transmitted from person to person via blood containing the virus.

It’s also transmittable via sexual activity, especially if blood is involved. This could occur during menstruation or anal sex, which could cause bleeding.

The risk of HCV transmission from sexual activity increases when there are multiple sexual partners who have the condition. Consistent condom or other barrier use can help reduce the likelihood of transmission.

Are there symptoms of hepatitis C?

It’s possible to acquire HCV and not know it. According to the Centers for Disease Control (CDC), many people with an acute HCV infection don’t show symptoms.

You can live with hepatitis C for years before the first symptoms appear, or you can begin to show symptoms between 1 and 3 months after transmission.

Symptoms may include:

  • bleeding or bruising more easily than usual
  • yellowing skin and eyes
  • dark urine
  • light-colored stool
  • nausea, vomiting, abdominal pain, and discomfort
  • loss of appetite
  • extreme fatigue
  • swelling in the legs
  • appearance of spiderlike blood vessels

Among those living with an HCV infection, more than half will develop chronic illness. According to the Centers for Disease Control and Prevention CDC, of those with chronic hepatitis C:

  • 5 to 25 percent will develop cirrhosis within 10 to 20 years
  • 1 to 4 percent have an annual risk for developing hepatocellular carcinoma
  • 3 to 6 percent have an annual risk for hepatic decompensation (deterioration in liver function)

Hepatitis C is one of the top causes of liver disease and liver transplants. It’s the leading cause of death from liver disease.

Does everyone need treatment?

As mentioned, a small number of acute HCV infection cases clear up without treatment. Generally, treatment is recommended for all acute and chronic hepatitis C diagnoses unless otherwise directed by a doctor.

Is there a vaccine for hepatitis C?

Currently, there’s no vaccination for hepatitis C.

Some proof of concept studies are showing promise and could lead to future clinical trials of an HCV vaccine, though more research is needed.

Who is most at risk for hepatitis C?

Due to certain known factors, some people may be at higher risk for contracting HCV and developing hepatitis C.

Known risk factors include:

  • sharing needles
  • receiving contaminated blood products (since new screening procedures were implemented in 1992, this is a rare occurrence in the United States)
  • getting body piercings or tattoos with instruments that have not been properly sterilized
  • working in healthcare where there’s an increased chance of getting accidentally stuck with needles contaminated with HCV
  • having HIV
  • being a newborn whose mother is 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.

How much blood is needed to transmit hepatitis C?

HCV is bloodborne and can be transmitted with a very small amount of blood. The virus is resilient and can survive in open air for days and inside a syringe for even longer.

But since HCV transmission requires blood-to-blood contact, meaning that blood from a person with the virus needs to enter the bloodstream of another person, it’s more difficult for it to pass from items like razors, toothbrushes, and nail clippers.

How is hepatitis C diagnosed?

Diagnosis is made through blood testing. Several types of blood tests can detect HVC including:

  • antibody screening test (or anti-HCV test)
  • qualitative nucleic acid tests to detect the presence of HCV RNA
  • quantitative nucleic acid tests to detect the levels of HCV RNA

Screening tests can take a few days or a few weeks to return results. Rapid screening tests, which can return results within 20 to 30 minutes, are also sometimes available.

Positive antibody tests require a follow-up test to confirm the results. After exposure, antibody tests may not show a positive result for weeks or months.

A nucleic acid test (NAT), on the other hand, can show results within 1 to 2 weeks after exposure to the virus.

The CDC recommends regular testing if a person injects drugs or shares needles. They also recommend testing for those getting maintenance hemodialysis and for anyone who’s pregnant.

Ways the hepatitis C virus is transmitted

Advanced screening has reduced the risk of blood banks transmitting the virus. Prior to 1992, they were the leading cause of transmission. Now that risk is very rare due to more advanced screening processes.

HCV is not transmitted through:

  • coughing
  • sneezing
  • being in proximity to someone with HCV

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 6 out of every 100 babies born to an HCV-positive mother will contract HCV. It’s important to note that HCV can’t be transmitted through breast milk.

The most common methods of HCV transmission include:

  • sharing needles or injecting drugs
  • receiving a tattoo or piercing with nonsterile equipment
  • receiving treatment with nonsterile equipment in a medical or dental setting
  • getting an accidental needle stick while working in a medical setting

Other, less common ways of transmitting HCV include:

  • sharing hygiene items such as razors, toothbrushes, and nail scissors
  • having sexual contact with someone who has HCV
  • being transmitted from mother to baby during pregnancy or labor

Transmission from blood transfusions is very rare where since better screening practices have been added, but it can still happen in some countries.

Here are some ways to lower the chance of transmitting HCV:

  • keeping cuts and scrapes covered
  • avoiding sharing personal items such as toothbrushes or nail clippers
  • talking with all healthcare providers about having hepatitis C before receiving medical care

Can you get hepatitis C more than once?

Having hepatitis C once does not give you immunity, though your chances of developing it again are much lower than if you had never had it.

Achieving an immunological state known as sustained virologic response (SVR) means the HCV infection has been cured and the person is no longer able to transmit the virus to others.

Of those who achieve SVR, approximately 99 percent of people are considered cured after the virus is not detected 12 weeks after treatment. After this time, a recurrence is more likely the result of a new transmission from another source.

If a person is still at risk of contracting HCV after the first transmission due to having known risk factors, regular testing is recommended.

What are the chances of getting hepatitis C sexually?

The chances of acquiring HCV from sexual activity is low.

Certain activities such as sex during menstruation, anal sex, rough sex, and sex with multiple partners, or sex with a partner who has acquired HIV can increase the chance of contracting HCV.

Using condoms or other barrier methods and limiting sexual partners can help reduce the risk.

Where is hepatitis C most common?

According to the CDC, in 2018 there were about 3,621 reported cases of acute HCV infections. The CDC estimates the actual number of acute HCV cases to be 50,300.

Approximately 2.4 million people in the United States were living with chronic hepatitis C in 2016.

HCV can be found throughout the world. Regions with the highest prevalence of HCV infections include Central and East Asia and Northern Africa.

According to the World Health Organization (WHO), both hepatitis C and B cause chronic illness for hundreds of millions of people around the world.

According to WHO:

  • Less than half of people who acquire HCV get better within 6 months without ever receiving treatment.
  • Many people are unaware that they have the virus.
  • 55 to 85 percent will develop chronic hepatitis C.
  • For people with chronic hepatitis C, 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 infections as of 2017.
  • 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 of cirrhosis of the liver and liver cancer.
  • Antiviral treatment works for over 95 percent of people treated.
  • About 399,000 people died from HCV-related complications in 2016.

Is hepatitis C more common than HIV?

Hepatitis C is more common than human immunodeficiency virus (HIV) in the United States, but both are challenging to track due to the number of people who don’t know they have the conditions.

The CDC estimates that 2.4 million Americans are living with hepatitis C as of 2016. Over 1.2 million Americans are living with HIV as of 2018.

According to the CDC, HCV coinfection occurs in between 62 and 80 percent of people with HIV due to known risk factors such as men who have sex with men (MSM) and people who inject drugs.

A review of studies found that those living with HIV were six times more likely to have hepatitis C than people who didn’t have HIV.

Additionally, hepatitis C tends to progress faster in people with HIV.

In most people, HCV can be treated with antivirals and eradicated from the body. In some cases, this virus could go away on its own. But leaving the virus untreated can cause preventable damage to the liver.

For those with known risk factors or who experience any symptoms of hepatitis C, it’s important that they talk with their doctor about the condition.

One way to keep the liver healthy is avoiding alcohol. It’s also important to note that some medications — even those sold over the counter — can damage the liver.

Talk with a doctor before taking medication or dietary supplements and ask if a hepatitis A or B vaccination is needed.