Hepatitis C is a contagious liver disease that can lead to cirrhosis, liver failure, and liver cancer. Early diagnosis can prevent liver damage, but it can be fatal without treatment. It spreads through blood-to-blood contact.

The hepatitis C virus (HCV) causes hepatitis C. It invades liver cells, causing inflammation, swelling, dysfunction, and eventual organ damage.

Hepatitis C is the most common blood-borne viral infection in the United States, with around 2.4 million people living with the disease. However, many people with the infection do not know that they have it.

A person can transmit the virus to someone else through blood-to-blood contact. According to the Centers for Disease Control and Prevention (CDC), most new cases of hepatitis C occur from contact with used needles or other equipment that people use to prepare or inject drugs. This is often from sharing needles or accidental contact in healthcare settings.

Hepatitis C infections can be acute (short-term) or chronic (long-lasting). When a person has acute hepatitis, symptoms can last for 6 months. However, in more than 50% of cases, an acute infection becomes chronic, meaning the body cannot clear the virus.

New medications can cure chronic hepatitis C, and some researchers believe the infection could become rare in the U.S. by the year 2036. Although there is no vaccine to prevent hepatitis C, people can take steps to reduce their risk of infection.

This article provides an overview of acute and chronic hepatitis C, including their symptoms, causes, and treatments.

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Hepatitis C can range from a mild illness lasting a few weeks to a severe and chronic health condition.

People can have hepatitis C with no symptoms, especially at the acute stage, and may not know they have it. This makes it easier to transmit to others.

Acute hepatitis C

Most people with acute hepatitis C do not develop symptoms. If they do, symptoms usually arise between 2 and 12 weeks after exposure.

People rarely receive a diagnosis of acute hepatitis C as it lacks definitive symptoms. Because of this, doctors often call hepatitis C the silent epidemic.

The acute symptoms are very similar to other viral infections. Symptoms of acute hepatitis C include:

According to the CDC, almost half of people with acute hepatitis C clear the virus from their bodies without treatment and do not develop the chronic condition. Researchers do not know why this happens to some people and not others.

Chronic hepatitis C

Hepatitis C becomes chronic when the body cannot clear the virus. In most cases, chronic hepatitis C does not cause any symptoms or causes general symptoms, such as chronic fatigue or depression. A person may only find out they have the condition during a routine blood test or screening for a blood donation.

Early diagnosis and treatment can prevent liver damage. Left untreated, chronic hepatitis C can lead to:

  • chronic liver disease, which can happen slowly over several decades without any symptoms
  • cirrhosis, or liver scarring
  • liver failure
  • liver cancer

HCV causes hepatitis C. People contract the virus through blood-to-blood contact with contaminated blood. For transmission to occur, blood containing HCV must enter the body of a person without HCV.

A speck of blood, invisible to the naked eye, can carry hundreds of hepatitis C virus particles, and the virus is not easy to kill.

The CDC report the following risk factors for developing hepatitis C:

  • using or having used injectable drugs, which is currently the most common route in the U.S.
  • receiving transfusions or organ transplants before 1992, which is before blood screening became available
  • having exposure to a needle stick, which is most common in people who work in healthcare
  • being born to a mother who has hepatitis C

The CDC offer advice on cleaning syringes if it is not possible to use clean and sterile ones. Although bleach can kill the HCV in syringes, it may not have the same effect on other equipment. Boiling, burning and using alcohol, peroxide, or other common cleaning fluids to wash equipment can reduce the amount of HCV but might not stop a person from contracting the infection.

It is extremely dangerous to inject bleach, disinfectant, or other cleaning products, so people should make sure they rinse the syringe thoroughly. A person should only ever use bleach to clean equipment if new, sterile syringes and equipment are not available.

A person cannot contract the virus from casual contact, breathing, kissing, or sharing food. There is no evidence that mosquito bites can transfer the virus. The risk is low, but people can also contract hepatitis C by:

  • having sexual contact without barrier protection, especially rough or anal sex, which makes blood-to-blood contact more likely
  • sharing items that could have contact with blood, such as toothbrushes or razors
  • having invasive healthcare procedures, such as injections
  • getting a tattoo from an unregulated provider

People who are at risk due to these factors can have screening to rule out HCV.

Yes. Modern treatments can cure hepatitis C in most cases. These treatments involve a combination of antiviral medications taken for 8–24 weeks. However, as many people with HCV do not know they are infected, they may not seek testing and treatment for many years.

Yes, hepatitis C is contagious. Individuals become infected with HCV through blood-to-blood contact with infected blood.

Direct-acting antiviral medicines (DAAs) can cure most cases of chronic hepatitis C and acute hepatitis C. These are modern medicines that the authorities approved in 2013. Most people tolerate the medications, with the most common side effects being a headache and fatigue.

These medications work by targeting specific steps in the HCV life cycle to disrupt the reproduction of viral cells.

DAAs to treat hepatitis C include:

  • elbasvir/grazoprevir (Zepatier)
  • glecaprevir and pibrentasvir (Mavyret)
  • ledipasvir/sofosbuvir (Harvoni)
  • peginterferon alfa-2a (Pegasys)
  • sofosbuvir (Sovaldi)

The choice of medication and duration of treatment depends on the genotype of the virus. Genotype 1a is the most prevalent in the U.S.

Before DAAs became available, the treatment for chronic hepatitis C was lengthy and uncomfortable, with less than ideal cure rates. Today, cure rates are over 90%.

However, new medications can be very costly. Most government and private health insurance prescription drug plans will help provide some coverage for these medications. Some drug companies and other programs can help, too.

Speak with a healthcare professional for advice on paying for hepatitis C treatment.

It is important to note that a person can get hepatitis C more than once. After successful treatment, the person should take steps to prevent another infection.

Doctors can diagnose hepatitis C using blood tests:

  • First, the doctor performs a simple blood test to look for hepatitis C antibodies in the blood. A positive test means that the person has had exposure to the virus, but it does not necessarily prove ongoing infection.
  • If the antibody test is positive, the person may then have a second blood test called a hepatitis C RNA test. This will check whether the virus is still present in the blood.
  • A third blood test — called a genotype test — can determine which type of hepatitis C virus is present.

If the person has had hepatitis C for a long time, a doctor may recommend further tests to look for liver damage, measure the severity of any existing damage, and rule out other causes of damage.

These tests usually involve blood tests and ultrasound scans. Doctors only use a liver biopsy — which involves taking a small sample of liver tissue — when the other tests do not provide enough information.

People can get vaccines to prevent hepatitis A and hepatitis B, but there is currently no vaccine for hepatitis C. To prevent infection, people must avoid exposure to the virus that causes it.

The best way to prevent hepatitis C is to avoid contaminated blood. Using drug treatments such as methadone or buprenorphine reduces the risk because they do not involve injections.

If a person continues to inject, they can reduce their risk of hepatitis C by using a new needle each time, never sharing needles with another person, and making sure the environment, injection site, and all equipment are clean and sterilized before injecting.

Obesity, smoking, diabetes, and alcohol consumption can accelerate the rate of liver scarring. It is important that all individuals with hepatitis C maintain good health. This involves:

  • quitting smoking
  • maintaining a healthy weight
  • managing other health problems
  • avoiding alcohol

The National Institute of Diabetes and Digestive and Kidney Diseases recommends that people who have hepatitis C use the following methods to prevent transmitting it to others:

  • avoiding sharing drug needles or other drug materials
  • wearing gloves when touching another person’s open sores
  • telling any tattooists or piercer about the hepatitis C and making sure they use sterile tools and unopened ink
  • avoiding sharing items such as toothbrushes, razors, and nail clippers
  • telling any new sexual partners about the hepatitis C and using barrier protection during sexual activity

Hepatitis C is the most common blood-borne viral infection in the U.S. and can cause fatal liver damage if left untreated. In 2016, the CDC reported at least 18,153 deaths related to hepatitis C.

However, with improvements in education, risk-based screening, prevention methods, and modern treatments, the outlook for hepatitis C is better than ever.

Early diagnosis and treatment can significantly improve a person’s outlook and prevent liver damage. Modern medicines can cure hepatitis C in 90% of cases.

These treatments are expensive. If a person is at risk of exposure to the virus, they should undergo regular screenings to make sure they do not have the virus. Following prevention strategies correctly can usually help a person avoid contracting the virus.

The hepatitis C virus (HCV) causes the liver disease hepatitis C. Hepatitis C infections can be acute and short-term or chronic, meaning the body cannot clear the virus.

People catch the disease through blood-to-blood contact, often by sharing needles while using injectable drugs or accidental needle sticks. Organ transplants and being born to a mother who has hepatitis C are other potential risks of infection.

HCV is a serious condition that causes inflammation of the liver and can lead to organ damage, cirrhosis, liver cancer, and eventual failure. However, thanks to modern treatments, doctors can cure hepatitis C in most cases.

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