Chronic hepatitis C is a liver infection caused by the hepatitis C virus.

According to the Centers for Disease Control and Prevention (CDC), between 2013 and 2016, nearly 2.4 million people in the United States had hepatitis C.

Hepatitis C is one of five hepatitis viruses: A, B, C, D, and E. Although vaccines exist for hepatitis A and B, none currently exists for hepatitis C.

Hepatitis C can cause either acute or chronic infection. Acute hepatitis C infection develops quickly and can last for up to 6 months. Only 30% of people with acute hepatitis C infection experience symptoms.

According to the CDC, around 75–85% of people with acute hepatitis C go on to develop chronic hepatitis C. This happens when the body is unable to fight off the virus.

If a person does not receive the right treatment, chronic hepatitis C can lead to serious complications, such as liver damage or liver cancer.

In this article, we outline the symptoms of hepatitis C infection and the ways in which a person can develop it. We also discuss the treatment options and the outlook for people living with chronic hepatitis C.

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A person with chronic hepatitis C may experience nausea and fatigue.

Many people who have chronic hepatitis C are unaware of it. Most only experience symptoms once they have developed significant liver damage. This can take years or even decades.

People with chronic hepatitis C may experience the following symptoms:

People with advanced liver damage may develop jaundice. This causes the skin and the whites of the eyes to turn yellow.

Hepatitis C can infect a person when blood from someone with the infection enters their bloodstream.

The following situations can expose people to the hepatitis C virus:

  • coming into contact with the blood of someone who has hepatitis C
  • sharing or reusing needles
  • receiving a tattoo or piercing with unsterilized tools
  • receiving infected blood or organ transplants
  • being born to a woman who has hepatitis C infection

A person can also contract hepatitis C through sex with someone who has the infection, though this is rare.

The hepatitis C virus only travels through the blood. As a result, the following situations will not expose people to the virus:

  • touching, hugging, holding hands
  • being coughed or sneezed on
  • sharing food or drinks
  • breastfeeding

The goal of treatment is to rid the body of the hepatitis C virus.

Ideally, this will result in a sustained virologic response, which involves the virus remaining undetectable in the blood for 12 or more weeks after the person completes the course of treatment.

Treatment also aims to slow down inflammation and scarring of the liver, which will help prevent further complications.

Medications

In the past, doctors used a combination of antiviral medications and interferon injections to treat hepatitis C.

Today, they prescribe oral medications called direct-acting antivirals (DAAs). These drugs target the hepatitis C virus at various stages of its life cycle, disrupting its ability to replicate.

DAA treatment type and duration vary, depending on the disease stage and the extent of damage to the liver. On average, DAA treatment for hepatitis C usually lasts 12–24 weeks.

Although experts consider DAAs safe for most people, these drugs can cause side effects, such as:

Surgery

People who have advanced liver damage, liver failure, or liver cancer may require a liver transplant.

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Blood tests help doctors diagnose hepatitis C.

Chronic hepatitis C infection can lead to life threatening complications if a person does not receive the right treatment. Some examples of these complications include:

  • cirrhosis, an excessive buildup of scar tissue within the liver, which results in a permanent loss of liver function
  • liver failure, a life threatening condition in which the liver is losing or has lost all function
  • liver cancer, which is more common among people who have cirrhosis

Today, people have access to highly effective DAAs. These can cure over 90% of hepatitis C infections.

The extent of liver damage can affect treatment outcomes. A 2018 study reports the treatment outcomes of 906 adults with chronic hepatitis C infection and varying degrees of liver damage after DAA treatment.

In this study, 40.6% of participants had a 12-week sustained virologic response after DAA treatment. The researchers also noted that people with more extensive liver damage had a higher risk of treatment failure.

The results of this study indicate that early diagnosis can lead to better treatment outcomes.

Because chronic hepatitis C rarely causes symptoms during the early stages of infection, screening is crucial for people at risk.

Certain factors can increase a person's risk of hepatitis C. The CDC recommend that people receive hepatitis C testing if they:

  • were born between 1945 and 1965
  • were born to a woman who had hepatitis C
  • have any history of injected drug use
  • show signs of liver disease
  • have HIV
  • received an organ transplant, blood, or blood components — such as clotting factor concentrates or plasma — before 1992
  • received a blood transfusion or an organ transplant from a donor who tested positive for hepatitis C

Doctors check for hepatitis C using blood tests.

Chronic hepatitis C is a long term viral infection that affects the liver. Most people who contract the hepatitis C virus develop chronic infection.

If a person does not receive the right treatment, chronic hepatitis C can lead to long term complications, such as liver disease or liver cancer. However, there are safe and highly effective treatments for hepatitis C.

Anyone who may have been exposed to the virus should contact their doctor, who can order blood tests to check for hepatitis C.

People should not wait for symptoms to appear before seeking medical attention. Early diagnosis can lead to improved treatment outcomes and prevent serious complications.