People living with chronic hepatitis C have a higher risk of developing severe COVID-19 symptoms than individuals without the condition. Those who do develop severe illness may also have a higher risk of liver damage.

However, a 2021 study found that despite the higher risk for severe illness, people with hepatitis C did not have a higher risk of admission to an intensive care unit (ICU) or death due to COVID-19 compared with those without the condition.

Read on to learn more about hepatitis C and COVID-19, including the risks, how the two conditions interact, and whether people with hepatitis C can receive a COVID-19 vaccine.

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Yes — the Centers for Disease Control and Prevention (CDC) list liver disease as a risk factor for developing severe illness from COVID-19. Hepatitis C is a type of liver disease.

The risk for severe COVID-19 symptoms can depend on the level of liver scarring, or cirrhosis, a person has. According to a 2021 study, people with the hepatitis C virus (HCV) are more likely to develop serious COVID-19 symptoms and receive treatment in the hospital if they have a high fibrosis-4 score, a method that doctors use to estimate liver cirrhosis.

Despite the higher risk for severe illness, individuals with HCV do not appear to have a higher risk of ICU admission or death compared with those who do not have HCV. However, they may have a higher risk for complications.

Evidence suggests that severe COVID-19 can cause liver damage and that this may be especially harmful to individuals with preexisting liver disease.

A 2020 review found that up to half of people hospitalized with COVID-19 had elevated liver enzyme levels, which can indicate liver damage. This result was more common in those who:

  • were older
  • had severe COVID-19 symptoms
  • already had hepatitis or cirrhosis

The 2021 study also notes that in people with existing cirrhosis, COVID-19 has links with a deterioration in liver function.

However, it is important to note that most individuals with HCV do not develop severe COVID-19 symptoms, while liver injury is less prevalent among people with mild symptoms.

HCV cannot kill SARS-CoV-2, the virus that causes COVID-19. Having HCV does not protect someone from the disease.

However, both these viruses share a similar structure. They are both positive single-stranded RNA viruses that cause a similar immune system response. Because of this, some antiviral drugs that target HCV may also affect SARS-CoV-2.

The effectiveness of HCV medications for treating COVID-19 is still unknown. At present, the only drug with approval from the Food and Drug Administration (FDA) for treating COVID-19 is remdesivir, an antiviral that doctors can use with or without the anti-inflammatory drug dexamethasone.

Yes, people with hepatitis C can get the vaccine for COVID-19.

The CDC included anyone with a medical condition that increases the risk for severe COVID-19 in their phase 1 vaccine priority group. This meant anyone aged 16–64 years with HCV could receive a vaccination earlier than other adults. Now, the vaccine is available to all adults.

The only situation where a person with HCV could not get the COVID-19 vaccine is if they have:

  • severe allergies to any of the ingredients in the vaccine
  • a serious allergic reaction to their first dose, which would prevent them from getting another
  • another chronic medical condition that could affect how they react to the vaccine

People can speak with a doctor if they have concerns about the safety of a COVID-19 vaccine.

Read more about COVID-19 vaccine safety.

The most effective way to stay safe from COVID-19 is to avoid coming into contact with the virus that causes the disease. Actions that everyone can take to prevent the spread of COVID-19 include:

  • wearing a mask that covers the nose and mouth when around others
  • avoiding crowded or poorly-ventilated spaces where possible
  • staying 6 feet away from others
  • covering coughs and sneezes with a tissue and disposing of it safely
  • regularly washing the hands with soap and water for 20 seconds
  • using a hand sanitizer that contains at least 60% alcohol if soap and water are not available
  • avoiding touching the face or mouth
  • getting a COVID-19 vaccine, if or when possible

There are also special precautions people with HCV can take to protect themselves. These include:

  • staying at home whenever possible
  • avoiding unnecessary travel
  • continuing with HCV treatment or monitoring, even if this means having appointments over the phone rather than in person
  • keeping at least a 30-day supply of medication at home to reduce trips to pharmacies
  • continuing with preventative care, such as vaccines for hepatitis A, B, and influenza (flu)
  • maintaining a balanced diet and getting regular exercise
  • looking after mental health
  • stopping smoking or vaping tobacco or cannabis, as this may increase the risk for respiratory illnesses

If a person is using drugs or has a substance abuse disorder, they should not delay seeking help from a doctor or counselor. People with a substance abuse disorder are at a higher risk for severe COVID-19. However, there are virtual treatment and recovery programs that can help.

Learn more about treatments for addiction.

People with HCV may wish to speak with a doctor to get more information about COVID-19 and how it may affect them. Some potential questions to ask include:

  • Am I at risk for serious illness?
  • What risk factors do I have, and is there anything I can do to reduce them?
  • What telemedicine services do you offer that could help?
  • Can I start or continue with HCV treatment during this time?
  • Is it possible to increase my medication prescription to reduce trips outside?
  • How soon can I get a COVID-19 vaccine?
  • Do I need to take special precautions when getting the vaccine to prevent transmission of HCV?
  • Is there any reason I should not get the vaccine?

If someone thinks they have COVID-19 symptoms, they should remain at home and follow the guidance from their local health authority. The symptoms of COVID-19 can vary, but the most common include:

  • fever
  • chills
  • cough
  • shortness of breath
  • difficulty breathing
  • new loss of taste or smell
  • fatigue
  • body or muscle aches
  • headache
  • congestion or a runny nose
  • sore throat
  • nausea
  • vomiting
  • diarrhea

Call 911 or the nearest emergency department and notify them that an individual may have COVID-19 if their COVID-19 symptoms suddenly worsen or they develop any of the following:

  • blue or white discoloration in the skin, mouth, or nails
  • trouble breathing
  • difficulty staying awake
  • chest pain or pressure
  • new confusion

Research suggests that people with HCV are more likely to experience serious illness and hospitalization if they develop COVID-19. They may also be at a higher risk for liver damage or reduced liver function as a result of the disease. However, individuals with HCV do not appear to have higher mortality rates than those without the condition.

Anyone with liver disease or cirrhosis can help reduce their risk of serious complications by receiving the COVID-19 vaccine if they are eligible. It is also important to continue taking precautions. People can remain at home as much as possible and make use of virtual medical and mental health support services.

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