What is hepatitis C?
According to the Centers for Disease Control (CDC), more than 2.4 million people – and as many as 4 million people – had hepatitis C from 2017–2020. Hepatitis C is an inflammation of the liver caused by the hepatitis C virus (HCV). This type of viral hepatitis is transmitted through blood-to-blood contact, which can happen with shared needles or unscreened blood transfusions. It less commonly occurs through sexual contact or from mother to child during childbirth. An HCV infection can be acute (short-term) or chronic (long-term). Most people with acute hepatitis C develop chronic hepatitis C, which can last for years or even a lifetime. If not treated properly, chronic hepatitis C can lead to serious liver problems, including liver cirrhosis (scarring of the liver), liver failure, and liver cancer.
While there is no vaccine for hepatitis C, safe and highly effective treatments that can cure hepatitis C have been available since 2014. It is important to get tested for HCV as soon as possible if you think you have been exposed to this virus. Early diagnosis and treatment can help prevent serious complications.
What causes hepatitis C?
Hepatitis C is caused by the hepatitis C virus (HCV). This virus primarily spreads through blood-to-blood contact. The most common ways HCV is transmitted include:
- Sharing syringes, needles, or other drug-injection equipment
- Blood transfusions and organ transplants (before 1992)
- Sharing personal items that may have contacted an infected person’s blood, such as toothbrushes, nail clippers, razor blades, and blood sugar monitors
- Tattooing or body piercing with non-sterile instruments
- Mother-to-child transmission during childbirth
- Sexual contact, particularly with blood exposure or multiple partners
- Accidental needle sticks among healthcare workers
What does not cause hepatitis C?
Hepatitis C is not spread through breast milk, food, or water. It is also not caused by casual contact such as hugging, kissing, sharing utensils, or coughing and sneezing. Direct blood exposure is required to transmit HCV from person to person.
What are the symptoms of hepatitis C?
Hepatitis C symptoms can vary from mild to severe, and many people do not notice symptoms in the early stages of infection. When symptoms do appear, they often occur in two phases: during acute infection and in the chronic phase.
Acute Hepatitis C Symptoms
- Fatigue
- Fever
- Jaundice (yellowing of the skin and eyes)
- Dark urine
- Pale or clay-colored stool
- Abdominal pain or discomfort, particularly on the right side under the ribs
- Nausea or vomiting
- Loss of appetite
- Joint or muscle pain
Acute symptoms may appear 2 weeks to 6 months after exposure and may last for weeks to months. Many people with acute hepatitis C have no symptoms, making diagnosis difficult.
Chronic Hepatitis C Symptoms
- Persistent fatigue and lack of energy
- Difficulty concentrating (brain fog)
- Severe muscle and joint pain
- Persistent jaundice
- Swelling in the abdomen (ascites) and legs
- Spider-like blood vessels on the skin
- Easy bruising or bleeding
- Unexplained weight loss
Chronic hepatitis C can persist for years without noticeable symptoms. Left untreated, it can lead to chronic liver disease, cirrhosis, liver cancer, and death. Early testing and treatment are essential.
How is hepatitis C diagnosed?
Your healthcare provider will typically diagnose hepatitis C through blood tests that detect the infection or your body’s response to it. Common tests include:
Hepatitis C Antibody Test (Anti-HCV Test)
Tests for antibodies that your immune system produces in response to HCV. A positive result indicates past exposure but not necessarily active infection.
HCV RNA Test (HCV Viral Load Test)
Measures the amount of HCV RNA in your blood to confirm active infection and guide treatment.
HCV Genotype Test
Determines the strain (genotype) of HCV you have, which helps tailor treatment.
Additional tests may include:
- Liver Function Tests (LFTs) to assess inflammation or damage
- Liver biopsy or FibroScan to evaluate scarring (fibrosis)
How is hepatitis C treated?
Treatment typically involves antiviral medications that eliminate the virus, prevent liver damage, and reduce complications. Options include:
Direct-Acting Antivirals (DAAs)
Highly effective drugs targeting specific steps in the HCV life cycle. Cure rates exceed 95% with 8–12 week courses. Common regimens include:
- Epclusa (sofosbuvir/velpatasvir)
- Mavyret (glecaprevir/pibrentasvir)
- Harvoni (ledipasvir/sofosbuvir)
- Zepatier (elbasvir/grazoprevir)
- Vosevi (sofosbuvir/velpatasvir/voxilaprevir)
Older therapies such as ribavirin and peginterferon may be used in combination for certain cases.
Liver Transplant
Considered for severe cirrhosis or liver cancer. Antivirals are given post-transplant to prevent reinfection of the new liver.
Lifestyle Changes
- Avoid alcohol to protect liver health
- Maintain a balanced diet and regular exercise
Is there a vaccine for hepatitis C?
There is no vaccine for hepatitis C. Your provider may recommend hepatitis A and B vaccination to protect your liver from other infections.
Can hepatitis C be cured?
Yes. Antiviral treatments can cure over 95% of HCV infections. Early testing and prompt treatment are key to preventing serious liver damage.
Sources
- American Association for the Study of Liver Diseases and the Infectious Diseases Society of America. HCV guidance: Recommendations for testing, managing, and treating hepatitis C. Accessed Sept. 13, 2024.
- Centers for Disease Control and Prevention (CDC). Hepatitis C.
- World Health Organization (WHO). Hepatitis C [Fact sheet]. Accessed Sept. 13, 2024.
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Hepatitis C. Accessed Sept. 13, 2024.
- U.S. Department of Health and Human Services. Hepatitis C Basics. Accessed Sept. 13, 2024.