June 28, 2015
Hepatitis C (HCV) is a virus that causes inflammation of the liver. It is a member of the family of viruses that include hepatitis A and hepatitis B. The viruses behave differently and have different modes of transmission. Hepatitis C can cause serious liver damage, liver failure, liver cancer, and even death.
About 3.2 million people in the U.S. currently live with chronic hepatitis C infection. The virus is most common in baby boomers who represent 75% of infected adults. The rates of hepatitis C were the highest in the 1970s and 1980s, the time when many baby boomers were likely infected. Many people who have hepatitis C are unaware because the virus may not produce symptoms until decades after infection.
Hepatitis C is a blood-borne illness, meaning it is transmitted via contact with infected blood. Usually the virus enters the body through a puncture wound on the skin. The most common way hepatitis C is transmitted is via injection drug use when uses share needles. Health care professionals may contract the virus via needlestick injury. Prior to 1992, the U.S. blood supply was not screened the way it is today, so some people contracted hepatitis C from infected blood transfusions. Rarely, babies born to hepatitis C-infected mothers acquire the virus. Hepatitis C can also be spread by having sex with an infected person or sharing personal items (for example, a razor or toothbrush) with someone who has the virus, but these cases are rare.
About 70% to 80% of people with hepatitis C infection do not have any symptoms, especially in the early stages. In these people, symptoms may develop years, even decades later, when liver damage occurs. A person who has hepatitis C infection but isn't exhibiting any symptoms can still pass the virus on to others. Others develop symptoms between 2 weeks to 6 months after infection. The average time to develop symptoms is 6 to 7 weeks after acquiring the virus. Individuals newly infected with hepatitis C may experience mild-to-severe fever, fatigue, abdominal pain, loss of appetite, nausea, vomiting, joint pain, dark urine, clay-colored stool, and yellowing of the skin (jaundice).
Hepatitis B infection may be chronic or acute. Acute hepatitis C infection refers to symptoms that appear within 6 months of newly acquiring the virus. About 20% to 30% of those who acquire hepatitis C experience acute illness. After this, the body either clears the virus or goes on to develop chronic infection. Chronic hepatitis C infection refers to long-lasting infection. The majority of people who have acute hepatitis C infection (75% to 85%) go on to develop the chronic form of the illness.
Hepatitis C infection is diagnosed with several blood tests. The hepatitis C antibody test checks for antibodies (immune particles) that fight the virus. A "non-reactive" result means that antibodies to the virus are not detected. A "reactive" result means antibodies to the virus are present, but the test is unable to indicate whether the infection is current or in the past. Another blood test assessing the presence of hepatitis C genetic material (HCV RNA test) is available. The results of this test can help doctors determine whether hepatitis C infection is current or not. Additional blood tests can be used to determine the amount of virus in the body, known as a titer.
Chronic hepatitis C infection is a long-lasting illness with potentially serious complications. About 75% to 85% of those with acute hepatitis C infection go on to develop chronic illness. Of those in the chronic illness group, more than two-thirds will develop liver disease. Up to 20% will develop cirrhosis, or scarring of the liver, within 20 to 30 years. Cirrhosis affects liver function and causes elevated blood liver enzymes. Up to 5% of people with chronic hepatitis C infection will die from liver cancer or cirrhosis. Chronic hepatitis C infection is the most