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  • Hepatitis C

    (HCV; Hep C)

    Definition

    Hepatitis C is an infection of the liver. The hepatitis C virus (HCV) causes it.
    Hepatitis
    IMAGE
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    Causes

    The hepatitis C virus is spread through contact with the blood of an infected person.
    A woman with hepatitis can pass the virus on to her baby during birth. The hepatitis C virus is not spread through food or water.

    Risk Factors

    Factors that increase your chance of this infection:
    • Injecting illicit drugs, especially with shared needles
    • Receiving a blood transfusion before 1992—this risk is very low in the United States.
    • Receiving blood clotting products before 1987
    • Receiving an HCV-infected organ transplant
    • Long-term kidney dialysis treatment
    • Sharing toothbrushes, razors, nail clippers, or other personal hygiene items that have HCV-infected blood on them
    • Being accidentally stuck by an HCV-infected needle—a concern for healthcare workers
    • Frequent contact with HCV-infected people—a concern for healthcare workers
    • Tattooing
    • Body piercing
    • Having sex with partners who have hepatitis C or other sexually transmitted diseases—this is most common in men who have sex with men.

    Symptoms

    Eighty percent of people with hepatitis C have no symptoms. Over time, the disease can cause serious liver damage.
    Symptoms may include:
    • Fatigue
    • Loss of appetite
    • Jaundice (yellowing of the eyes and skin)
    • Darker colored urine
    • Loose, light, or chalky colored stools
    • Abdominal pain
    • Aches and pains
    • Itching
    • Hives
    • Joint pain
    • Cigarette smokers may suddenly dislike the taste of cigarettes
    • Nausea
    • Vomiting
    Chronic hepatitis C may cause some of the above symptoms, as well as:
    • Weakness
    • Severe fatigue
    • Loss of appetite
    Serious complications of hepatitis C include:
    • Chronic infection that will lead to cirrhosis (scarring) and progressive liver failure
    • Increased risk of liver cancer

    Diagnosis

    Your doctor will ask about your symptoms and medical history. A physical exam will be done. You will also discuss your risk factors.
    Tests may include:
    • Blood tests—to look for hepatitis C antibodies or genetic material from the virus (antibodies are proteins that your body has made to fight the hepatitis C virus)
    • Liver function studies— to initially determine and follow how well your liver is functioning
    • Ultrasound of the liver—to assess liver damage
    • Liver biopsy—removal of a sample of liver tissue to be examined

    Treatment

    Hepatitis C is usually treated with combined therapy, consisting of:
    • Interferon—given by injection
    • Ribavirin—given orally
    • Protease inhibitor
    These medicines can cause difficult side effects. They also have limited success rates.
    In unsuccessful cases, chronic hepatitis C can cause cirrhosis and serious liver damage. A liver transplant may be needed, although it does not typically cure hepatitis C.
    If you are diagnosed with hepatitis C, follow your doctor's instructions .

    Prevention

    To prevent becoming infected with hepatitis C:
    • Do not inject illicit drugs. Shared needles have the highest risk. Seek help to stop using drugs.
    • Do not have sex with partners who have sexually transmitted diseases (STDs).
    • Practice safe sex (using latex condoms) or abstain from sex.
    • Limit your number of sexual partners.
    • Do not share personal items that might have blood on them, such as:
      • Razors
      • Toothbrushes
      • Manicuring tools
      • Pierced earrings
    • Avoid handling items that may be contaminated by HCV-infected blood.
    • Donate your own blood before elective surgery to be used if you need a blood transfusion.
    To prevent spreading hepatitis C to others if you are infected:
    • Tell your dentist and physician before receiving check-ups or treatment.
    • Get both a hepatitis A and hepatitis B vaccination.
    • Do not donate blood or organs for transplant.

    RESOURCES

    American Liver Foundation http://www.liverfoundation.org

    Hepatitis Foundation International http://www.hepfi.org

    CANADIAN RESOURCES

    Canadian Liver Foundation http://www.liver.ca

    Health Canada http://www.hc-sc.gc.ca

    References

    Chang MH, Gordon LA, Fung HB. Boceprevir: A protease inhibitor for the treatment of hepatitis C.Clin Ther. 2012 Sep 10. pii: S0149-2918(12)00490-0. doi: 10.1016/j.clinthera.2012.08.009. [Epub ahead of print]

    Hepatitis C. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/hepatitis/HCV/index.htm. Updated March 14, 2011. Accessed October 15, 2012.

    Hepatitis C. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us . September 10, 2012. Accessed October 15, 2012.

    Sexual transmission of hepatitis C virus among HIV-infected men who have sex with men—New York City, 2005-2010. MMWR Morb Mortal Wkly Rep . 2011 Jul 22;60:945-50.

    Sexually transmitted diseases. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/std/default.htm. Updated August 31, 2012. Accessed October 15, 2012.

    What is a blood transfusion? National Heart Lung and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/bt/. Updated January 30, 2012. Accessed October 15, 2012.

    What I need to know about hepatitis C. National Digestive Diseases Information Clearinghouse website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/hepc%5Fez/. Published April 2009. Updated May 10, 2012. Accessed October 15, 2012.

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