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Hepatitis C(HCV; Hep C)
Definition

Hepatitis C is an infection of the liver.

Hepatitis


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Causes

Hepatitis C is caused by the hepatitis C virus (HCV). The hepatitis C virus is spread through contact with the blood of an infected person or IV drug use.

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 may increase your chance of hepatitis C include:

  • Injecting illicit drugs, especially with shared needles
  • Receiving a blood transfusion before 1992—this risk is 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
Symptoms

Most people with hepatitis C do not have symptoms. Over time, untreated disease can cause serious liver damage.

Symptoms may include:

  • Fatigue
  • Loss of appetite
  • Yellowing of the eyes and skin
  • Darker colored urine
  • Loose, light, or chalky colored stools
  • Abdominal pain
  • Aches and pains
  • Itching
  • Rash
  • 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 untreated hepatitis C include:

  • Chronic infection that will lead to cirrhosis (scarring) and progressive liver failure
  • Increased risk of liver cancer
Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. You will also discuss your risk factors.

Your bodily fluids and tissues may be tested. This can be done with:

  • Blood tests
  • Liver biopsy—tissue is examined under a microscope

Your liver function may be evaluated. This can be done with liver function studies.

Images may be needed of your liver. This can be done with an ultrasound.

Treatment

In some people, hepatitis C may resolve on its own.

The goals of treatment are to attain a cure and prevent further liver damage. Hepatitis C is usually treated with:

  • Medications to boost the immune system
  • Combinations of antiviral medications

You will be advised to stop drinking alcohol and smoking, which can further damage your liver, especially when undergoing treatment. If you have problems stopping alcohol, your doctor can refer you to counseling or a treatment program. There are several ways to successfully quit smoking .

In severe cases with cirrhosis and serious liver damage a liver transplant may be needed, although it does not typically cure hepatitis C.

Prevention

To prevent becoming infected with hepatitis C:

  • Do not inject illegal 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.
  • Go to regular check ups and get tested for hepatitis C and other STDs as advised.

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:

2015 Sexually transmitted diseases treatment guidelines. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/std/tg2015/default.htm. Updated October 6, 2015. Accessed October 8, 2015.

Acute hepatitis C infection. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T413896/Acute-hepatitis-C-infection. Updated April 27, 2017. Accessed August 21, 2017.

Centers for Disease Control and Prevention (CDC). 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;60(28):945-950.

Chronic hepatitis C infection. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115157/Chronic-hepatitis-C-infection. Updated June 5, 2017. Accessed August 21, 2017.

Explore 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 8, 2015.

Viral hepatitis—hepatitis C information. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/hepatitis/hcv/index.htm. Updated January 27, 2017. Accessed August 21, 2017.

What are my treatment options? Hep C 1,2,3—American Liver Foundation website. Available at: http://hepc.liverfoundation.org/taking-action/what-are-my-options-for-treatment. Updated April 2015. Accessed August 21, 2017.

What I need to know about hepatitis C. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://www.niddk.nih.gov/health-information/health-topics/liver-disease/hepatitis-c/Pages/ez.aspx. Updated May 2017. Accessed August 21, 2017.

12/9/2013 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T115157/Hepatitis-C: US Food & Drug Administration. FDA news release: FDA approves new treatment for hepatitis C virus. Food & Drug Administration website. Accessed October 8, 2015.

4/29/2014 12/9/2013 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T115157/Hepatitis-C: American Association for the Study of Liver Diseases/Infectious Diseases Society of America (AASLD/IDSA) recommendations on testing, managing, and treating hepatitis C. Available at: http://www.hcvguidelines.org/fullreport. Accessed October 8, 2015.

10/8/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T115157/Hepatitis-C: British Association of Sexual Health and HIV (BASHH) recommendations on testing for sexually transmitted infections in men who have sex with men. Available at: http://www.bashh.org/documents/BASHH%20Recommendations%20for%20testing%20for%20STIs%20in%20MSM%20-%20FINAL.pdf. Accessed October 8, 2015.



Last reviewed August 2017 by Michael Woods, MD FAAP

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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