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Hepatitis C

• Hepatitis C is a viral infection of the liver.
• Hepatitis C is spread mainly by direct contact with blood.
• About 4 million people in the United States are infected with hepatitis C virus, and most do not know it.
• About 15% of persons infected with hepatitis C get better on their own. The rest develop a long-term infection. Most people with hepatitis C are unaware of their infection until they develop signs of liver failure, often many years later.
• There is no preventive vaccine for hepatitis C. Treatment is effective in some persons but not all.
• Persons who may be at risk for having hepatitis C should get a blood test. Persons found to have hepatitis C should see a doctor to: determine if they have liver disease, determine if they should be treated for liver disease, learn how to protect their liver from further harm, and learn how to prevent spreading hepatitis C to others.

Hepatitis C is an infection of the liver that can have serious, long-lasting health consequences.

Hepatitis C infection is caused by the hepatitis C virus. Hepatitis C virus is present in the blood of infected persons. Hepatitis C virus attacks the liver and, over time, disrupts its vital functions.

Hepatitis C virus occurs worldwide.

Hepatitis C is spread by contact with the blood of an infected person. People have become infected with hepatitis C virus by:

• Sharing equipment for injecting street drugs
• Receiving blood, blood products, or solid organs from a donor whose blood contained hepatitis C virus
• Being on long-term kidney dialysis, during which they unknowingly shared supplies or equipment that had someone else's blood on them
• Having frequent occupational contact with blood in a health-care setting, especially accidental needlesticks
• Being born to a mother with hepatitis C
• Having sex with a person infected with hepatitis C virus
• Living with someone who was infected with hepatitis C virus and sharing items such as razors or toothbrushes that might have had that person's blood on them

Although the main route of infection in the past was through transfusion of contaminated blood and blood products, screening of blood, organ, and tissue donors has virtually eliminated the risk of hepatitis C virus transmission from these sources. Since more advanced tests have been developed for use in blood banks, the chance that a person can get hepatitis C virus infection from transfused blood or blood products is now about 1 in 100,000 units transfused.

What are the signs and symptoms of hepatitis C?

Most infected persons have no symptoms and feel well. For some persons, the most common symptom is extreme tiredness. Other symptoms are loss of appetite, nausea, and stomach pain. More serious infections can cause yellowing of the eyes and skin (jaundice). Most often, however, hepatitis C is first discovered when a routine medical examination shows an abnormality on a blood test for liver function.

Hepatitis C is serious for some persons but not for others. About 15% of persons with hepatitis C get better on their own. The rest carry the virus for the rest of their lives. Most of these persons have some liver damage, but many do not feel sick from the disease. Some persons with liver damage due to hepatitis C develop cirrhosis (scarring) of the liver and liver failure, which can take many years to develop. Others have no long-term effects.

Often, a person is not aware of hepatitis C infection until signs of liver failure appear, often decades after infection. Eighty-five percent of persons with hepatitis C develop long-term infection, 70% develop chronic liver disease, 15% may develop cirrhosis over a period of 20-30 years, and 5% may die from liver cancer or cirrhosis. Hepatitis C is the leading reason for liver transplantation in the United States.

There are several blood tests to diagnose hepatitis C virus infection.

Hepatitis C virus infection occurs in all age groups. Generally, about 60% of infections are in persons ages 30-49 years. Injecting drug use currently accounts for more than half of all hepatitis C virus infections in the United States. Because so few infections cause symptoms, many people in the United States are infected with hepatitis C virus but do not know it. These persons need to be identified, tested, and counseled.

People are at increased risk for infection with hepatitis C virus if they:

• Were notified that they received blood from a donor who later tested positive for

• Have ever injected illegal drugs, even if only a few times many years ago
• Received a blood transfusion or solid organ transplant before July 1992
• Received a blood product for clotting problems produced before 1987
• Have ever been on long-term kidney dialysis
• Have evidence of liver disease

There is no preventive vaccine or universally effective treatment for hepatitis C. Antiviral drugs are licensed for treatment of persons aged 18 years and older who have long-lasting infection. Treatment is effective in 10%-40% of persons.

There are no licensed drugs or guidelines for the treatment of infants or children infected with hepatitis C virus. About 5 out of every 100 infants born to women infected with hepatitis C virus become infected. This occurs at the time of birth, and there is no treatment that can prevent it from happening. Children with hepatitis C should be referred to a children's specialist in liver diseases.

Hepatitis C virus infection is the most common chronic bloodborne infection in the United States. Approximately 4 million persons in the United States are infected with hepatitis C virus.

Hepatitis C virus was discovered in 1989. Infections have declined during the 1990s, and transfusion-associated cases that occurred before donor screening are now very rare. Most new infections are associated with high-risk drug behaviors.

There is no vaccine against hepatitis C virus. Prevention focuses on reducing the risk of getting infected with hepatitis C virus, reducing the risk of chronic disease in persons who are already infected, and reducing the spread of disease from infected to uninfected persons.

Hepatitis C virus can be spread by sex, but this does not occur very often. Persons who are having sex but not with one steady partner should use latex condoms correctly to prevent getting other diseases spread by having sex. They should also get vaccinated against hepatitis B.

Most of the estimated 4 million Americans who are infected with hepatitis C virus do not have symptoms and are unaware of their infection. They can be identified by finding out their history of possible exposures and testing them for hepatitis C. Testing should be offered routinely to persons most likely to be infected with hepatitis C virus:

Pregnant women do not need to be routinely tested for hepatitis C. Pregnant women have no greater risk of being infected with hepatitis C virus than non-pregnant women. If a pregnant woman has risk factors for hepatitis C, she should be tested.

Persons found to be infected with hepatitis C virus will need to see a doctor to: determine if they have liver disease and how severe it is, determine if they should be treated for liver disease, learn how to protect their liver from further harm, and learn how to prevent spreading hepatitis C to others. To protect their own health, infected persons should:

To prevent the further spread of hepatitis C virus, infected persons should do the following:

This fact sheet is for information only and is not meant to be used for self-diagnosis or as a substitute for consultation with a health-care provider. If you have any questions about the disease described above, consult a health-care provider.

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