Hepatitis C

[HEP-uh-TI-tus see]

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.

What is hepatitis C?

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

What is the infectious agent that causes hepatitis C infection?

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.

Where is hepatitis C virus infection found?

Hepatitis C virus occurs worldwide.

How do people get hepatitis C infection?

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.

What complications can result from hepatitis C?

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.

How is hepatitis C diagnosed?

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

Who is at risk for hepatitis C?

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

hepatitis C

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

What is the treatment for hepatitis C?

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.

How common is hepatitis C?

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.

Is hepatitis C a new or emerging infectious disease?

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.

How can hepatitis C be prevented?

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.

Reducing the risk of getting hepatitis C

1. Do not shoot drugs. Persons who shoot drugs should stop and get into a treatment program. Persons who cannot stop should never reuse or share syringes, water, or drug works. They should get vaccinated against hepatitis A and hepatitis B.

2. Do not share toothbrushes, razors, or other personal care items. They might have blood on them.

3. Health-care workers should always follow routine barrier precautions and safely handle needles and other sharp instruments. Health-care workers should get vaccinated against hepatitis B.

4. Consider the health risks before getting a tattoo or body piercing. The tools that are used might have someone else's blood on them. The artist or piercer might not follow good health practices, such as washing hands and using disposable gloves.

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.

Reducing the risk of chronic disease in infected persons

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:

1. Persons who ever injected illegal drugs, even if a few times many years ago

2. Persons who were treated for clotting problems with a blood product made before 1987 when more advanced methods for manufacturing the products were developed

3. Persons who were notified that they received blood from a donor who later tested positive for hepatitis C

4. Persons who received a blood transfusion or solid organ transplant before July 1992 when better testing of blood and organ donors became available

5. Long-term kidney dialysis patients

6. Persons who have signs or symptoms of liver disease

7. Health-care and public-safety workers after on-the-job exposure (e.g., needlesticks or splashes to the eye) to blood that tests positive for hepatitis C virus

8. Children born to women who are 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:

1. Stop using alcohol.

2. See a doctor regularly.

3. Get vaccinated against hepatitis A if liver damage is present.

Stopping the spread of hepatitis C virus

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

1. Do not donate blood, body organs, other tissue, or semen.

2. Do not share personal items that might have blood on them, such as toothbrushes, dental appliances, nail-grooming equipment, or razors.

3. Cover cuts and skin sores to keep from spreading hepatitis C virus.

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.