What is hepatitis C—and how can you protect yourself?

Hepatitis C is a liver disease caused by the hepatitis C virus (HCV). For a small percentage of people who get hepatitis C, the infection clears within six months without treatment. But for most people (between 55 and 85 percent), the infection does not clear and they develop chronic hepatitis C. This long-term infection can potentially cause serious health complications, including liver damage, cirrhosis of the liver (where scar tissue gradually replaces healthy liver tissue), and liver cancer.

How many people have hepatitis C?

About 50 million people worldwide have chronic hepatitis C, the World Health Organization (WHO) estimates. In the United States, there are more than 2 million people living with the condition.

How is hepatitis C transmitted?

HCV is most often transmitted when someone comes into contact with the blood of an infected person. This can happen in several different ways, including:

• Sharing drug equipment, such as needles
• Getting tattoos or piercings from a person or facility that doesn’t clean its instruments properly
• Sharing equipment like razors, toothbrushes, blood sugar (glucose) monitors, or nail clippers that may have blood on them, even if the blood is not visible
• Having sex, especially for men who have sex with men

Healthcare workers have at times contracted HCV after being accidentally injured with a contaminated needle or other piece of sharp medical equipment. Infants born to infected people can also become infected, though it’s relatively uncommon.

While HCV used to be spread through blood transfusions, blood products have been screened since 1992. The risk of getting hepatitis C after receiving donated blood or a blood product is very low. And you can’t get HCV through kissing, hugging, nursing a baby, coughing, or sneezing.

Which groups are most at risk for hepatitis C?

In the past, hepatitis C was the most prevalent among people born in the United States between 1945 and 1965. This is partly because blood transfusions, organ transplants, and hemodialysis procedures before 1992 sometimes used blood components that had not been properly screened.

In recent years, however, new HCV infections are found mostly among young adults, especially those between 20 and 39 years old. This seems to be linked to the rise of injection drug use among this age group, including use of shared or unsterilized needles.

Other groups at a higher risk for contracting the virus include people with HIV and anyone who has used injection drugs at any point in their life.

Does hepatitis C have symptoms?

Not usually, which is why the disease can go unreported. About 80 percent of people with new infections have no symptoms at all.

For those who do experience symptoms, they usually show up within 2 to 12 weeks. They tend to be mild and may seem like flu symptoms, such as fever and fatigue or tiredness. Other possible symptoms include nausea, loss of appetite, abdominal pain, joint pain, dark urine, and jaundice. Jaundice is a condition where the whites of the eyes and the skin take on a yellowish color; in people with darker skin tones, it’s most visible in the whites of the eyes.

Most people with chronic hepatitis C have either nonspecific symptoms like fatigue or depression, or they continue to have no symptoms until they begin experiencing the first signs of liver damage.

What are the complications of hepatitis C?

Many people with untreated chronic hepatitis C develop liver disease. Between 5 and 25 percent will develop cirrhosis of the liver within 10 to 20 years. This means the liver becomes badly scarred over the course of many years and stops functioning properly. People with chronic hepatitis C who’ve also developed cirrhosis have a 1 to 4 percent annual risk of developing liver cancer.

Sometimes, people with chronic HCV infections can develop medical conditions that aren’t related to the liver, including diabetes and non-Hodgkin’s lymphoma. It’s a cancer that begins in the lymphatic system, which is made up of tissues and organs that produce, store, and carry white blood cells that fight infections and other diseases.

How do healthcare providers test for hepatitis C?

The U.S. Preventive Services Task Force is an organization that provides recommendations for preventive health care, including screenings. They recommend a one-time HCV infection screening for healthy adults ages 18 to 79 who don’t have symptoms or a known liver disease. People at higher risk may receive them more frequently. Speak to a provider about a schedule that’s right for you.

To be screened for hepatitis C, your healthcare provider (HCP) will order a blood test called an HCV antibody test, which checks whether you have ever been infected. If there is a positive test result, there will be another blood test to confirm that the infection is still active. This is because some people who contract HCV will clear it on their own and don't need further treatment.

How is hepatitis C treated?

There are several treatments available for hepatitis C. They usually involve 8 to 12 weeks of taking pills and cure the disease in more than 90 percent of cases, according to the CDC. It is better to diagnose and receive treatment for chronic hepatitis C as early as possible. Treatment can help prevent more liver damage but it cannot reverse damage that has already occurred.

Those who’ve had chronic hepatitis C, even if it has been cured, may need to make lifestyle changes to prevent any further damage to the liver. These steps can include being vaccinated against hepatitis A and hepatitis B, avoiding alcohol, and carefully checking with an HCP before taking any new medications, over-the-counter drugs, supplements, or herbs.