Definition

Hepatitis C is an infection of the liver. It is caused by the hepatitis C virus (HCV).

Hepatitis

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Causes

HCV is carried in the blood of people infected with the virus. It is most often spread through contact with infected blood, such as:

• Injecting illicit drugs with shared needles
• Receiving HCV-infected blood transfusions (before 1992) or blood clotting products (before 1987)
• Receiving an HCV-infected organ transplant
• Receiving long-term kidney dialysis treatment (machine can be tainted with HCV-infected blood)
• 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
• Receiving a tattoo, body piercing, or acupuncture with unsterilized or improperly sterilized equipment

Hepatitis C can also spread through:

• An HCV-infected mother to her baby at the time of birth
• Sexual contact with someone infected with HCV
• Sharing a straw or inhalation tube when inhaling drugs with someone infected by HCV
• Receiving a blood transfusion

HCV cannot spread through:

• The air
• Unbroken skin
• Casual social contact
• Breastfeeding

Risk Factors

Factors that increase your chance of this infection:

• Receiving a blood transfusion before 1992
• Receiving blood clotting products before 1987
• Long-term kidney dialysis treatment
• Tattooing
• Body piercing
• Injecting illicit drugs, especially with shared needles
• Having sex with partners who have hepatitis C or other sexually transmitted diseases

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
• Light or chalky colored stools
• Loose, light-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 infection may cause some of the above symptoms, as well as:

• Weakness
• Severe fatigue
• Loss of appetite

Serious complications of hepatitis C infection 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

These medications can cause difficult side effects. They also have limited success rates.

In unsuccessful cases, chronic hepatitis C can cause cirrhosis (scarring) and serious liver damage. A liver transplant may be needed.

Prevention

To prevent becoming infected with hepatitis C:

• Do not inject illicit drugs. Shared needles have highest risk. Seek help to stop using drugs.
• Do not have sex with partners who have STDs.
• Practice safe sex (using latex condoms) or abstain from sex.
• Limit your number of sexual partners.
• Avoid sharing personal hygiene products, such as toothbrushes.
• 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.