What is hepatitis?
Hepatitis management involves a combination of medical treatment, lifestyle changes, and preventive measures to manage the symptoms and prevent the progression of the disease. Hepatitis means inflammation of the liver. When inflammation or damage affects the liver, it can impact its function. Heavy alcohol use, toxins, some medications, and certain medical conditions can all cause hepatitis. However, a virus often causes hepatitis. In the United States, the most common hepatitis viruses are hepatitis A virus, hepatitis B virus, and hepatitis C virus.
What is the difference between hepatitis A, hepatitis B, and hepatitis C?
Three different viruses cause liver infections known as hepatitis A, hepatitis B, and hepatitis C. Although they can produce similar symptoms, each virus spreads in distinct ways and affects the liver differently. Hepatitis A is usually a short-term infection. Hepatitis B and hepatitis C can also begin as short-term infections, but in some people, the virus remains in the body and causes chronic (long-term) infection. There are vaccines to prevent hepatitis A and hepatitis B; however, there is no vaccine for hepatitis C.
This page “What is viral hepatitis?” specifically explains in detail the differences between hepatitis A, hepatitis B, and hepatitis C.
What is hepatitis C?
Hepatitis C is blood borne virus that predominantly infects the cells of a liver. This can result in inflammation and significant damage to the liver. It can also affect the livers ability to perform its essential functions. Infected blood transmits the virus. Medical professionals often categorize Hepatitis C as either ‘acute,’ indicating a new infection, or ‘chronic,’ signaling long-term infection.
- Acute hepatitis C occurs within the first 6 months after someone is exposed to the hepatitis C virus. Hepatitis C can be a short-term illness, but for most people, acute infection leads to chronic infection.
- Chronic hepatitis C can be a lifelong infection if left untreated. Chronic hepatitis C can cause serious health problems such as liver damage, cirrhosis (scarring of the liver), liver cancer, and even death.
How serious is chronic hepatitis C?
Chronic hepatitis C can be a serious disease resulting in long-term health problems, including liver damage, liver failure, cirrhosis, liver cancer, and even death. It is the most common reason for liver transplantation in the United States. There were 15,713 deaths related to hepatitis C virus reported to CDC in 2018, but this is believed to be an underestimate.
How likely is it that someone with acute hepatitis C will become chronically infected?
More than half of people who become infected with hepatitis C virus will develop a chronic infection..
How common is acute hepatitis C West Africa?
In sub-Saharan Africa, studies have reported HCV prevalence to be less than 1% in southern African countries (43, 45), while ranging between 1.7 and 27.5% in central Africa (5, 25, 29), and between 1.4 and 7% in West and East Africa (1, 10, 36, 39)
Transmission / Exposure of Hepatitis.
The hepatitis C virus is usually spread when someone comes into contact with blood from an infected person. This can happen through the following:
Health care exposures.
Although uncommon, people can become infected when health-care professionals do not follow the proper steps needed to prevent the spread of bloodborne infections.
Unregulated tattoos or body piercings.
Hepatitis C can spread when getting tattoos or body piercings in unlicensed facilities, informal settings, or with
non-sterile instruments.
Sex with an infected person.
While uncommon, hepatitis C can spread during sex, though it has been reported more often among men who have sex with their fellow men.
Sharing personal items.
Sharing glucose monitors, razors, nail clippers, toothbrushes, and other items that may have touched infected blood, even in trace amounts too small to see, can transmit infections to people.
Hepatitis C is not spread by sharing eating utensils, breastfeeding, hugging, kissing, holding hands, coughing, or sneezing. It is also not spread through food or water.
Can one get hepatitis C more than once?
Yes! People can become reinfected even after clearing the virus or undergoing successful treatment and cure. That’s why it’s crucial for individuals currently engaging in needle sharing or receiving maintenance hemodialysis to undergo regular testing for hepatitis C
Does sexual contact spread the hepatitis C virus?
Yes, hepatitis C virus (HCV) can spread through sexual contact, although it’s typically considered less likely compared to other routes like sharing needles or syringes. However, factors such as having multiple sexual partners, engaging in rough sex causing bleeding, or having a sexually transmitted infection (STI) increase the risk While the risk is lower through sexual contact than blood-to-blood transmission, it’s still possible, and using condoms can help reduce transmission risk.
Can you get hepatitis C by getting a tattoo or piercing?
Research has not demonstrated the spread of hepatitis C within licensed, commercial tattooing facilities. However, transmission of hepatitis C (and other infectious diseases) is possible at facilities that don’t take the necessary measures to control infections during tattooing or piercing. Unregulated tattooing and piercing occurring in prisons and other informal settings may put a person at risk of infection.
Does hepatitis C spread within a household?
Yes, but this does not occur very often. If hepatitis C virus is spread within a household, it is most likely a result of direct, through-the-skin exposure to the blood of an infected household member.
What is the risk of a pregnant woman passing hepatitis C to her baby?
Of every 100 infants born to mothers with hepatitis C, about six will become infected with the hepatitis C virus. However, the risk is greater if the mother has both HIV and hepatitis C.
Can women with hepatitis C breastfeed their babies?
Yes. There is no evidence that breastfeeding spreads hepatitis C, so infected women can safely breastfeed their babies. However, women with cracked or bleeding nipples should stop nursing temporarily until their nipples have healed. Hepatitis C is spread through contact with blood, and not enough is known about whether this practice is safe.
Can I get hepatitis C from a mosquito or other insect bite?
No. The hepatitis C virus has not been shown to be transmitted by mosquitoes or other insects.
Can I donate blood if I have tested positive for hepatitis C?
The American Red Cross does not accept blood donations from anyone who has ever tested positive for hepatitis C or from anyone with current signs or symptoms of hepatitis.
Can someone with hepatitis C donate organs?
According to the U.S. Department of Health & Human Service’s online information on organ donation and transplantation, very few conditions would prevent someone from being an organ, eye, or tissue donor. Even with acute or chronic hepatitis C, you may be able to donate your organs or tissues. The transplant team will determine what organs or tissue can be used based on a clinical evaluation, medical history, and other factors.
Symptoms
What are the symptoms of acute (new) hepatitis C?
Many people newly infected with the hepatitis C virus don’t have symptoms, don’t look or feel sick, and therefore don’t know they are infected. For people who develop symptoms, they usually happen 2–12 weeks after exposure to the hepatitis C virus and can include yellow skin or eyes, not wanting to eat, upset stomach, throwing up, stomach pain, fever, dark urine, light-colored stool, joint pain, and feeling tired.
What are the symptoms of chronic (long-term) hepatitis C?
Most people with chronic hepatitis C don’t have any symptoms or have only general symptoms like chronic fatigue and depression. Many people eventually develop chronic liver disease, which can range from mild to severe and include cirrhosis (scarring of the liver) and liver cancer. Chronic liver disease in people with hepatitis C usually happens slowly, without any signs or symptoms, over several decades. Chronic hepatitis C virus infection is often not recognized until people are screened for blood donation or from an abnormal blood test found during a routine doctor’s visit.
Can a person spread hepatitis C without having symptoms?
Yes. If you are infected with the hepatitis C virus, you can spread it to others even if you have no symptoms.
Testing
Who should get tested for hepatitis C?
You should get tested for hepatitis C if you:
- Are 18 years of age and older (get tested at least once in your lifetime)
- Are pregnant (get tested during each pregnancy)
- Currently inject drugs (get tested regularly)
- Have ever injected drugs, even if it was just once or many years ago
- Have HIV
- Have abnormal liver tests or liver disease
- Are on hemodialysis
- Received donated blood or organs before July 1992
- Received clotting factor concentrates before 1987
- Have been exposed to blood from a person who has hepatitis C
- Were born to a mother with hepatitis C
Should anyone be tested for hepatitis C more than once?
Yes. Regular testing is recommended for people who currently inject and share needles, syringes, or other drug preparation equipment and for those currently getting maintenance hemodialysis.
If I am pregnant, should I be tested for hepatitis C?
Yes, CDC recommends you get tested for hepatitis C during every pregnancy. CDC also recommends that if you have hepatitis C your baby be tested as early as two months old.
What tests are used to diagnose someone with hepatitis C?
A blood test, called an HCV antibody test, is used to find out if someone has ever been infected with the hepatitis C virus. This test, looks for antibodies, which are proteins released into the bloodstream when someone gets infected with the virus that causes hepatitis C. People who have positive or reactive HCV antibody tests are given a follow-up nucleic acid test (NAT) for HCV RNA to learn whether they have current infection.
When should I expect to get my test results?
Test results can take anywhere from a few days to a few weeks to come back. Rapid HCV antibody tests are available in some health clinics, and the results of these tests are available in 20–30 minutes, but the antibody test does not tell you whether you have current HCV infection. It is important to know that:
- Once you have been infected, you will always have antibodies in your blood. This is true if you have cleared the virus, have been cured, or still have the virus in your blood.
How are hepatitis C test results interpreted?
Your doctor will help interpret the results from your HCV testing and help guide you through next steps. Complete HCV testing requires an HCV antibody test followed by an HCV RNA test when the antibody test is positive/reactive. When the antibody test is “non-reactive,” or “negative,” you are not currently infected with the hepatitis C virus. When the antibody test is “reactive,” or “positive,” you have been infected with the hepatitis C virus at some point in time and need a NAT for HCV RNA (this can also be called a PCR test) to determine if you have current HCV infection.
- If the nucleic acid test for HCV RNA (or PCR test) is:
- Negative – this means you were infected with hepatitis C virus, but the virus is no longer in your body because you were cured or cleared the virus naturally.
- Positive – this means you currently have the virus in your blood and are infectious, meaning you can spread the virus to others.
- If you have a reactive antibody test and a positive NAT for HCV RNA, you need to talk to a doctor about treatment. Treatments are available that can cure most people with hepatitis C in 8–12 weeks.
How soon can a test detect if someone is infected after exposure to the hepatitis C virus?”
After exposure to the hepatitis C virus, it can take 8–11 weeks for an HCV antibody test to be reactive/positive. For most people who are infected, the HCV antibody blood test will typically become positive about 10 weeks after exposure. A special kind of blood test called a nucleic acid test (NAT), which detects HCV RNA (also known as a PCR test), can determine if a person is infected within 1–2 weeks of exposure. If you suspect exposure to hepatitis C within the past 6 months, inform your doctor..
Can a person have normal liver enzyme level and still have hepatitis C?
Yes. For people with hepatitis C, it is common for liver enzyme levels to go up and down, sometimes returning to normal or near normal. Some people with hepatitis C have liver enzyme levels that are normal for over a year even though they have chronic liver disease.
Treatment
What is the treatment for hepatitis C?
Healthcare providers recommend treatment for all individuals, including non-pregnant women, with acute or chronic hepatitis C, including children aged ≥3 years and adolescents’ Current treatments usually involve just 8–12 weeks of oral therapy (pills) and cure over 90% with few side effects. The FDA has a list of currently approved FDA treatments for hepatitis C.
What can people with chronic hepatitis C do to protect the liver?
Doctors should regularly monitor people with chronic hepatitis C and those with cirrhosis, even if they have been cured of their hepatitis C infection, because these individuals have a continued risk of complications of advanced liver disease, including liver cancer. In addition, people living with hepatitis C should
- Get vaccinated against hepatitis A and hepatitis B.
- avoid alcohol because it can cause additional damage to the liver
- check with their doctor before taking any prescription pills, herbs, supplements, or over-the-counter medications, as these can potentially damage the liver
- Test for HIV, as individuals with both infections are more prone to developing cirrhosis.
Prevention
Is there a vaccine that can prevent hepatitis C?
No. Currently, there is no vaccine to prevent hepatitis C.
Hepatitis C and Employment
Should certain jobs or settings restrict a person infected with the hepatitis C virus from working?
The CDC’s recommendations for prevention and control of hepatitis C virus infection state that people with hepatitis C virus infection should not face exclusion from work, school, play, childcare, or other settings. There is no evidence that people can get hepatitis C from food handlers, teachers, or other service providers without blood-to-blood contact.