Hepatitis C

Topic Overview

What is hepatitis C?

Hepatitis C is a disease caused by a virus that infects the liver. In time, it can lead to permanent liver damage as well as cirrhosis, liver cancer, and liver failure.

Many people do not know that they have hepatitis C until they already have some liver damage. This can take many years. Some people who get hepatitis C have it for a short time and then get better. This is called acute hepatitis C. But most people who are infected with the virus go on to develop long-term, or chronic, hepatitis C.

Although hepatitis C can be very serious, most people can manage the disease and lead active, full lives.

What causes hepatitis C infection?

Hepatitis C is caused by the hepatitis C virus. It is spread by contact with an infected person's blood.

You can get hepatitis C if:

• You share needles and other equipment used to inject illegal drugs. This is the most common way to get hepatitis C in the United States.
• You had a blood transfusion or organ transplant before 1992. As of 1992 in the United States, all donated blood and organs are screened for hepatitis C.
• You get a shot with a needle that has infected blood on it. This happens in some developing countries where they use needles more than once when giving shots.
• You get a tattoo or a piercing with a needle that has infected blood on it. This can happen if equipment isn't cleaned properly after it is used.

In rare cases, a mother with hepatitis C spreads the virus to her baby at birth, or a health care worker is accidentally exposed to blood that is infected with hepatitis C.

Experts are not sure if you can get hepatitis C through sexual contact. If there is a risk of getting the virus through sexual contact, it is very small. The risk is higher if your sex partner has hepatitis C or if you have many sex partners.

You cannot get hepatitis C from casual contact such as hugging, kissing, sneezing, coughing, or sharing food or drink.

What are the symptoms?

Most people have no symptoms when they are first infected with the hepatitis C virus. If you do develop symptoms, they may include:

• Feeling very tired.
• Joint pain.
• Belly pain.
• Itchy skin.
• Sore muscles.
• Dark urine.
• Yellowish eyes and skin (jaundice). Jaundice usually appears only after other symptoms have started to go away.

Most people go on to develop chronic hepatitis C but still do not have symptoms. This makes it common for people to have hepatitis C for 15 years or longer before it is diagnosed.

How is hepatitis C diagnosed?

Many people find out by accident that they have the virus. They find out when their blood is tested before a blood donation or as part of a routine checkup. Often people with hepatitis C have high levels of liver enzymes in their blood.

If your doctor thinks you may have hepatitis C, he or she will talk to you about having a blood test. If the test shows hepatitis C antibodies, you have had hepatitis C at some point. A second test can tell if you have hepatitis C now.

When blood tests show that you have hepatitis C, you may need a liver biopsy to see if the virus has caused scarring in your liver. During a liver biopsy, a doctor will insert a needle between your ribs to collect a small sample of liver tissue to look at under a microscope. See a picture of the placement of the needle for a liver biopsy .

Some people prefer to find out on their own if they have been exposed to hepatitis C. You can buy a home test called a Home Access Hepatitis C Check kit at most drugstores. If the test shows that you have been exposed to the virus in the past, be sure to talk to your doctor to find out if you have the virus now.

How is it treated?

You and your doctor need to decide if you should take antiviral medicine to treat hepatitis C. It may not be right for everyone. If your liver damage is mild, you may not need medicine.

If you do take medicine, the best treatment is a combination of two medicines that fight infection: peginterferon and ribavirin. How well these medicines work depends on how damaged your liver is, how much virus you have in your liver, and what type of hepatitis C you have.

Taking care of yourself is an important part of the treatment for hepatitis C. Some people with hepatitis C do not notice a change in the way they feel. Others feel tired, sick, or depressed. You may feel better if you exercise and eat healthy foods. To help prevent further liver damage, avoid alcohol and illegal drugs and certain medicines that can be hard on your liver.

Frequently Asked Questions

Learning about hepatitis C:	What is hepatitis C? What causes hepatitis C? Can I prevent hepatitis C? What are the symptoms of hepatitis C? What happens in hepatitis C? What increases my risk for hepatitis C? How common is hepatitis C?
Being diagnosed:	How is hepatitis C diagnosed? Who can diagnose hepatitis C? What is a hepatitis C antibody test? What blood test can show whether I have active hepatitis C infection? What kind of blood tests may be done to check the health of my liver? What is a liver biopsy? Should I be tested for hepatitis B and C?
Getting treatment:	How is hepatitis C treated? Should I take medicines for hepatitis C? What is combination antiviral treatment?
Ongoing concerns:	Will I need surgery?
Living with hepatitis C:	What can I do to treat hepatitis C at home?
End-of-life issues:	How can I prepare for end-of-life issues if needed?

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Author:	Maria Essig	Last Updated: July 13, 2009
Medical Review:	Kathleen Romito, MD - Family Medicine W. Thomas London, MD - Hepatology
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