Hepatitis C: How It Spreads, Who Should Be Tested, and the Cure

What it is

Hepatitis is inflammation of the liver — swelling that happens when tissue is injured or infected, and that can damage organs. Hepatitis C is caused by the hepatitis C virus (HCV). It can be a mild illness lasting a few weeks or a serious, lifelong one.

• Acute hepatitis C is a short-term infection, with symptoms lasting up to 6 months. Sometimes the body clears the virus, but for most people acute infection becomes chronic.
• Chronic hepatitis C lasts; untreated, it can last a lifetime and cause liver damage, cirrhosis (scarring), liver cancer and even death.

How it spreads

Through contact with the blood of someone with HCV:

• sharing needles or other drug equipment — the most common way in the United States;
• an accidental needlestick, as can happen in health care;
• tattoos or piercings done with unsterilized tools or ink;
• contact with an infected person's blood or open sores;
• sharing razors, toothbrushes or other items that may touch blood;
• being born to a mother with HCV;
• unprotected sex with someone who has HCV.

Before 1992, it also spread through transfusions and organ transplants; since then the U.S. blood supply has been routinely tested, and that is now very rare.

Who is at higher risk

You're more likely to get hepatitis C if you have injected drugs; had a transfusion or transplant before July 1992; have hemophilia and got clotting factor before 1987; have been on kidney dialysis; have been exposed to blood or needles at work; have tattoos or piercings; have worked or lived in a prison; were born to a mother with hepatitis C; have HIV; have had more than one sex partner in the last 6 months or a sexually transmitted infection; or are a man who has sex with men. If you're at high risk, your provider will likely recommend testing.

Symptoms

Most people have none. Some with acute hepatitis C get symptoms 1 to 3 months after exposure: dark yellow urine, fatigue, fever, gray or clay-colored stools, joint pain, loss of appetite, nausea or vomiting, belly pain, and jaundice (yellow eyes and skin). Chronic hepatitis C usually causes no symptoms until complications appear — sometimes decades later — which is why screening matters even if you feel fine.

Diagnosis and treatment

Providers diagnose it from your history, a physical exam and blood tests; you may need more tests of liver damage, such as other blood tests, a liver ultrasound or a biopsy.

Antiviral medicines cure hepatitis C in most cases. With acute infection, your provider may wait to see whether it becomes chronic before treating. If you have cirrhosis, see a liver specialist; its complications may need medicines, surgery or other procedures, and liver failure or cancer may call for a liver transplant. Early diagnosis and treatment can prevent these complications.

Prevention

There is no vaccine, but you can protect yourself:

• don't share needles or drug equipment;
• wear gloves if you must touch someone's blood or open sores;
• make sure tattoo artists and piercers use sterile tools and unopened ink;
• don't share toothbrushes, razors or nail clippers;
• use a latex condom during sex — or a polyurethane one if either partner is allergic to latex.

Sources

Based on "Hepatitis C," MedlinePlus, National Library of Medicine, with its summary from the National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health; a work of the United States government in the public domain.