Hepatitis C (Hep C) Symptoms and Treatment
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What Is Hepatitis C (Hep C, HCV)?
Hepatitis C (HCV) is a virus that causes
inflammation of the liver. Hepatitis means inflammation of the liver. It is a
member of the family of viruses that include hepatitis A and hepatitis B. The
viruses behave differently and have different modes of transmission. Hepatitis
C can cause serious liver damage, liver failure, liver cancer, and even death.
How Common Is Hepatitis C?
About 2.7-3.9 million people in the U.S.
currently live with chronic hepatitis C infection. 75%-85% of people infected
with hepatitis C are infected with chronic hepatitis C. The virus is most
common in baby boomers who represent 75% of infected adults. The rates of
hepatitis C were the highest in the 1970s and 1980s, the time when many baby
boomers were likely infected. Many people who have hepatitis C don't know they
have it because the virus may not produce symptoms until decades after
infection.
Hepatitis C in Children
Hepatitis C is less common in children, but
there are approximately 23,000-46,000 children in the U.S. with hepatitis C.
Most children are infected by hepatitis C at birth. A child has a 1 in 20
chance of being infected if the mother has hepatitis C. Adolescents can be
infected with hepatitis C by exposing themselves to IV drug use, sharing
needles, and high-risk sexual behaviors. Up to 40% of hepatitis C cases in
children will go away on their own by age 2, if the virus is transmitted at
birth.
How Do You Get Hepatitis C?
Hepatitis C is a blood-borne illness,
meaning it is transmitted via contact with infected blood. Usually the virus
enters the body through a puncture wound on the skin.
Is Hepatitis
C Contagious?
Yes, hepatitis C is contagious. The most common way hepatitis C
is transmitted is via injection drug use. Sharing needles with someone who is
infected can transmit hepatitis C. Health care professionals may contract the
virus via needlestick injury. Prior to 1992, the U.S. blood supply was not
screened the way it is today, so some people contracted hepatitis C from
infected blood transfusions. Rarely, babies born to hepatitis C-infected
mothers acquire the virus. Hepatitis C can also be spread by having sex with an
infected person or sharing personal items (a razor or toothbrush) with someone
who has the virus, but these cases are rare.
Hepatitis C (Hep C) Symptom
About 70% to 80% of people with the hepatitis C virus do not
have any symptoms, especially in the early stages. In these people, symptoms
may develop years, even decades later, when liver damage occurs. Others develop
symptoms between 2 weeks to 6 months after infection. The average time to
develop symptoms is 6 to 7 weeks after acquiring the virus. A person who has
hepatitis C infection, but isn't exhibiting any symptoms can still pass the
virus on to others. Hepatitis C symptoms may include:
- Mild-to-severe
fever
- Fatigue
- Abdominal pain
- Loss of appetite
- Nausea
- Vomiting
- Joint pain
- Dark urine
- Clay-colored
stool
- Yellowing of the
skin (jaundice)
Acute vs. Chronic Hepatitis C Infection
Acute hepatitis C infection refers to symptoms that appear
within 6 months of newly acquiring the virus. About 20% to 30% of those who
acquire hepatitis C experience acute illness. After this, the body either
clears the virus or goes on to develop chronic infection.
Chronic hepatitis C infection refers to long-lasting infection.
The majority of people who have acute hepatitis C infection (75% to 85%) go on
to develop the chronic form of the illness.
How Is Hepatitis C Diagnosed?
Hepatitis C infection is diagnosed with several blood tests. The
hepatitis C antibody test checks for antibodies (immune particles) that fight
the virus. A "non-reactive" result means that antibodies to the virus
are not detected. A "reactive" result means antibodies to the virus
are present, but the test is unable to indicate whether the infection is
current or from the past. Another blood test to assess the presence of
hepatitis C genetic material (HCV RNA test) is available. The results of this
test can help doctors determine whether hepatitis C infection is current or
not. Additional blood tests can be used to determine the amount of virus in the
body, known as a titer.
When someone has confirmed hepatitis C infection, the doctor
will order more tests to assess the degree of liver damage. A liver biopsy may
be performed. There are several different strains of the hepatitis C virus that
respond to different treatments. For this reason, the doctor will order a test
to determine the genotype(s) of the hepatitis C infection to help determine the
course of treatment.
Who
Should Get Tested for Hepatitis C?
- Current or
former drug users who use needles
- Healthcare
workers exposed to blood or bodily fluids
- People with a
sex partner infected with chronic hepatitis C
- People who had their
blood filtered by a machine for a long time
- People who
received a blood transfusion or organ transplant from a donor before July
1992
- People with HIV
- People born
between 1945 and 1965
Potential
Hepatitis C Complications
Chronic hepatitis C infection is a
long-lasting illness with potentially serious complications. About 75% to 85%
of those with acute hepatitis C infection go on to develop chronic hepatitis C.
Of those in the chronic illness group, more than two-thirds will develop liver
disease. Up to 20% will develop cirrhosis, or scarring of the liver, within 20
to 30 years. Cirrhosis affects liver function and causes elevated blood liver
enzymes. Up to 5% of people with chronic hepatitis C infection will die from
liver cancer or cirrhosis. Chronic hepatitis C infection is the most common
reason for liver transplantation in the U.S.
Hepatitis
C (Hep C) Treatment
Treatment for hepatitis C is available. The course of treatment
depends on whether the infection is acute or chronic, the strain (genotype) of
the virus, the amount of the virus in the body (viral load), the degree of
liver damage, response to previous treatment, and the health of the patient.
Hepatitis C treatment is highly individualized, so it's important to be under
the care of a doctor with expertise in this area. The goal of treatment is to
achieve sustained virologic response (SVR), which means there is no detectable
virus in the blood 6 months after treatment. While it's not a cure, achieving
SVR is the next best thing. Many people with hepatitis C can achieve SVR with
treatment.
Medications
That Treat Hepatitis C
- Interferon
(Infergen, Roferon, Intron A)
- Peglyated
interferon (Pegasys, Pegintron)
- Ribavirin
(CoPegus, Rebetol)
- Boceprevir
(Victrelis)
- Telaprevir
(Incivek)
- Simprevir
(Olysio)
- Sofosbuvir
(Sovaldi)
- Ledipasvir/sofosbuvir
(Harvoni)
- Ombitasvir/paritaprevir/ritonavir
tablets; dasabuvir tablets (Viekira Pak)
- Ombitasvir/paritaprevir/ritonavir
(Technivie)
- Daclatasvir
(Daklinza)
Your doctor can choose the best treatment for your individual
circumstances.
Hepatitis
C and Liver Transplantation
Some people with advanced hepatitis C and
severe liver damage undergo a liver transplant, but that doesn't eradicate the
infection. Patients with an active infection at the time of the transplant will
develop hepatitis C in the new liver. Sometimes the infection recurs even when patients
are on antiviral treatment. Those who have achieved sustained virologic
response (SVR) - meaning no detectable virus in the blood 6 months after
treatment - have a very low risk of developing hepatitis C infection in the new
liver.
Is
Hepatitis C Curable?
About 15% to 25% of people who are infected with the hepatitis C
infection clear the virus on their own. Scientists are still trying to
determine why hepatitis C goes away in some patients, while others go on to
develop symptoms. There is no cure for an active or chronic hepatitis C
infection, but sustained virologic response (SVR) is the next best thing.
Hepatitis C infection rarely recurs in those who have achieved SVR.
Hepatitis
C Vaccine
There is currently no vaccine for hepatitis
C. Research is ongoing to develop a vaccine against the virus. There are
vaccines for hepatitis A and hepatitis B.
How to
Prevent Hepatitis C Infection
Hepatitis C is a blood-borne infection. To reduce the risk of
infection, avoid sharing personal items (toothbrushes and razors) with others.
Do not use injected drugs. If you do use injected drugs, never share needles
and equipment with others. Getting tattoos and body piercings can put you at
risk. Use condoms during sex. Health care workers should take precautions to
avoid needle-sticks and properly dispose of needles and other materials that
come into contact with blood. Speak to your doctor about your risk factors and
follow recommended screening standards for hepatitis C.
How to
Prevent Giving Hepatitis C
If
you have hepatitis C, these common precautions should be followed to prevent
spreading or giving hepatitis C to others:
- Cover cuts and
blisters
- Properly dispose
of any used bandages, tissues, tampons, or anything else containing your
blood
- Wash your hands
or any objects that have come in contact with your blood
- Clean spilled
blood on surfaces with household bleach and water
- Don’t share
personal items that have your blood on it
- Do not
breastfeed if your nipples becomes cracked and bleed
- Do not donate
blood, sperm, or organs
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