Hepatitis C

(HCV; Hep C)


Hepatitis C is an infection of the liver.


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Causes    TOP

Hepatitis C is caused by the hepatitis C virus (HCV). The hepatitis C virus is spread through contact with the blood of an infected person.

A woman with hepatitis can pass the virus on to her baby during birth. The hepatitis C virus is not spread through food or water.

Risk Factors    TOP

Factors that may increase your chance of hepatitis C include:

  • Injecting illicit drugs, especially with shared needles
  • Receiving a blood transfusion before 1992—this risk is low in the United States
  • Receiving blood clotting products before 1987
  • Receiving an HCV-infected organ transplant
  • Long-term kidney dialysis treatment
  • 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
  • Tattooing
  • Body piercing
  • Having sex with partners who have hepatitis C or other sexually transmitted diseases

Symptoms    TOP

Most people with hepatitis C do not have symptoms. Over time, the disease can cause serious liver damage.

Symptoms may include:

  • Fatigue
  • Loss of appetite
  • Yellowing of the eyes and skin
  • Darker colored urine
  • Loose, light, or chalky colored stools
  • Abdominal pain
  • Aches and pains
  • Itching
  • Rash
  • Joint pain
  • Cigarette smokers may suddenly dislike the taste of cigarettes
  • Nausea
  • Vomiting

Chronic hepatitis C may cause some of the above symptoms, as well as:

  • Weakness
  • Severe fatigue
  • Loss of appetite

Serious complications of hepatitis C include:

  • Chronic infection that will lead to cirrhosis (scarring) and progressive liver failure
  • Increased risk of liver cancer

Diagnosis    TOP

You will be asked about your symptoms and medical history. A physical exam will be done. You will also discuss your risk factors.

Your bodily fluids and tissues may be tested. This can be done with:

  • Blood tests
  • Liver biopsy—tissue is examined under a microscope

Your liver function may be evaluated. This can be done with liver function studies.

Images may be needed of your liver. This can be done with an ultrasound.

Treatment    TOP

Hepatitis C is usually treated with combined therapy, consisting of:

  • Medication to boost the immune system
  • Antiviral medications

You will be advised to stop drinking alcohol and smoking, which can further damage your liver, especially when undergoing treatment. If you have problems stopping alcohol, your doctor can refer you to counseling or a treatment program. There are several ways to successfully quit smoking.

In unsuccessful cases, chronic hepatitis C can cause cirrhosis and serious liver damage. A liver transplant may be needed, although it does not typically cure hepatitis C.

Prevention    TOP

To prevent becoming infected with hepatitis C:

  • Do not inject illegal drugs. Shared needles have the highest risk. Seek help to stop using drugs.
  • Do not have sex with partners who have sexually transmitted diseases (STDs).
  • Practice safe sex (using latex condoms) or abstain from sex.
  • Limit your number of sexual partners.
  • Do not share personal items that might have blood on them, such as:
    • Razors
    • Toothbrushes
    • Manicuring tools
    • Pierced earrings
  • 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.
  • Go to regular check ups and get tested for hepatitis C and other STDs as advised.

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.


American Liver Foundation
Hepatitis Foundation International


Canadian Liver Foundation


2015 Sexually transmitted diseases treatment guidelines. Centers for Disease Control and Prevention website. Available at:
...(Click grey area to select URL)
Updated October 6, 2015. Accessed October 8, 2015.
Centers for Disease Control and Prevention (CDC). Sexual transmission of hepatitis C virus among HIV-infected men who have sex with men—New York City, 2005-2010. MMWR Morb Mortal Wkly Rep. 2011;60(28):945-950.
Chang MH, Gordon LA, Fung HB. Boceprevir: A protease inhibitor for the treatment of hepatitis C. Clin Ther. 2012;34(10):2021-2138.
Explore blood transfusion? National Heart Lung and Blood Institute website. Available at:
...(Click grey area to select URL)
Updated January 30, 2012. Accessed October 8, 2015.
Hepatitis C. EBSCO DynaMed website. Available at:
...(Click grey area to select URL)
Updated July 6, 2015. Accessed October 8, 2015.
Viral hepatitis—hepatitis C information. Centers for Disease Control and Prevention website. Available at:
...(Click grey area to select URL)
Updated May 31, 2015. Accessed October 8, 2015.
What I need to know about hepatitis C. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at:
...(Click grey area to select URL)
Updated December 19, 2012. Accessed October 8, 2014.
12/9/2013 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
US Food & Drug Administration. FDA news release: FDA approves new treatment for hepatitis C virus. Food & Drug Administration website. Accessed October 8, 2015.
4/29/2014 12/9/2013 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
American Association for the Study of Liver Diseases/Infectious Diseases Society of America (AASLD/IDSA) recommendations on testing, managing, and treating hepatitis C. Available at: http://www.hcvguidelines.org/fullreport. Accessed October 8, 2015.
10/8/2014 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
British Association of Sexual Health and HIV (BASHH) recommendations on testing for sexually transmitted infections in men who have sex with men. Available at: http://www.bashh.org/documents/BASHH%20Recommendations%20for%20testing%20for%20STIs%20in%20MSM%20-%20FINAL.pdf. Accessed October 8, 2015.
Last reviewed August 2015 by Daus Mahnke, MD
Last Updated: 10/8/2015