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Hepatitis C

(HCV; Hep C)

Definition

Hepatitis C is an infection of the liver. Over time, it can cause serious liver damage if it is not treated.

Hepatitis

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Causes  ^

Hepatitis C is caused by a virus (HCV). The virus can be spread:

  • Through contact with the blood of an infected person
  • Through IV drug use
  • To a baby during birth, if the mother has the infection

The hepatitis C virus is not spread through food or water.

Risk Factors  ^

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 (current testing process prevents this today)
  • Receiving blood clotting products before 1987 (current testing process prevents this today)
  • 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  ^

Symptoms may not be present or be too minor to notice. Those that do have symptoms may have:

  • 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

Long term (chronic) hepatitis C may also cause:

  • Weakness
  • Severe fatigue
  • Loss of appetite

Diagnosis  ^

The doctor will ask about your symptoms and past medical issues. A physical exam will be done. Your doctor may suspect hepatitis based on your risk factors. Blood tests will be done to confirm hepatitis by looking for:

  • Signs of the virus
  • Antibodies—the immune system reaction to the virus; not present early in the infection
  • Changes in liver function

Other tests may be done to rule out other liver conditions.

Treatment  ^

In some people, the infection may go away on its own. It is important to follow up with the doctor to make sure the infection has cleared.

If the infection does not pass, the goal of treatment is to:

  • Cure the infection
  • Prevent further liver damage

Antiviral medicine will help the body fight and clear the virus.

It is important to stop habits that cause more stress and damage to the liver. You will be advised to:

  • Stop drinking alcohol. Talk to your doctor if you have problems with alcohol. Your doctor can refer you to counseling or a treatment program.
  • Quit smoking. There are several tools to help you quit smoking. Talk to your doctor about methods that are safe for you.
  • Avoid certain medicine. For example, acetaminophen can be harmful to the liver. Talk to your doctor about any medicine or supplements you are taking.

To prevent spreading hepatitis C to others:

  • Let your dentist and doctors know before check-ups or treatment.
  • Get vaccines for both hepatitis A and hepatitis B.
  • Do not donate blood or organs for transplant.

Prevention  ^

If you were born between 1945 and 1965, you should get screened for hepatitis C infection.

To prevent a hepatitis C infection:

  • 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 infections (STIs).
  • Practice safe sex. Use latex condoms.
  • 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
  • If you are having a planned surgery, ask if you may need a blood transfusion. You can donate your blood before the surgery so that, if you need blood in surgery it will be your own.
RESOURCES:

American Liver Foundation
http://www.liverfoundation.org

Hepatitis Foundation International
http://www.hepfi.org

CANADIAN RESOURCES

Canadian Liver Foundation
http://www.liver.ca

Health Canada
http://www.hc-sc.gc.ca

REFERENCES:

2015 Sexually transmitted diseases treatment guidelines. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/std/tg2015/default.htm. Updated October 6, 2015. Accessed October 8, 2015.

Acute hepatitis C infection. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T413896/Acute-hepatitis-C-infection. Updated April 27, 2017. Accessed August 21, 2017.

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.

Chronic hepatitis C infection. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T115157/Chronic-hepatitis-C-infection. Updated June 5, 2017. Accessed August 21, 2017.

Explore blood transfusion? National Heart Lung and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/bt. Updated January 30, 2012. Accessed October 8, 2015.

Hepatitis C: screening. US Preventive Services Task Force website. Available at: https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/hepatitis-c-screening?ds=1&s=hepatitis%20C. Updated June 2013. Accessed March 14, 2018.

Viral hepatitis—hepatitis C information. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/hepatitis/hcv/index.htm. Updated January 27, 2017. Accessed August 21, 2017.

What are my treatment options? Hep C 1,2,3—American Liver Foundation website. Available at: http://hepc.liverfoundation.org/taking-action/what-are-my-options-for-treatment. Updated April 2015. Accessed August 21, 2017.

What I need to know about hepatitis C. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://www.niddk.nih.gov/health-information/health-topics/liver-disease/hepatitis-c/Pages/ez.aspx. Updated May 2017. Accessed August 21, 2017.

12/9/2013 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T115157/Hepatitis-C: 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 Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T115157/Hepatitis-C: 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 Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T115157/Hepatitis-C: 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 2017 by Michael Woods, MD FAAP  Last Updated: 8/21/2017

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