What is Hepatitis C?

What's in this article?

1 How is Hepatitis C spread?
2 Symptoms of acute stage hepatitis C
3 Symptoms of chronic stage hepatitis C
4 What Causes hepatitis C
5 Treatment Guidelines for hepatitis C
6 Goals of Therapy for hepatitis C infection?

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

Many people don’t 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.

Other hepatitis viruses also exist and cause a small number of infections. Additionally, other viruses can cause hepatitis even though they are not specifically “hepatitis viruses”. These most commonly include Epstein Barr Virus (EBV), the cause of mononucleosis, and cytomegalovirus (CMV), which causes a variety of illnesses in different parts of the body, especially in patients whose immune function is depressed due to steroids, chemotherapy for cancer, and HIV/AIDS.

How is Hepatitis C spread?

Hepatitis C is usually spread when blood from a person infected with the Hepatitis C virus enters the body of someone who is not infected. Today, most people become infected with the Hepatitis C virus by sharing needles or other equipment to inject drugs. Before 1992, when widespread screening of the blood supply began in the United States, Hepatitis C was also commonly spread through blood transfusions and organ transplants.

People can become infected with the Hepatitis C virus during such activities as

Sharing needles, syringes, or other equipment to inject drugs
Needlestick injuries in health care settings
Being born to a mother who has Hepatitis C

Less commonly, a person can also get Hepatitis C virus infection through

Sharing personal care items that may have come in contact with another person’s blood, such as razors or toothbrushes
Having sexual contact with a person infected with the Hepatitis C virus

Symptoms of acute stage hepatitis C

In the acute stage, more than two thirds of people who become infected have no symptoms. For those who develop symptoms (2 to 26 weeks after infection), the symptoms last for 2 to 12 weeks. The symptoms are:

Upper abdominal pain, especially on the right
Dark urine
Light colored bowel movements
Jaundice (yellowing of the skin and eyes)
Nausea and upset stomach
Fatigue
Low grade fever and chills
Muscle aches
Loss of appetite
Mood swings
Joint pains
Itching of the skin

Symptoms of chronic stage hepatitis C

In the chronic stage, patients typically go years or decades with no symptoms. This is sometimes referred to as “latent” or “dormant” hepatitis C. Eventually, the chronic hepatitis becomes active with liver inflammation and scarring. Left untreated, this can progress to cirrhosis, liver failure, liver cancer (hepatocellular carcinoma), and death. The initial symptoms of chronic hepatitis C are:

Weakness and fatigue
Nausea
Loss of appetite
Muscle and joint aching
Weight loss

As chronic hepatitis C progresses to liver failure (hepatic decompensation), additional symptoms develop including:

Dark urine
Light colored bowel movements
Jaundice (yellowing of the skin and eyes)
Itching
Swelling of the abdomen (ascites) due to fluid accumulation
Swelling of the legs and feet (edema) due to fluid accumulation
Vomiting blood
Confusion
Easy bruising and bleeding
Generalized abdominal pain

What Causes hepatitis C

Because HCV infection usually produces no symptoms or very mild symptoms during the early stages, many people don’t know they have it until liver damage shows up – sometimes decades later – during routine medical tests. Some people who get HCV have it for a short time (up to six months) and then get better on their own. This is called acute Hepatitis C. But most people (about 75% – 85%) will go on to develop chronic (or long-term) Hepatitis C, meaning it doesn’t go away.

Whereas Hepatitis A generally gives rise to acute hepatitis, Hepatitis C results in chronic hepatitis in most patients. An easy reminder is C for chronic in Hepatitis C and A for acute in Hepatitis A.

Treatment Guidelines for hepatitis C

The treatment of hepatitis C is best discussed with a doctor or specialist familiar with current and developing options as this field is changing, and even major guidelines may become outdated quickly.

The latest treatment guidelines by the American Association for the Study of Liver Disease (AASLD) and Infectious Disease Society of America (IDSA) recommends use of DAAs as first-line treatment for hepatitis C infection. The choice of DAA varies by specific virus genotype, and the presence or absence of cirrhosis. In the U.S., specific insurance providers also might influence the choice due to the high cost of DAAs. Patients are encouraged to discuss options with their health-care professional.

Treatment is recommended in all patients with chronic hepatitis C unless they have a short life expectancy that is not related to liver disease. Severe life-threatening liver disease may require liver transplantation. Newer therapies with DAAs have allowed more and more patients to be treated.