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Hepatitis C

Medically reviewed by Drugs.com. Last updated on Aug 23, 2023.

Overview

Hepatitis C is a viral infection that causes liver swelling, called inflammation. Hepatitis C can lead to serious liver damage. The hepatitis C virus (HCV) spreads through contact with blood that has the virus in it.

Newer antiviral medicines are the treatment of choice for most people with the ongoing, called chronic, hepatitis C infection. These medicines often can cure chronic hepatitis C.

But many people with hepatitis C don't know they have it. That's mainly because symptoms can take decades to appear. So, the U.S. Preventive Services Task Force recommends that all adults ages 18 to 79 years be screened for hepatitis C.

Screening is for everyone, even those who don't have symptoms or known liver disease.

The liver

The liver is the largest internal organ in the body. It's about the size of a football. It sits mainly in the upper right portion of the stomach area, above the stomach.

Symptoms

Every long-term hepatitis C infection starts with what's called an acute phase. Acute hepatitis C usually isn't diagnosed because it rarely causes symptoms. When there are symptoms in this phase, they may include jaundice, fatigue, nausea, fever and muscle aches.

Long-term infection with the hepatitis C virus is called chronic hepatitis C. Chronic hepatitis C usually has no symptoms for many years. Symptoms appear only after the virus damages the liver enough to cause them.

Symptoms can include:

Acute hepatitis C infection doesn't always become chronic. Some people clear the infection from their bodies after the acute phase. This is called spontaneous viral clearance. Antiviral therapy also helps clear acute hepatitis C.

Causes

Hepatitis C infection is caused by the hepatitis C virus (HCV). The infection spreads when blood that has the virus enters the bloodstream of a person who isn't affected.

Around the world, hepatitis C infection exists in several forms, called genotypes. There are seven genotypes and 67 subtypes. The most common hepatitis C genotype in the United States is type 1.

Chronic hepatitis C follows the same course no matter what the genotype of the infecting virus. But treatment can vary depending on viral genotype. However, newer antiviral drugs can treat many genotypes.

Risk factors

Screening for hepatitis C

The U.S. Preventive Services Task Force recommends that all adults ages 18 to 79 years be screened for hepatitis C. Screening is very important for people at high risk of exposure. This includes:

Complications

Hepatitis C infection that continues over many years can cause serious complications, such as:

Healthy liver vs. liver cirrhosis

A healthy liver, at left, shows no signs of scarring. In cirrhosis, at right, scar tissue replaces healthy liver tissue.

Liver cancer

Liver cancer begins in the liver cells. The most common type of liver cancer starts in cells called hepatocytes and is called hepatocellular carcinoma.

Prevention

The following might protect from hepatitis C infection:

Diagnosis

If a screening test shows hepatitis C, other blood tests can:

Tests for liver damage

One or more of the following tests looks for liver damage in chronic hepatitis C.

Treatment

Antiviral medicines

Antiviral medicines treat hepatitis C. They're used to clear the virus from the body. The goal of treatment is to have no hepatitis C virus found in the body for at least 12 weeks after treatment ends.

Some newer antiviral medicines, called direct-acting, have better outcomes, fewer side effects and shorter treatment times. Treatment can be as short as eight weeks. The choice of medicines and length of treatment depend on the hepatitis C genotype, whether the liver is damaged, other medical conditions and earlier treatments.

Throughout treatment, the care team watches the treatment for response to the medicines and side effects. Treatment with direct-acting antiviral medicines usually lasts 12 weeks.

Due to the pace of research, treatments are changing quickly. So it's best to discuss treatment choices with a specialist.

Liver transplantation

Having a liver transplant might be an option for serious liver damage from chronic hepatitis C infection. During a liver transplant, a surgeon removes the damaged liver and replaces it with a healthy liver. Most transplanted livers come from dead donors. A small number come from living donors who donate a part of their livers.

In most cases, a liver transplant alone doesn't cure hepatitis C. The infection is likely to return. This means more treatment with antiviral medicines to prevent damage to the new liver. Several studies have shown that newer antiviral medicines cure hepatitis C after a transplant. Sometimes, the newer antivirals can cure hepatitis C before a liver transplant.

Vaccinations

There's no vaccine for hepatitis C. But a health care provider will likely recommend vaccines against the hepatitis A and B viruses. These are viruses that also can cause liver damage and make hepatitis C worse.

Lifestyle and home remedies

Certain lifestyle changes can help manage hepatitis C. These measures can help keep you healthy longer and protect the health of others:

Preparing for an appointment

If you think you might be at risk of hepatitis C, see your health care provider. If you're diagnosed with a hepatitis C infection, your provider might refer you to a specialist in liver diseases, called a hepatologist, or a specialist in infectious diseases.

What you can do

Consider taking a family member or friend with you to the appointment to help you remember the information you get.

Make a list of:

Some basic questions to ask about hepatitis C include:

Be sure to ask all the questions you have about your condition.

What to expect from your doctor

Your health care provider is likely to ask you questions, such as:

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