Hepatitis C

Last Reviewed: October 2008

What is hepatitis C?

Hepatitis C is a liver disease caused by the hepatitis C virus (HCV), which is found in the blood of persons who have this disease. HCV is spread by contact with the blood of an infected person.

Who gets hepatitis C?

Persons at highest risk for HCV infection include:

  • persons who ever injected illegal drugs, including those who injected once or a few times many years ago,
  • people who had blood transfusions, blood products or organ donations before June 1992, when sensitive tests for HCV were introduced for blood screening, and
  • persons who received clotting factors made before 1987.

Other persons at risk for hepatitis C include:

  • long-term kidney dialysis patients,
  • health care workers after exposures (i.e., needle stick or splashes to the eye) to the blood of an infected person while on the job,
  • infants born to HCV-infected mothers,
  • people with high-risk sexual behavior, multiple partners and sexually transmitted diseases,
  • people who snort cocaine using shared equipment, and
  • people who have shared toothbrushes, razors and other personal items with a family member who is HCV-infected.

How is the virus spread?

Like hepatitis B virus, hepatitis C virus is spread when blood of an infected person enters the body of a person who is not infected, such as through sharing needles or "works" when shooting drugs or occupational needle stick injury. The risk of sexual transmission has not been thoroughly studied but appears to be low in long-term, monogamous relationships. There is no evidence that the hepatitis C virus can be transmitted by casual contact such as hugging or shaking hands, through foods, by sharing eating utensils or drinking glasses, or by coughing or sneezing. Hepatitis C is not spread by breastmilk.

What are the symptoms and consequences of infection?

Approximately 20 percent of persons exposed to the virus develop symptoms which may include jaundice (yellowing of the skin and whites of the eyes), fatigue, dark-colored urine, stomach pain, loss of appetite and nausea. After the initial infection, 15-25 percent will recover and 75-85 percent will become chronically infected (life-long infection). Approximately 70 percent of persons chronically infected may develop liver disease, sometimes decades after initial infection.

How soon do symptoms occur?

Symptoms may occur from two weeks to six months after exposure but usually within six to nine weeks.

When and for how long is a person able to spread hepatitis C?

Persons with acute hepatitis C virus infection are generally contagious from one or more weeks before the onset of symptoms. The contagious period is indefinite in chronically infected persons. All persons who test positive should be considered to be potentially contagious.

What is the treatment for hepatitis C?

Drugs (anti-viral) are licensed for treatment of persons with chronic hepatitis C. Combination drug therapy, using pegylated interferon and ribavirin, can get rid of the virus in up to five out of ten of persons with genotype 1, the most common genotype in the U.S. and eight out of ten persons with genotype 2 or 3. It is important to know that not everyone will need treatment. The decision to treat hepatitis C is complex and is best made by a physician experienced in treating the disease.

Is donated blood tested for this virus?

Since the early 1990s, blood donation centers throughout the U.S. have routinely used a blood donor screening test for hepatitis C. Widespread use of this test has significantly reduced the number of post-transfusion hepatitis C infections.

How can the risk of chronic liver disease be reduced among persons infected with hepatitis C?

People who are infected with hepatitis C should not drink alcohol. They should talk with their doctor before taking any new medications, including over-the-counter and herbal medications. They should also talk with their doctor about getting the hepatitis A and hepatitis B vaccines.

How can the spread of hepatitis C be prevented?

People who have had hepatitis C should remain aware that their blood is potentially infectious.

  • Do not shoot drugs; if you shoot drugs, stop and get into a treatment program; if you can't stop, never share needles, syringes, water or "works", and get vaccinated against hepatitis A and B.
  • Do not share personal care items that might have blood on them (razors, toothbrushes).
  • If you are a health care or public safety worker, always follow routine barrier precautions and safely handle needles and other sharps; get vaccinated against hepatitis B.
  • Consider the risks if you are thinking about getting a tattoo or body piercing. You might get infected if the tools have someone else's blood on them or if the artist or piercer does not follow good health practices.
  • HCV can be spread by sex, but this is rare. If you are having sex with more than one steady sex partner, use latex condoms correctly and every time to prevent the spread of sexually transmitted diseases. You should also get vaccinated against hepatitis B.
  • If you are infected with HCV, do not donate blood, organs or tissue.

Is there a vaccine for hepatitis C?

At present time, a hepatitis C vaccine is not available.