Hepatitis C

Let's continue the series on hepatitis this week with a discussion of hepatitis C.  Hepatitis C is another viral infection that leads to inflammation of the liver.  The symptoms of hepatitis C are the same as those discussed in my previous Health Tip on hepatitis.  Hepatitis C can cause an acute or chronic infection.  Chronic hepatitis C can lead to serious liver damage.  Unlike hepatitis A and B, there is no vaccine for prevention of hepatitis C, but there are good treatments available.

How do you get hepatitis C?
 
Hepatitis C is spread through contact with the blood of a person infected with hepatitis C.  It is not spread through casual contact with an infected person, such as working in the same office.  It is not spread through kissing an infected person, nor is it spread through contaminated food or water.  Although this virus can be spread through sexual contact, the risk of sexual transmission is thought to be low.

What are the risk factors for hepatitis C?

• Being a health care worker exposed to infected blood, including accidental needle sticks.
• Having a history of illicit drug use, including injection or inhaled drug use.
• Having an HIV infection
• Having received a blood transfusion or organ transplant prior to 1992
• Having received clotting factor concentrates prior to 1987
• Getting a piercing or tattoo with equipment that was not sterilized properly
• Being born to a mother with an acute or chronic hepatitis C infection
• Having been in prison
• If you were born between 1945 and 1965

How serious is hepatitis C?

Hepatitis C is a serious infection.  Although the acute phase of hepatitis C infection may cause only mild symptoms of hepatitis, which some people do not even recognize, most people infected with hepatitis C will go on to develop a chronic infection.  Only about 15-25% of people will be able to clear the hepatitis C virus from their body without treatment.  Between 75-85% of people will develop a chronic infection, which can lead to severe and progressive liver damage.

How common is hepatitis C?

According to statistics from the CDC, in 2016, there were an estimated 2.4 million people living with chronic hepatitis C in the US.  Because so many people with acute hepatitis C don't have symptoms, it is difficult to know how many acute cases there are, because acute cases are frequently not diagnosed.  The CDC estimates that there were almost 41,200 cases of acute hepatitis C infection in 2016.

What are the long-term complications of hepatitis C?

• Cirrhosis - A condition in which scar tissue replaces healthy liver tissue.  The risk of developing cirrhosis from hepatitis C is more likely if you are male, age 50 years and older, drink alcohol, have non-alcoholic fatty liver disease, have a coinfection with hepatitis B or HIV, or take immunosuppressive drugs.
• Liver failure - As cirrhosis progresses over months to years, the function of the liver declines and the liver can no longer perform the important functions that we talked about in the first Health Tip in this series.  The scar tissue can also block the blood flow through the liver, leading to many other serious problems.
• Liver cancer - Hepatitis C infection with cirrhosis increases your risk of liver cancer.

How is hepatitis C treated?

If you are diagnosed with an acute hepatitis C infection, there is no recommended treatment.  You should be followed by your doctor to determine if your body is able to clear the infection.  Treatment is only recommended if the infection becomes a chronic infection.

There are now several medications available for the treatment of chronic hepatitis C.  The treatment has improved significantly over the past 20 years regarding length of treatment, side effects, and cure rates.  Current treatments usually involve taking oral medication for 8-12 weeks.  This results in a cure for over 90% of patients with very few side effects.  Chronic liver disease can be avoided if treatment occurs prior to the onset of liver damage.  Follow this link to see a complete list of currently approved treatments of hepatitis C http://www.hepatitisc.uw.edu/page/treatment/drugs.

Should you be screened for hepatitis C? 

The US Preventive Services Task Force recommends screening for hepatitis C infection in persons at high risk for infection (including the risk factors above).  The USPSTF also recommends offering one-time screening for adults born between 1945 and 1965 (the age group with the highest incidence of hepatitis C infection).

For more information about hepatitis C, follow this link https://www.cdc.gov/hepatitis/hcv/cfaq.htm.

If you have any questions about Hepatitis C, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor