Hepatitis C

Overview

The liver Enlarge image

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The liver

The liver

The liver is the largest organ inside the body. It sits mainly in the upper right part of the stomach areaabove the stomach.

Hepatitis C is a viral infection that causes liver swellingcalled 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 ongoingcalled chronichepatitis 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. Sothe U.S. Preventive Services Task Force recommends that all adults ages 18 to 79 years be screened for hepatitis C.

Screening is for everyoneeven those who don't have symptoms or known liver disease.

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 phasethey may include jaundicefatiguenauseafever 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:

• Bleeding easily.
• Bruising easily.
• Fatigue.
• Not wanting to eat.
• Yellowing of the skincalled jaundice. This might show up more in white people. Alsoyellowing of the whites of the eyes in whiteBlack and brown people.
• Dark-colored urine.
• Itchy skin.
• Fluid buildup in the stomach areacalled ascites.
• Swelling in the legs.
• Weight loss.
• Confusiondrowsiness and slurred speechcalled hepatic encephalopathy.
• Spiderlike blood vessels on the skincalled spider angiomas.

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 worldhepatitis C infection exists in several formscalled 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. Howevernewer 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:

• Anyone who has ever injectedsnorted or inhaled an illegal drug.
• Anyone who has atypical liver test results in which the cause wasn't found.
• Babies born from someone who has hepatitis C.
• Pregnant people during the pregnancy.
• Healthcare and emergency workers who have been in contact with blood or been stuck by a needle.
• People with hemophilia who were treated with clotting factors before 1987.
• People who have had long-term hemodialysis.
• People who got donated blood or organ transplants before 1992.
• Sexual partners of anyone diagnosed with hepatitis C infection.
• People with HIV infection.
• Men who have sex with men.
• Sexually active people about to start taking medicine to prevent HIVcalled pre-exposure prophylaxis or PrEP.
• Anyone who has been in prison.

Complications

Healthy liver vs. liver cirrhosis Enlarge image

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Healthy liver vs. liver cirrhosis

Healthy liver vs. liver cirrhosis

A healthy liverat leftshows no signs of scarring. In cirrhosisat rightscar tissue replaces healthy liver tissue.

Liver cancer Enlarge image

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Liver cancer

Liver cancer

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

Hepatitis C infection that continues over many years can cause serious complicationssuch as:

• Scarring of the livercalled cirrhosis. Scarring can occur after decades of hepatitis C infection. Liver scarring makes it hard for the liver to work.
• Liver cancer. A small number of people with hepatitis C infection get liver cancer.
• Liver failure. A lot of scarring can cause the liver to stop working.

Prevention

The following might protect from hepatitis C infection:

• Stop using illegal drugs. If you use illegal drugsseek help.
• Be careful about body piercing and tattooing. For piercing or tattooinglook for a shop that's known to be clean. Ask questions about how the equipment is cleaned. Make sure the employees use sterile needles. If employees won't answer questionslook for another shop.
• Practice safer sex. Don't have sex without protection with any partner whose health status you don't know. Don't have sex with more than one partner. The risk of couples who only have sex with each other getting hepatitis C through sex is low.