Hepatitis C is an infection of the liver caused by the hepatitis C virus (HCV).

Causes

Hepatitis C virus is carried in the blood of people infected with the virus. It is primarily spread through contact with infected blood, such as:

• Injecting illicit drugs with shared needles

• Receiving HCV-infected blood transfusions (before 1992) or blood clotting products (before 1987)

• Receiving an HCV-infected organ transplant

• Receiving long-term kidney dialysis treatment (The dialysis machine can be tainted with HCV-infected blood.)

• Sharing toothbrushes, razors, nail clippers, or other personal hygiene items that have HCV-infected blood on them

• Being accidentally stuck by an HCV-infected needle (a concern for healthcare workers)

• Frequent contact with HCV-infected people (a concern for healthcare workers)

• Receiving a tattoo, body piercing, or acupuncture with unsterilized or improperly sterilized equipment

Hepatitis C can also spread through:

• An HCV-infected mother to her baby at the time of birth

• Sexual contact with someone infected with HCV

• Sharing a straw (or inhalation tube) when inhaling drugs with someone infected by HCV

• Receiving a blood transfusion

HCV cannot spread through:

• The air

• Unbroken skin

• Casual social contact

• Breastfeeding

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

Risk factors include:

• Receiving a blood transfusion before 1992

• Receiving blood clotting products before 1987

• Long-term kidney dialysis treatment

• Tattooing

• Body piercing

• Injecting illicit drugs, especially with shared needles

• Having sex with partners who have hepatitis C or other sexually transmitted diseases

Symptoms

Eighty percent of people with hepatitis C have no symptoms. However, over time, the disease can cause serious liver damage.

Symptoms may include:

• Fatigue

• Loss of appetite

• Jaundice (yellowing of the eyes and skin)

• Darker colored urine

• Light or chalky colored stools

• Loose, light-colored stools

• Abdominal pain

• Aches and pains

• Itching

• Hives

• Joint pain

• Cigarette smokers may suddenly dislike the taste of cigarettes.

• Nausea

• Vomiting

Chronic hepatitis C infection may cause some of the above symptoms, as well as:

• Weakness

• Severe fatigue

• Loss of appetite

Serious complications of hepatitis C infection include:

• The possibility that the infection will become chronic, leading to cirrhosis (scarring) and progressive liver failure

• Increased risk of liver cancer

Diagnosis

Your healthcare provider will ask about your symptoms and medical history, and perform a physical exam. You will also discuss your risk factors for hepatitis C.

Tests may include:

Blood Tests – to look for hepatitis C antibodies or genetic material from the virus (The antibodies are proteins that your body has made to fight the hepatitis C virus.)

Liver Function Studies – to initially determine and follow how well your liver is functioning

Ultrasound of the Liver – to assess liver damage

Liver Biopsy – removal of a sample of liver tissue to be examined

Treatment

Hepatitis C is treated with medications, including:

• Interferon, given by injection

• Ribavirin, given orally

• A combination of interferon and ribavirin

These medications can cause difficult side effects and have limited success rates. In unsuccessful cases, chronic hepatitis C can cause cirrhosis (scarring) and serious liver damage. In rare cases, a liver transplant may be needed.

Prevention

To prevent becoming infected with hepatitis C:

• Do not inject illicit drugs, especially with shared needles. Seek help to stop using drugs.

• Do not have sex with partners who have sexually transmitted diseases.

• Practice safe sex (using latex condoms) or abstain from sex.

• Limit your number of sexual partners.

• Avoid sharing personal hygiene products, such as toothbrushes.

• Avoid handling items that may be contaminated by HCV-infected blood.

• Donate your own blood before elective surgery to be used if you need a blood transfusion.

To prevent spreading hepatitis C to others if you are infected:

• Tell your dentist and physician before receiving check-ups or treatment.

• Get both a hepatitis A and hepatitis B vaccination.

• Do not donate blood or organs for transplant.

RESOURCES:

American Liver Foundation
http://www.liverfoundation.org

Hepatitis Foundation International
http://www.hepfi.org

CANADIAN RESOURCES

Canadian Institute for Health Information
http://www.cihi.ca/cihiweb/dispPage.jsp?cw_page=home_e

Canadian Liver Foundation
http://www.liver.ca/Home.aspx

References:

Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/.

The Merck Manual of Medical Information. Simon and Schuster, Inc.; 2000.

National Digestive Diseases Information Clearinghouse website. Available at: http://digestive.niddk.nih.gov/.