Hepatitis is an inflammation of the liver, and hepatitis C is liver inflammation caused by the hepatitis C virus (HCV).
Other types of viral hepatitis include hepatitis A, B, D, and E.
Hepatitis A and E are generally acquired from contaminated food and drink, while B, C, and D are transmitted via bodily fluids.
Vaccines are available to prevent hepatitis A and B, but no vaccines exist for hepatitis C and E.
You can only acquire hepatitis D if you already have hepatitis B, so the hepatitis B vaccine can protect you from both B and D infections.
HCV causes hepatitis C infections.
There are six major strains of HCV, or HCV genotypes, and more than 50 subtypes of hepatitis C, according to the World Health Organization (WHO).
These genotypes respond differently to treatments, and it's possible to be infected with more than one HCV genotype at the same time.
Hepatitis C is a contagious disease that is transmitted when the blood of an infected person enters the body of someone who isn't infected.
Today, the most common ways this occurs is through:
Though less common, it's also possible to acquire a hepatitis C infection by having unprotected sex with someone who has the virus, or using personal care items including razors and toothbrushes that have come in contact with blood infected with HCV.
Some factors that increase your risk of hepatitis C:
Though viruses are the most common causes of hepatitis, there are also numerous types of non-viral hepatitis, including:
Hepatitis C comes in two forms: acute and chronic.
According to the Centers for Disease Control and Prevention (CDC), approximately 15 to 25 percent of people who become infected with hepatitis C only develop an acute infection, which spontaneously clears from the body within six months.
The other 75 to 85 percent of people go on to become hepatitis C carriers and develop a chronic infection, which can last a lifetime and lead to hepatitis C-related liver complications, including chronic liver disease, cirrhosis (irreversible scarring of the liver), and liver cancer.
Men are less likely than women to spontaneously clear an acute infection from their blood, and more likely to develop liver complications from the infection, according to a 2006 article in the journal Gut.
There were approximately 21,870 new acute cases of hepatitis C in the United States in 2012, and chronic HCV infections affect about 3.2 million Americans, according to the CDC.
On a global scale, two to three percent of the world's population is living with hepatitis C, and about 350,000 people die each year from complications related to the disease, according to 2012 report in the journal Clinical Infectious Diseases.
About 70 to 80 percent of people who become infected with acute hepatitis C do not show any symptoms at first, notes the CDC.
Those who do, however, may have:
People with chronic hepatitis C, on the other hand, don't normally show any symptoms until the liver becomes damaged.
The standard treatment for hepatitis C is a combination antiviral drug therapy.
This drug treatment is effective for 50 to 90 percent of people, according to WHO.
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Hepatitis C is a contagious inflammation of the liver caused by the hepatitis C virus, or HCV.
Hepatitis C can be transmitted to you if the blood of an infected person gets into your body, such as from sharing needles during IV drug use, being born to a mother infected with hepatitis C, or suffering an accidental needle injury.
Its unlikely you could get hepatitis C from a blood transfusion today, because blood banks test all donated blood samples for hepatitis C.
In some cases, hepatitis C only causes a mild illness for less than six months before the virus passes out of the body.
In other cases, however, its a serious, lifelong illness that damages the liver.
Hepatitis C is sometimes classified by different stages of the disease: acute, chronic, and end-stage.
For acute hepatitis C, the incubation period the time between becoming infected and the manifestation of symptoms is two weeks to six months after exposure, with an average time of six to seven weeks, according to the Centers for Disease Control and Prevention (CDC).
Up to 80 percent of people who contract acute hepatitis C do not show any symptoms, the CDC notes.
For the other 20 percent of people with acute hepatitis C, symptoms include:
About 15 to 25 percent of people exposed to HCV only develop an acute infection, which spontaneously clears from the body within six months, according to the CDC.
The remaining 75+ percent develop can develop complications from hepatitis C, including chronic hep C.
And women are more likely than men to have only an acute infection, according to a 2006 article in the journal Gut.
The majority of people with chronic hepatitis C are asymptomatic until the liver becomes severely damaged, often decades after exposure.
In fact, it's common for people to unknowingly carry HCV until they go through a blood screening or other examination for reasons unrelated to hepatitis C.
However, chronic hepatitis C is a serious issue that can result in long-term health problems, including liver damage, liver cancer, liver failure, and death.
According to the CDC, five to 20 percent of people develop cirrhosis an irreversible scarring of the liver that prevents the organ from functioning normally over a period of two to three decades.
And one to five percent of people die from their chronic illness.
Chronic hepatitis C is slower to progress to cirrhosis and liver cancer in premenopausal women than men, according to a 2013 report in Southern Medical Journal.
Alcohol can accelerate the development of these issues.
The symptoms of chronic hepatitis C vary depending on the type of liver damage.
Cirrhosis produces many of the hallmark symptoms of acute hepatitis C, including:
Liver cancer, which generally develops after a patient already has cirrhosis, can result in jaundice, easy bruising and bleeding, swollen abdomen, and abdominal pain or tenderness.
If chronic hepatitis C is not treated, it can progress to end-stage hepatitis C, or HCV-induced end-stage liver disease, which can be fatal.
The illness is accompanied by many debilitating symptoms, including:
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Hepatitis C is a type of hepatitis, or inflammation of the liver, caused by the hepatitis C virus (HCV).
When a person initially contracts hepatitis C, HCV incubates for an average of six to seven weeks before producing any symptoms, according to the Centers for Disease Control and Prevention (CDC).
However, in many cases of acute hepatitis C, people with HCV have no symptoms.
And about three-quarters of people with HCV can develop complications, including a chronic HCV infection that can last a lifetime.
The different types of viral hepatitis, which also includes hepatitis A and B, are transmitted in different ways.
For instance, the hepatitis A virus is transmitted through contaminated food and drink, while the hepatitis B virus is spread through contact with various bodily fluids, including blood, semen, and vaginal secretions.
Hepatitis C is less transmissible than A and B because you can only get it through blood contact; but unlike A and B, there is no vaccine for C.
In the past, hepatitis C was often spread through blood transfusions and organ transplants, but this changed in 1992, when widespread blood screening became available.
The risk of contracting HCV in this manner is now less than one chance per two million units transfused, according to the CDC.
Today, the most common way that hepatitis is spread is through the sharing of needles and other equipment for drug use.
You can also be exposed to HCV through:
Though the risk is believed to be low, you can also contract hepatitis C by having unprotected sex with an HCV-infected person.
This risk increases if you have multiple sex partners, have a sexually transmitted disease, or engage in rough sex that causes bleeding.
Because anal sex is more likely to result in bleeding than vaginal sex, men who have sex with men have a greater chance of getting hepatitis C, according to the National Institutes of Health.
Having sex with a woman during menstruation can also increase your risk.
Aside from unsafe sexual activity, there are numerous other factors that increase your risk of getting hepatitis C, including if you:
Additionally, HIV is considered a strong risk factor for hepatitis C, as HIV and HCV coinfections are common.
In fact, about 25 percent of people with HIV also have hepatitis C, according to the CDC.
Moreover, mothers with both HIV and HCV are more likely to pass on HCV to their infants at birth than mothers without HIV.
Because HCV is spread through blood, you cannot get the virus from:
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Hepatitis C, an inflammation of the liver caused by the hepatitis C virus (HCV), often goes undiagnosed until serious liver problems develop decades after contracting the virus.
This is because the illness is asymptomatic for most people, according to the Centers for Disease Control and Prevention (CDC).
For these asymptomatic people, hepatitis C is generally detected when blood screenings (such as for blood donations) show they are HCV-positive, or routine examinations show they have elevated levels of the liver enzyme alanine aminotransferase (ALT), an indication of liver cell damage.
Hepatitis C is transmitted when the blood of an infected person gets into an uninfected person's body, such as from sharing needles for intravenous drug use (the most common way people become infected today).
You should get tested for hepatitis C if you:
However, a 2015 report in the medical journal BMJ questioned whether exhaustive screening for hepatitis C was necessary, or even safe.
Only a minority of the people with the hepatitis C virus will develop end-stage liver disease, the report's authors noted, and the long-term effectiveness and risks of the new drugs that cure the disease are unknown.
There are several tests your doctor may conduct to diagnose you with hepatitis C.
The first diagnostic tool is a blood test that screens for HCV antibodies proteins the body produces in response to the virus. The most widely used anti-HCV test is the enzyme immunoassay (EIA).
A negative result for the antibody test means that you've never had HCV in your blood, while a positive result means you were exposed to the virus at one point in your life (up to a quarter of people spontaneously clear the virus from their blood within six months of contracting it).
Because EIA sometimes produces false-positive results, a test called recombinant immunoblot assay may be used to confirm that you have the HCV antibody.
Additionally, a negative EIA result may just mean your body has not yet produced the HCV antibody, and you may need to be tested again in a few months.
If you have a positive antibody test, your doctor will use another blood sample to conduct a qualitative polymerase chain reaction (PCR) test, which looks for the RNA (genetic material) of HCV in your blood. A positive result means you're currently infected with HCV.
Your doctor may also order a quantitative PCR test or a so-called branched DNA test to determine your HCV viral load, or the concentration of HCV in your blood. The lower your viral load, the more likely youll respond positively to treatment.
Before recommending a treatment plan, your doctor may conduct other tests.
The six major strains, or genotypes, of HCV respond differently to treatment, so your doctor will conduct another blood test that determines your HCV genotype (you may be infected with more than one genotype at a time).
A liver function test, also called the hepatic function panel, looks for elevated levels of bilirubin (a substance produced by the breakdown of hemoglobin) and liver enzymes including ALT, aspartate aminotransferase, alkaline phosphatase, and gamma glutamyl transpeptidase in your blood to help determine how much damage your liver cells have sustained.
A liver biopsy, in which a liver tissue sample is removed with a thin needle inserted through your skin and into your liver, can provide more details about the amount of scarring and damage HCV has caused.
Your doctor may also order an imaging test, such as a CT scan, MRI, or ultrasound, to see if your hepatitis C has caused liver cancer, a possible complication of hepatitis C.
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Across the globe, some 130 to 170 million people are living with hepatitis C, an inflammation of the liver caused by the hepatitis C virus (HCV), according to a 2012 report in the journal Clinical Infectious Diseases.
Hepatitis C is responsible for 350,000 deaths each year, most of which are due to HCV-induced cirrhosis (irreversible scarring of the liver that prevents the organ from functioning properly) and liver cancer, the report notes.
Though no vaccine exists for hepatitis C, medications are available to treat and cure liver disease.
A person is considered cured of hepatitis C if they're declared to have a sustained virologic response (SVR), which means their HCV viral load is undetectable six months after treatment.
Though highly unlikely, its possible for some of the virus to survive and replicate after a patient achieves SVR.
Furthermore, surviving hepatitis C doesn't make you immune, and it's possible to contract the illness again if you are re-exposed to the virus.
Along with abstinence from alcohol (which can cause HCV to multiply in the liver), the standard treatment for chronic hepatitis C used to be a combination antiviral therapy consisting of a pegylated interferon and ribavirin, sometimes called PEG/riba therapy.
A pegylated interferon is a long-acting form of an interferon, a synthetic copy of an infection-fighting protein secreted by immune system cells in response to pathogens.
Ribavirin is a drug that interferes with HCV's ability to replicate (make copies of itself).
In some cases, pegylated interferon was used without ribavirin, but ribavirin isn't effective against hepatitis C alone.
To treat hepatitis C, doctors prescribed weekly injections of the pegylated interferons peginterferon alfa-2a (Pegasys) or peginterferon alfa-2b (Intron A), along with twice-daily oral doses of ribavirin (Rebetol, Copegus).
There are six major genotypes, or strains, of hepatitis C, and the length of treatment depends on the genotype.
People with HCV genotypes 1, 4, 5, and 6, for example, would undergo PEG/riba therapy for 48 weeks, while people with HCV genotypes 2 and 3 required 24 weeks of PEG/riba therapy.
However, PEG/riba therapy is not a cure-all: It's only effective for 40 to 50 percent of people with genotype 1, and around 80 percent of those with genotypes 2 and 3, according to a 2011 report in the journal Hepatology.
What's more, interferon is not widely available globally and its not an option for people with liver failure, autoimmune diseases, and psychiatric illness.
It can also cause a range of life-threatening complications that prevent many people from completing their therapy.
And newer drug regimens that can cure hepatitis C have forced a change in the standard treatment for the disease.
In recent years, the Food and Drug Administration (FDA) has approved several new oral drugs to help treat hepatitis C, the most effective of which are simeprevir (Olysio) and sofosbuvir (Sovaldi).
Simeprevir is part of a class of drugs called protease inhibitors, which block a specific protein HCV needs to replicate; today, simeprevir is heavily preferred over two older protease inhibitors, boceprevir (Victrelis) and telaprevir (Incivek, which Vertex Pharmaceuticals stopped selling in 2014).
Approved to treat HCV genotype 1, a once-a-day simeprevir pill is taken for 12 weeks along with pegylated interferon and ribavirin, and is followed by an additional 12 to 36 weeks of PEG/riba therapy.
Simeprevir has been shown to cure hepatitis C about 80 percent of the time, according to a 2014 report in the British Medical Journal (BMJ).
Sofosbuvir is part of a class of drugs called polymerase inhibitors, which block a different protein that HCV produces.
It's approved to treat genotypes 1, 2, 3, and 4, and has a cure rate of over 90 percent, according to the BMJ.
Sofosbuvir is the only drug on the market that can cure hepatitis C without the need for interferon injections in some patients.
Sofosbuvir is taken:
In 2014, the FDA approved Harvoni, a combination drug for hepatitis C that includes sofosbuvir and ledipasvir.
In three clinical trials with more than 1,500 participants, at least 90 percent of them taking Harvoni achieved an SVR, including people who were treated for as little as eight weeks.
In December 2014, the FDA approved Viekira Pak, an interferon-free cure for hepatitis C genotype 1. This combination drug includes ombitasvir, paritaprevir, and ritonavir tablets, combined with dasabuvir tablets.
Viekira Pak, taken for 12 to 24 weeks, was shown to be more than 95 percent effective against genotype 1, according to a report in the New England Journal of Medicine.
The use of Viekira Pak isn't recommended for patients whose liver cannot function properly due to an advanced state of liver disease known as decompensated cirrhosis, according to the FDA.
Though the latest generation of hepatitis C drugs can effectively cure the disease, if a person's hepatitis C infection has progressed to the point of causing advanced cirrhosis or liver failure, a patient may require a liver transplant to fully recover.
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If blood infected with the hepatitis C virus (HCV) gets into your body, such as from needles contaminated with the virus, you will probably contract hepatitis C.
Up to a quarter of the people who contract HCV each year only experience the acute form of hepatitis C, in which the virus spontaneously clears from the body within six months, according to the Centers for Disease Control and Prevention (CDC).
Though some of these people may experience numerous hepatitis C symptoms, including gastrointestinal issues, fever, dark urine, and jaundice, they suffer no lasting damage or complications.
The other three-fourths of people with hepatitis C, however, come down with the chronic form of the disease, which can last a lifetime if left untreated.
Hepatitis C is ultimately responsible for 350,000 deaths worldwide each year, according to a 2012 report in the journal Clinical Infectious Diseases.
The majority of these deaths are due to severe complications of hepatitis C, particularly cirrhosis (scarring of the liver) and liver cancer.
About five to 20 percent of people with chronic hepatitis C develop cirrhosis, generally after 20 to 30 years of living with the virus, according to the CDC.
The scarring, which is irreversible, ultimately prevents the liver from functioning properly.
Cirrhosis causes numerous symptoms, including itchiness, loss of appetite, fatigue, and spider angiomas (spiderlike blood vessels visible through the skin).
A common complication of the liver scarring is portal hypertension, in which there's an increase in pressure in the portal vein that carries blood between the digestive organs and liver.
Portal hypertension can cause various other issues, including:
Cirrhosis can eventually lead to end-stage liver disease and liver failure, which is accompanied by several debilitating symptoms, including hepatic encephalopathy, a buildup of toxins in the brain that can result in decreased mental function, stupor, and coma.
Hepatocellular carcinoma (HCC) is the most common type of liver cancer, making up 85 to 90 percent of all cases, according to a 2009 article in the Journal of Global Infectious Diseases (JGID).
And about two to six percent of patients with HCV-related cirrhosis develop HCC.
In rare cases, liver cancer can also develop without cirrhosis.
The symptoms of liver cancer are similar to those of cirrhosis, but also include pain in the upper right abdomen, stool that is white and chalky, and easy bruising.
HCC is the major cause of death in patients with chronic liver cancer, according to the JGID report.
If you have hepatitis C, doctors can gauge the level of liver damage you've experienced.
One useful diagnostic tool is called a hepatic function panel, a blood test that examines the levels of certain liver enzymes, bilirubin, and proteins circulating in the blood.
Higher-than-normal levels of the liver enzymes, indicate that your liver is damaged, possibly from cirrhosis or liver cancer.
Albumin may be low, and your total bilirubin levels may also be elevated.
Along with the hepatic function panel, your doctor may also order a test to determine the levels of the liver enzyme gamma-glutamyl transpeptidase in your blood, and a prothrombin time test, which measures how well your blood clots.
Various imaging tests and liver biopsies (in which liver tissue is extracted and examined) are also used to determine if you have active or persistent hepatitis, cirrhosis, or liver cancer.
For people with liver failure from HCV-related cirrhosis, a liver transplant is the only real treatment.
Liver transplants are also the standard treatment for early HCC, but other therapies, including chemotherapy and hepatectomy (removing the diseased parts of the liver), may also work depending on the progression of the cancer.
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