How Hepatitis C Affects the Body: Symptoms, Testing & Treatment

Sarah Vordermeier

 

Chronic hepatitis C affects around 71 million people worldwide. Hepatitis C – whether chronic or acute – has become an emerging health issue particularly within the United States over recent years – in fact, it is estimated that a total of 2.7 million people are living with a chronic hepatitis C infection.[1]

But what exactly is hepatitis C? Although generally considered an STI or STD, hepatitis C is not efficiently transmitted through sexual contact – it’s rather a blood-borne disease that is typically transmitted by people between 20 and 39 years in the United States. Possible ways of transmitting the virus include sharing infected equipment, such as syringes, needles, toothbrushes, or razors – and as those infected with hepatitis C are often asymptomatic, the infection can be passed on unknowingly.

To inform you on this topic of growing interest, we will explore various possible ways of hepatitis C transmission and list various common hepatitis C symptoms – as well as forms of testing and treatment.

What Is Hepatitis C?

model of hepatitis C virus

Hepatitis C, also known as hep C or HCV, is a liver disease caused by the hepatitis C virus. It is a virus that is considered a short-term illness, but for more than 50 percent of those infected, it can develop into a chronic lifelong illness.[2]

The virus can be classed as either acute hepatitis C, chronic hepatitis C, or perinatal hepatitis C, depending on various factors. Someone who has had hepatitis C in their system for less than six months is considered to have acute hepatitis C, while chronic hepatitis C occurs when somebody has been infected with the virus for longer than six months. It is the chronic form of the virus that leads to serious health conditions and, if untreated, can lead to death.[3]

Perinatal hepatitis C occurs when a mother passes a hepatitis C infection on to her child; this is also known as vertical transmission. According to various sources, HCV infections among women have risen in the United States, meaning that vertical hepatitis C transmission is also expected to rise.[4]

How Hepatitis C Affects the Body

Once HCV has entered the body, the virus invades various cells and multiplies there, leading to liver inflammation and damage. As an organ that processes important nutrients, filters our blood, and fights off infections, hepatitis C can severely affect liver function if not treated.

Chronic hepatitis C can ultimately lead to various serious and even life-threatening liver diseases, such as liver cirrhosis or liver cancer. It is common for people with chronic HCV to be asymptomatic and feel generally healthy; when symptoms do emerge, however, the disease has already reached an advanced stage.

Hepatitis C Versus Hepatitis B and Hepatitis A: What’s the Difference?

Did you know that there are, in fact, at least five types of hepatitis that are caused by viruses? The most common of these are hepatitis A, which occurs with contaminated food and water; hepatitis B, which is passed on through sexual contact or shared needles; and hepatitis C, which is also transmitted through sharing needles. There are other types of hepatitis – including alcoholic hepatitis.[5] Although many of us are aware of hepatitis A, B, and C, it is important to recognize fundamental similarities and differences between all three viruses.

All hepatitis infections impact the health of the liver. Both hepatitis B and C are leading causes of liver cancer in the United States.[2] We have briefly already mentioned that there are some similarities when it comes to hepatitis B and hepatitis C transmission – that is, they are often transmitted through sharing infected equipment, such as needles. Death can occur with all three forms of hepatitis; however, death is less common with hepatitis A. With hepatitis B and C, up to 25 percent of people infected will develop long-term liver disease or cancer.[2]

Unlike hepatitis C, hepatitis A and B are preventable through vaccination. In fact, the number of reported hepatitis B cases dropped between 1990 and 2014 after the vaccination became routine for children. If we directly compare case numbers for hepatitis A, B, and C over the last few years, hepatitis C accounts for the majority of viral hepatitis infections in the United States.[2]

Hepatitis C Causes: How Do You Contract HCV?

Hepatitis C is a blood-borne virus, meaning that it is transmitted through exposure to infected blood. Examples of how the virus is often spread include the following:

  • Sharing injection equipment – often with recreational drug use
  • Inadequately disinfecting and sterilizing medical equipment – particularly syringes and needles 
  • Performing blood transfusion with unscreened infected blood 
  • Sharing objects such as razors or toothbrushes
  • Transmission from pregnant mother to foetus
  • Unprotected sex that leads to blood exposure – for example with men who have sex with men[6]

It’s important to note that, unlike other sexually transmitted diseases, hepatitis C can not be spread through casual contact such as kissing or sharing food and drinks with a HCV-infected person.[7]

Hepatitis C and Pregnancy: Can Babies Be Born with Hep C?

Although it is possible for an HCV-infected mother to pass the virus on to her baby, hepatitis C transmission is less common this way.[7] The infection can be passed on during pregnancy or near delivery, but not during breastfeeding – unless the mother’s nipples are cracked or bleeding. Children whose mothers are HCV-infected should be tested for hepatitis C infection.[1]

What Are Common Hepatitis C Symptoms?

Man holding his stomach

Hepatitis C symptoms often depend on whether you have progressed to the chronic stage of the virus. New infections – or acute infections – are often asymptomatic, meaning that no noticeable symptoms occur.[7] In fact, did you know that around 80 percent of people don’t notice any hepatitis C symptoms after they have initially contracted the virus? First noticeable signs of hep C may only appear when the liver has already been significantly damaged.

Those who do experience hepatitis C symptoms report a variety of symptoms within two weeks to six months after infection, such as:

  • Fever
  • Fatigue
  • Lack of appetite
  • Nausea and vomiting
  • Stomachaches
  • Dark urine and grey-colored stool
  • Joint pain
  • Jaundice[7]

When these generic symptoms do occur, it is not often clear that they are due to a hepatitis C infection. Some of the symptoms listed above, such as fever, fatigue, and joint pain, could even be confused with flu symptoms, for example. The only way to know for certain if these symptoms are caused by hepatitis C is to get tested.

Around 70 percent of new hepatitis C infections advance to chronic hepatitis C, meaning that common symptoms include noticeable liver damage, which occur within 20 years after infection.[7]

Many of these hepatitis C symptoms listed above vary greatly from other STI symptoms. To find out more about the signs of other STIs, head over to our dedicated Health Portal article.

Hepatitis C Transmission: How Do I Protect Myself from Hepatitis C?

As previously mentioned, there is not yet an effective vaccine to help curb hepatitis C transmission. This means that prevention is rather a case of collectively reducing transmission within risk groups and through education, awareness, and testing. It is important to ensure that equipment that is shared, such as needles and syringes, are adequately sterilized and disinfected, and that blood that is donated is screened for HCV (or, indeed, other diseases, such as HIV and syphilis).[7]

The best way to prevent hepatitis C transmission individually is to:

  • avoid sharing any injecting equipment with others
  • avoid sharing razor or toothbrushes
  • use condoms – especially when having anal sex, when you’re on your period, or when you’re having sex with a new partner[6]

Additionally, the World Health Organization recommends that people immunize themselves against hepatitis A and B in order to protect their liver as best as they can. 

Diagnosis: Who Should Get Tested?

It is important to test people who are most at risk of becoming infected with HCV. The World Health Organization considers the following as risk groups for hepatitis C transmission:

  • People who inject recreational drugs
  • People in prisons
  • Men who have sex with men
  • Sexual partners of someone with hepatitis C
  • Recipients of blood transfusions or other invasive medical procedures carried out in unhygienic environments
  • Babies and children with HCV-infected mothers
  • People who are HIV-positive
  • People who have been tattooed or pierced in unsanitary environments
  • Health workers who have accidentally been exposed to hepatitis C[7, 8]

    It is recommended that you seek medical advice or get tested for hepatitis C – even if you don’t necessarily experience any of the typical hepatitis C symptoms. This is because, in many cases, hepatitis C is asymptomatic.

    The Centers for Disease Control and Prevention now recommends that adults over the age of 18 should be tested at least once in their lifetime for hepatitis C and that all pregnant women should be tested during each pregnancy.

    How Do I Know I've Got Hepatitis C?

    To find out whether you have hepatitis C, you should carry out a blood test – either at your doctor’s, at various sexual health clinics, or at home.

    It is absolutely crucial that you get an early diagnosis of hepatitis C if you have any reason to believe that you have been infected with the virus. Early diagnosis means that hepatitis C treatment can effectively prevent or reduce liver damage and ensure that hepatitis C transmission to other people does not occur.

    How Does a Hepatitis C Test Work?

    Although HCV can be detected in various bodily fluids, including in saliva, breast milk, and semen, the most standard method for diagnosing the virus is through performing a blood test: usually a PCR test and an antibody test.[8, 9, 10]

    An antibody test works by detecting whether your immune system has developed antibodies to the virus – and thus if you have ever been exposed to hepatitis C. As it takes time for your body to produce antibodies, these tests only serve as a useful indication after months of infection. So, if your antibody test results come back negative, but you are still experiencing hepatitis C symptoms, it may be useful to take the test again after some time. If your test results come back positive, it means that you have been exposed to HCV at some point – it does not, however, mean you are currently infected.[8]

    These days, you can take such hepatitis C tests within the comfort of your own home. The laboratory simply requires a blood sample from you, from which they can then perform a sample analysis. All this means for you is that you can carry out the test in privacy and avoid long waiting times at the doctor’s. Depending on the results, you can then choose to take further actions under the medical supervision of your doctor – such as taking a PCR test.

    Using a PCR test to detect hepatitis C means that you can tell whether you are currently infected. A positive result indicates that the virus is multiplying in your body, and that the infection has reached an advanced stage – also known as chronic hepatitis C.[8] If results indicate a current HCV infection, you will most likely be referred to a specialist for further tests to check if any liver damage has occurred in your body. A specialist is also likely to review courses of hepatitis C treatment with you.

    Hepatitis C Treatment: Can Hepatitis C Be Cured?

    doctor holding hepatitis C medication

    Hepatitis C treatment is not always necessary; sometimes, our immune system is capable of clearing the infection alone. In fact, the World Health Organization reports that around 30 percent of HCV-infected people manage to clear the virus within six months of infection – without any treatment.[7] However, this means that over 50 percent of acute hepatitis C cases progress to chronic hepatitis C – where treatment is required.

    Pan-genotypic direct-acting antivirals (DAAs), such as simeprevir, sofosbuvir, and daclatasvir, are often recommended as a form of hepatitis C treatment – this type of medicine can cure most people with an HCV infection.[12] DAAs also only need to be taken for a matter of weeks, depending on the severity of the damage to the liver.

    However, this form of treatment is not always readily available to those who need it due to its price.[7] According to data, more than 95 percent of people infected with hepatitis C can be cured with such antiviral medicine and they can enjoy a normal life expectancy. Overall, with treatment, there are less fatalities caused by liver cirrhosis and liver cancer.

    As mentioned, there is currently no vaccine available to protect against hepatitis C, unlike with hepatitis A and B. However, research in this field is still ongoing.[7] It’s furthermore important to note that even after treatment, you are not immune to hepatitis C, and you should take the necessary steps, as mentioned above, to prevent hepatitis C transmission and infection.

    Hepatitis C Symptoms, Diagnosis, and Treatment – at a Glance

    What Is Hepatitis C?

    Hepatitis C, also known as hep C or HCV, is a liver disease caused by the hepatitis C virus. It is a virus that is considered a short-term illness, but for more than 50 percent of those infected, it can develop into a chronic lifelong illness.

    What Are Common Hepatitis C Symptoms?

     While those infected with hepatitis C can be asymptomatic, other people may experience certain hepatitis C symptoms within two weeks to six months after infection, such as fever, fatigue, lack of appetite, nausea and vomiting, stomachaches, dark urine and grey-colored stool, joint pain, and jaundice.

    How Do I Know I've Got Hepatitis C?

    You can carry out a blood test to screen for hepatitis C – either at your doctor’s, at various sexual health clinics, or at home. Blood tests include a PCR or antibody test – the combination of which is considered useful for diagnosis.

    What Are the Forms of Hepatitis C Treatment?

    Although there’s currently no vaccine to protect us from hepatitis C transmission, pan-genotypic direct-acting antivirals (DAAs), such as simeprevir, sofosbuvir, and daclatasvir, are often used as hepatitis C treatment. DAAs only need to be taken for a matter of weeks, depending on the severity of the damage to the liver.

    Sources

    [1]        Emerging Issues, Centers for Disease Control and Prevention, last reviewed June 4, 2015, available at https://www.cdc.gov/std/tg2015/emerging.htm, accessed on July 8, 2021.

    [2]        What is Viral Hepatitis? Centers for Disease Control and Prevention, last reviewed July 28, 2020, available at https://www.cdc.gov/hepatitis/abc/index.htm, accessed on July 8, 2021.

    [3]         Hepatitis C Questions and Answers for the Public, Centers for Disease Control and Prevention, last reviewed July 28, 2020, available at https://www.cdc.gov/hepatitis/hcv/cfaq.htm, accessed on July 8, 2021.

    [4]         Hepatitis C, Perinatal Infection: 2018 Case Definition, Centers for Disease Control and Prevention, last reviewed on April 16, 2021, available at https://ndc.services.cdc.gov/case-definitions/hepatitis-c-perinatal-infection-2018/, accessed on July 8, 2021.

    [5]         hepatitis, Merriam-Webster, available at https://www.merriam-webster.com/dictionary/hepatitis, accessed on July 9, 2021.

    [6]         Overview: hepatitis C, National Health Service, last reviewed on June 21, 2018, available at https://www.nhs.uk/conditions/hepatitis-c/, accessed on July 8, 2021.

    [7]         Hepatitis C, World Health Organization, July 27, 2020, available at https://www.who.int/news-room/fact-sheets/detail/hepatitis-c, accessed on July 8, 2021.

    [8]         Diagnosis: hepatitis C, National Health Service, last reviewed June 21, 2018, available at https://www.nhs.uk/conditions/hepatitis-c/diagnosis/, accessed on July 9, 2021.

    [9]         Thomas DL, Astemborski J, Rai RM, et al. The natural history of hepatitis C virus infection: host, viral, and environmental factors. JAMA 2000;284:450–6.

    [10]        Updated U.S. Public Health Service Guidelines for the management of occupational exposures to HBV, HCV, and HIV and recommendations for postexposure prophylaxis, MMWR Recomm Rep 2001, 50 (No. RR-11), pp. 1–52.

    [11]        Treatment: hepatitis C, National Health Service, last reviewed on June 21, 2018, available at https://www.nhs.uk/conditions/hepatitis-c/treatment/, accessed on July 8, 2021.

    [12]        Schillie, S., Wester, C., Osborne, M., Wesolowski, L., Ryerson, A. B. CDC Recommendations for Hepatitis C Screening Among Adults — United States, 2020, MMWR Recomm Rep 2020, 69 (No. RR-2), pp. 1–17, doi: 10.15585/mmwr.rr6902a1external icon.

    [13]        Hepatitis C, Acute: 2020 Case Definition, Centers of Disease Control and Prevention, last reviewed on April 16, 2021, available at https://ndc.services.cdc.gov/case-definitions/hepatitis-c-acute-2020/, accessed on July 13, 2021.

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