Hepatitis C

What is hepatitis C?
Hepatitis C is an infection caused by the hepatitis C virus (HCV).

How common is hepatitis C?
From 2010 to 2013, there was a significant increase of 151.5% in reported new cases of Hepatitis C. Most new cases are in white, non-urban young people with a history of injection drug use.1 An estimated 29,718 new HCV infections occurred in 2013. In the United States, 2.7 million persons are estimated to have chronic hepatitis C infections.2

How is hepatitis C spread?
HCV is usually spread through exposure to blood, from injection drug use, needle stick injuries, and even from tattoos from unregulated settings.3 It can also be spread through vaginal or anal sex. Therefore, hepatitis C is referred to as a sexually transmissible infection. Sexual transmission is more often seen with men who have sex with men (MSM), and who are HIV positive.4 There is also an increased risk of transmission with multiple sexual partners and with other sexually transmitted infections.5

HCV can be spread from an infected mother to her baby around the time of birth.2

Does hepatitis C cause symptoms?
Hepatitis C causes very few symptoms, if any, in the period immediately following infection; and about 80% of people with new infections have no symptoms.6 If symptoms do occur soon after HCV infection, it passes unnoticed as many people do not remember having symptoms when they are diagnosed with hepatitis C, years later.

What are the symptoms of hepatitis C?
Those who have symptoms experience flu-like symptoms, fatigue, and loss of appetite, nausea, vomiting, and pain in the upper, right part of their abdomen. Some people will notice jaundice (a yellowing of the skin and eyes.)

Are there any treatments available for hepatitis C?
Treatment is available for hepatitis C. When hepatitis C infection is diagnosed and treated within 6 months of acquiring the infection, the cure rate is very good. Treatment has been less successful after the infection becomes chronic.

However, in 2013, two new direct-acting oral medications became available; and in 2014 two more oral regimes were approved. These four new agents have become the standard of care in the U.S. and are dramatically increasing the cure rates for chronic Hepatitis C.7

What complications can result from hepatitis C?
Sometimes the immune system will clear the infection without the infected person ever knowing that they were infected. However, 75 – 85% of the people infected will develop chronic hepatitis C and about 60-70% will develop chronic liver disease.8

Up to 20% of people with chronic hepatitis C develop cirrhosis of the liver. 1-5% with chronic hepatitis C will die of liver disease. Because the severe liver damage caused by untreated chronic hepatitis C is irreversible and life-threatening, liver transplantation is the only option for many infected people. Hepatitis C is the most common reason for liver transplantation in the US.8
Hepatitis C can also be spread to a baby from a pregnant mother. Only about 6% of babies born to infected mothers will become infected, but all babies born to hepatitis C infected mothers should be tested for HCV after they are 18 months old.8

Can hepatitis C be prevented?
Yes. Sexual transmission can be prevented by refraining from sexual activity until a person is in a lifelong, mutually monogamous relationship with an uninfected partner. Transmission from blood can be prevented by eliminating exposure to blood from infected individuals, including illicit injectable drug use. When getting tattoos or body piercings, one should check for compliance with the Federal Bloodborne Pathogens Standards.

Unlike hepatitis B, no vaccine is available to prevent infection with HCV.

In 2012, the CDC began recommending one-time screening for Hepatitis C in individuals born between 1945 and 1965.7

 

This is an example of jaundice that occurs with hepatitis. This image is courtesy of CDC/Dr. Thomas F. Sellers/Emory University.

References:
1. Suryaprasad AG, White JZ, Xu F, et al, “Emerging epidemic of hepatitis C virus among young non-urban persons who inject drugs in the United States,” 2006 – 2011. Clin Infect Dis.2014; 59(10):271-8
2. Center for Disease Control and Prevention, “Surveillance for Viral Hepatitis – United States, 2013,” http://www.cdc.gov/hepatitis/Statistics/2013Surveillance/index.htm Accessed May 2015
3. Munir S, Saleem S, Indrees M, et al, “Hepatitis C Treatment: current and future perspectives,”
http://www.virologyj.com/content/7/1/296 Accessed May 2015
4. Centers for Disease Control and Prevention, “Sexual transmission of Hepatitis C virus among HIV-infected men who have sex with men—New York City, 2005-2010,” MMWR 2011; 60(28): 945-50
5. Tohme RA, Holmberg SD, “Is Sexual Contact a Major Mode of Hepatitis C virus Transmission,” Hepatology 2010 Oct; 52(4): 1497-505
6. Thomas DL, Ray SC, Lemon SM. Hepatitis C. In: Mandell GL, Bennett JE, Dolin
R, eds. Principles and Practice of Infectious Diseases. 6th ed. Philadelphia:Elsevier; 2005:1950-1981.
7. AASLD/IDSA, “Recommendations for testing, managing, and treating Hepatitis C,”
http://www.hcvguidelines.org Accessed May 2015
8. Center for Disease Control and Prevention, “Hepatitis C FAQs for Health Professionals,”
http://www.cdc.gov/hepatitis/HCV/HCVfaq.htm Accessed May 2015

 

 

Updated: May 2015