Hepatitis C is an inflammation of the liver. While different things can cause other types of hepatitis, a specific virus -- the
hepatitis C virus -- causes hepatitis C. This virus is also known as HCV.
Acute Versus Chronic Hepatitis C
There are two types of hepatitis C: acute and chronic. In acute hepatitis C, the body is able to completely kill the hepatitis C virus. This happens in about 15 percent of people infected with the hepatitis C virus. In about 85 percent of people infected with HCV, the body is not able to completely get rid of the virus and they end up having a long-term liver infection. This is called
chronic hepatitis C.
Just as there are different types of hepatitis viruses, there are also a few different types of the hepatitis C virus itself.
These are known as
hepatitis C genotypes. The main hepatitis C genotypes are known simply as: genotypes 1, 2, 3, 4, 5, and 6. The genotype is important to know because some genotypes are harder to treat than others.
Of the different hepatitis C genotypes, genotype 1 is the type most commonly found in the United States. Between 70 and 90 percent of Americans with hepatitis C have this genotype. Hepatitis C genotypes 2 and 3 are less common. Only 10 to 20 percent of infected people in this country have either of these genotypes.
How Is Hepatitis C Transmitted?
Hepatitis C transmission occurs most frequently when a person comes in contact with infected blood. This can happen by working in a dialysis unit or sharing needles for tattoos, body piercings, or drugs. Toothbrushes, razors, or manicure tools can also harbor small amounts of infected blood. While hepatitis C can be spread through sexual intercourse, this is rare.
About 80 percent of people infected with HCV have no symptoms of hepatitis C -- even after many years. You can look and feel perfectly healthy, yet still be infected with hepatitis C, and infect others. Most patients do not have symptoms of hepatitis C until there is already
cirrhosis, or even liver failure.
- Feel tired
- Feel sick to their stomach
- Not feel like eating
- Have a fever
- Have stomach pain
- Experience a dull pain or feeling of heaviness on the right side.
They may also have dark urine or yellowing of the skin, known as jaundice
(see Hepatitis C Pictures).
In order to make a
diagnosis of hepatitis C, the healthcare provider will ask a number of questions and perform a physical exam looking for signs or symptoms of hepatitis C. If he or she suspects a liver problem, certain tests or procedures may also be recommended. These hepatitis C tests can include:
- Liver enzyme test
- Viral RNA (HCV RNA) test measured with PCR
- Liver biopsy.
(Click Hepatitis C Test for more information on the tests used to make a hepatitis C diagnosis.)
Treatment for Hepatitis C
Chronic hepatitis C is a condition that can lead to more and more liver damage over time. However, everyone's situation is a little different. So, before
hepatitis C treatment is recommended, your healthcare provider will review the results of your blood work and other tests to determine several things, including:
- The amount of virus in your body (see Hepatitis C Viral Load)
- Its genotype
- How much liver damage has already occurred
- Any other medical conditions you may have.
Then together, you and your healthcare provider can decide what hepatitis C treatment, if any, is best for you.
If treatment is recommended, it usually involves two types of
hepatitis C medication: peginterferon and ribavirin. Peginterferon, which is sold under the brand names of PEGASYS
® or Peg-Intron
®, can be used by itself, or with ribavirin (COPEGUS
®, Rebetol
®). Using these drugs together is called combination therapy. Peginterferon is given by injection once a week, and ribavirin is a pill taken twice daily.
The goal of the hepatitis C treatment medications is to get rid of the
hepatitis C virus completely.
Hepatitis C Alternative Treatments
It is reported that up to 50 percent of people with hepatitis C try some type of hepatitis C alternative treatment.
If you are currently using alternative treatments or considering it, make sure to let your healthcare provider know. In order to keep you safe, it is important that he or she knows everything that you are taking, including herbal supplements,
dietary supplements, or medications (whether prescription or over-the-counter).
For more information on specific alternative treatments for hepatitis C, click on the following links:
Hepatitis C Prevention Strategies
Because hepatitis C is spread through infected blood, it is important to avoid other people's blood or things that might have other people's blood on them. Some specific
hepatitis C prevention strategies include the following:
- Don't ever shoot drugs. If you shoot drugs, stop and get into a treatment program. If you can't stop, never reuse or share syringes, water, or drug works, and get vaccinated against hepatitis A and hepatitis B.
- Don't share personal items that might have blood on them. These items include razors, toothbrushes, and personal health supplies.
- If you are a healthcare worker, always follow routine barrier precautions and safely handle needles and other "sharps." Get vaccinated against hepatitis B.
- Consider the health risks if you are thinking about getting a tattoo or body piercing. You might get infected if the tools have someone else's blood on them, or if the artist or piercer does not follow good health practices, such as washing hands and using disposable gloves.
- If you have multiple sex partners, practice safe sex, including always using a condom, dental dam, or other latex barrier and avoid "rough sex" or other activities that might cause bleeding.
Prognosis for Hepatitis C
People facing hepatitis C are naturally concerned about what the future holds. Understanding hepatitis C and what to expect can help patients and their loved ones plan
hepatitis C treatment, think about lifestyle changes, and make decisions about their quality of life and finances. Many people with this condition want to know their
hepatitis C prognosis. They may ask their doctor or search for
hepatitis C statistics on their own.
It is important to know that the
hepatitis C virus, or HCV, can affect you much differently than it does someone else. For example, some people have very bad
cirrhosis and
late symptoms of hepatitis C after many years of having hepatitis C, while others have very few scars. Of the people who have the virus for 20 years, approximately 20 percent, or 1 out of 5 patients, will have severe scarring (cirrhosis) of the liver. Once cirrhosis develops, the person is at risk for many life-threatening complications of hepatitis C liver disease.
How Common Is Hepatitis C?
Approximately 300 million people worldwide are infected with the
hepatitis C virus. Approximately 3.9 million people in the United States have
chronic hepatitis C. This represents about 1.8 percent of the population.
The number of hepatitis C cases in the United States has been decreasing since its peak in the 1980s. Currently, there are fewer than 30,000 cases of hepatitis C diagnosed each year.
It is estimated that 8,000 to 10,000 people a year die from chronic liver disease caused by hepatitis C.
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