Hep C and the Undiagnosed

Hepatitis C (hep C) is a viral infection that can cause liver damage. Luckily, hep C is easy to treat. But about half of people with hep C do not know they have it. In the United States, this is about 1.8 million people. Without treatment, hep C can cause serious liver damage and cancer.^1-3

Why can hep C be undiagnosed?

People may not realize they have hep C because symptoms can take a long time to show up. There are 2 phases of hep C: acute and chronic. Symptoms during the acute phase are rare and can go unnoticed. They include:¹

• Feeling tired
• Muscle aches
• Upset stomach
• Fever

The acute phase happens 1 to 3 months after exposure and can last 2 weeks to 3 months. But many people do not have these symptoms and do not know they have hep C.¹

Some people may only have acute hep C and clear the virus from their bodies. For others, it develops into chronic hep C.¹

Chronic hep C can be unnoticeable for a long time until it begins to cause liver damage. The symptoms people notice are often actually the signs of liver disease. These include:¹

• Bleeding or bruising easily
• Yellow skin or eyes
• Feeling tired or not hungry
• Dark urine
• Swollen legs
• Weight loss

How is hep C diagnosed?

Doctors use a blood test to check for hep C. But people may not know to test if they do not show symptoms. Even for people who do test, getting a diagnosis involves 2 tests. Some people do not return for the second test because of the time, cost, and effort involved.⁴

The US Preventive Services Task Force recommends screening all people ages 18 to 79 for hep C. This means testing people for hep C even if they do not show symptoms. The Centers for Disease Control and Prevention (CDC) also recommends hep C screening for people in many high-risk groups.³

Who might have undiagnosed hep C?

Diagnosed or undiagnosed hep C is more common in certain groups of people (populations). This is because something about the group can make people more likely to be exposed to hep C. For example, high-risk populations include:¹

• People born between 1945 and 1965. People this age are about 5 times more likely to have hep C.
• People who have injected or inhaled illegal drugs.
• Healthcare workers exposed to infected blood, such as through an accidental needle prick.
• People with HIV.
• People who are or have been in prison.
• Anyone born to a mother with hep C.
• People who have received a type of treatment called clotting factor concentrates before 1987 or hemodialysis treatments for a long time.
• People with tattoos or piercings done in an unclean or unsterile location.
• Anyone who received a blood transfusion or organ transplant before 1992.

Some people in these communities may also have barriers to accessing hep C testing. For example, some people do have access to healthcare. So it is possible there are even more undiagnosed people in these groups.^3,4

If you are worried about your risk for hep C, ask your doctor about a screening test. You can also take precautions such as:¹

• Practicing safer sex
• Checking for cleanliness when you get a tattoo or piercing
• Not inhaling (snorting) or injecting (shooting) drugs