What is Hepatitis C?

Reviewed by: HU Medical Review Board | Last reviewed: August 2021

Hepatitis means liver inflammation. The hepatitis C virus (HCV) is one of several hepatitis viruses that can live in human blood. It damages the liver.

Other hepatitis viruses include hepatitis A, B, D, and E. All cause liver damage, but may be transmitted in different ways. Hepatitis may also be caused by heavy alcohol use, some medicines, and toxins. It is also possible to have autoimmune hepatitis, where the body mistakenly attacks itself.1,2

How HCV infection happens

The hepatitis C virus is transmitted through contact with infected blood. The most common ways someone is infected with HCV include:1

  • Sharing personal tools during drug use, glucose monitoring, or shaving
  • Childbirth
  • Needle pricks in a healthcare setting
  • Sex with an infected person
  • Tattoos and body piercings in unregulated settings

Before donated blood was screened, it was possible to get HCV from a blood transfusion or organ donation. That risk is almost zero today.1

Phases of HCV infection

HCV can be acute (short-term) or chronic (long-term). Acute HCV happens within the first 6 months of being exposed to the virus. About half of those with HCV will clear the virus on their own at this point. However, the rest will go on to develop chronic HCV.1-4

Chronic HCV can last for years without symptoms. Up to half of people with chronic HCV do not know they have the virus. The longer the virus is undetected, the more damage it does. Chronic HCV can last a person’s entire life if it is not treated.1-4

Symptoms of HCV

Most people with HCV will not have symptoms. Those who do have symptoms during the acute phase may have:1-5

  • Fever
  • Feeling tired (fatigue)
  • Joint pain
  • Muscle aches
  • Loss of appetite, nausea, or vomiting
  • Belly pain
  • Dark or tea-colored urine
  • Light or gray-colored bowel movements
  • Yellowing of the skin or eyes (jaundice)

Many of these symptoms are signs of liver disease. Severe liver damage due to chronic HCV can happen decades after a person was first exposed.

Diagnosing HCV

Hepatitis C is diagnosed using blood tests. The first test, the HCV antibody test, looks to see if someone has ever been infected with HCV. Antibodies are chemicals the body’s immune system makes to kill invaders like viruses and other germs.3

Someone who tests positive for HCV exposure is given another blood test, the HCV RNA test. This second test tells your doctor if your HCV infection is active.3

Complications of HCV infection

Over time, HCV damages the liver. This leads to scarring. Fibrosis is an early type of scarring that may be reversible. However, once significant scarring occurs, the damage may be permanent. At this stage the damage is called cirrhosis.

All of the blood in our body passes through our liver. When it is scarred by cirrhosis, blood flow can be affected. This can cause fluid buildup in the legs or belly. Enlarged blood vessels around the esophagus can also occur and lead to bleeding.

A scarred liver may also have a hard time processing toxins and can lead to a buildup of waste products. This can lead to severe brain fog. Cirrhosis also increases the risk of developing liver cancer.3,6

Treatments for HCV

Many treatments to treat hepatitis C are available. The type of treatment your doctor will recommend will vary depending on several things, such as whether:7

  • You have been treated for HCV before
  • You also have human immunodeficiency virus (HIV), kidney problems, or cirrhosis
  • You have had a liver transplant
  • You are pregnant
  • You are an adult or a child

Reasons to be hopeful

Although the facts about HCV can be scary, there are some reasons to be hopeful if you have HCV:

  • HCV infection progresses slowly. There is time to get help.
  • You are not alone. At least 2 million people in the United States have HCV.
  • Treatment has greatly improved in recent years. New direct-acting antiviral drugs (DAAs) have cure rates reaching 100 percent.
  • Research is moving quickly. Promising new and effective treatments are on the horizon.

If you are concerned about HCV, talk with your doctor about testing and treatment.

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