Hepatitis C: Causes, Symptoms, Treatments

Acute hepatitis C occurs within six months of exposure to the virus. It can resolve with or without treatment, but as many as 85 percent of people with acute hepatitis C cannot clear the virus, and they progress to chronic hepatitis C.

Chronic hepatitis C can lead to serious complications and is the most common reason for liver transplants in the United States. Less than half of people with chronic hepatitis C are able to clear it from their bodies.

Hepatitis spreads though blood-to-blood contact. The most common way is through sharing needles and other drug use, but it can also transfer through an accidental needle stick, sharing personal care items like razors or toothbrushes, getting a piercing or tattoo with an unsterile needle, having unprotected sex, or during birth if the mother has hepatitis C.

According to the Centers for Disease Control, hepatitis C cases are increasing dramatically in the United States. New cases are four times higher than a decade ago, and adults between 20 and 39 have the highest rates of new cases. Researchers estimate that between 2.7 and 3.9 million people in the U.S. have chronic hepatitis C, and many do not even realize they have it.

Acute hepatitis C usually has no symptoms, but it can cause nausea, malaise, and pain in the right upper abdomen and may progress to a yellowing of the skin called jaundice and dark yellow urine. These symptoms are not specific to acute hepatitis C and may be difficult to diagnose.

As many as 20 percent of people with chronic hepatitis C and liver damage have significantly worsening symptoms within five years. Symptoms can include fluid collecting in the abdomen, called ascites, abnormally large veins lining the esophagus, and portal hypertension, which is high blood pressure in the veins leading to the liver.

Depending on the extent of the illness, people with chronic hepatitis C may also show signs of end-stage liver failure, including muscle wasting, clubbing of the fingers, edema in the ankles, petechiae, enlarged liver and spleen, and scant body hair.

Risk factors for getting hepatitis C are primarily related to lifestyle choices, such as injecting street drugs and sharing needles or having unprotected sex with someone infected with hepatitis C.

Other people who may be at risk for this condition are healthcare workers who come into regular contact with blood and people who received an organ transplant from someone with hepatitis C, were born to a mother with hepatitis C, or received a blood transfusion in the U.S. before 1992.

Diagnosing hepatitis C primarily depends on detecting antibodies with a blood test. For people who test positive, further testing may be required, including a biopsy to determine the stage of the disease and blood tests to determine the specific genetics of the virus to plan treatment.

Doctors treat hepatitis C with antiviral medications. Many newer drugs, called direct-acting antiviral medications, have been shown to be effective at curing chronic hepatitis. Treatment with medication can last as long as 24 weeks, depending on the type of hepatitis C, the amount of liver damage, and whether the person had a previous hepatitis C infection.

Without treatment, hepatitis C can lead to significant complications. Cirrhosis occurs when scar tissue replaces healthy liver tissue, and the liver begins to fail. Liver failure results in the liver no longer being able to perform essential functions.

Chronic hepatitis C also increases the risk of developing liver cancer, particularly for people who develop severe liver damage before getting treatment.

For most people, hepatitis C is a progressive disease. Only about ten to 15 percent of patients have a self-limited infection. About 20 percent develop cirrhosis within 20 years, and as many as five percent develop liver cancer within 30 years.

These complications are more likely in people with alcoholism or who have a concurrent hepatitis B infection. Early treatment can help; the lower the viral load, the lower the risk of complications.