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Hepatitis C

Hepatitis C Symptoms & Treatments 

Hepatitis is a group of viruses that causes liver inflammation and damage. The hepatitis C virus (HCV) is transmitted from one person to another in blood or other body fluids, such as semen and vaginal secretions.

Hepatitis C is the most common cause of viral hepatitis and one of the most common causes of chronic liver disease in the United States. The majority of people infected with hepatitis C develop chronic hepatitis C, however, most remain without symptoms.

While there is still no vaccine to prevent hepatitis C, there are now medications that can cure most cases of chronic HCV. These oral medications are taken every day for two to six months.

The first of a group of oral medications to significantly boost the cure rate for hepatitis C were approved by the FDA in 2013 and 2014. Until then, treatment to control chronic HCV required weekly injections and oral medications that many people couldn’t tolerate because of other health problems or unacceptable side effects.

Symptoms for hepatitis C can take decades to develop. Because of this, approximately half of those with HCV don't know they're infected. That’s why the U.S. Centers for Disease Control and Prevention recommends that everyone at risk for hepatitis C be screened for the infection.

In the United States, 75 percent of adults with HCV were born between 1945 and 1965 (the baby boomer generation). This is the largest group of people at risk in the US. However, the incidence of hepatitis C has been rising since 2006, primarily among those aged 30 and younger who inject heroin or prescription opioids.

Acute hepatitis C infection doesn't always become chronic. In some people, the virus can clear up on its own within a few months after exposure with no lasting damage to the liver. Acute HCV also responds well to antiviral therapy. However, chronic HCV can lead to serious and life-threatening conditions such as cirrhosis, end-stage liver disease, and liver cancer. In cases of liver failure, a liver transplant is the only permanent treatment.

Causes of Hepatitis C

The hepatitis C virus (HCV) is transmitted from person to person through blood, semen, vaginal secretions, or other body fluids. Risk factors for developing hepatitis C include: 

  • Having unprotected sex with multiple partners or an infected partner
  • Sharing needles during intravenous (IV) drug use
  • Having a job that exposes you to human blood and accidental needle sticks, such as a health care worker
  • Men who have sex with men
  • Being an infant born to an infected mother
  • Living with and caring for someone who has a chronic HCV infection
  • Being born between 1945 and 1965
Symptoms of Hepatitis C

Some people with an acute hepatitis C may have symptoms within one to three months after exposure to the virus. However, many people with hepatitis C do not experience symptoms for years or even decades, which is why it often goes undiagnosed. When symptoms do appear, they may include:

  • Dark urine
  • Fatigue
  • Nausea and vomiting
  • Abdominal pain
  • Gray- or clay-colored stools
  • Loss of appetite
  • Low-grade fever
  • Joint pain
  • Bleeding and bruising easily
  • Jaundice (yellowing of the skin and eyes)
Diagnosing Hepatitis C

Based on your symptoms and risk factors, the doctor will order a blood test to detect the hepatitis C virus in your body. There are at least six different strains, or genotypes, of hepatitis C. In the US, genotype 1 is the most common, followed by 2 and 3. Additional blood tests will identify the type of HCV you have and measure the viral load, or quantity of the virus in your blood. Knowing which type of HCV you have helps the doctor with your treatment plan.

Blood tests can also evaluate your liver functioning. If tests indicate that liver damage is present, your doctor may obtain a sample of your liver (biopsy) to determine the extent of scarring. Noninvasive tests, such as magnetic resonance elastography (MRE) or transient elastography (a type of ultrasound), may be used to assess the stiffness of the liver.

Treating Hepatitis C

Treatment for hepatitis C has made major advances in recent years. Since 2013, the FDA has approved a number of new drugs known as direct-acting antiviral medicines to treat HCV. These oral medications attack and destroy the virus. In most cases, both acute and chronic HCV can be cured.

Most of these medications are taken for 12 to 24 weeks. When deciding which drug to prescribe and for how long, your doctor will consider which genotype of HCV you have, the extent of liver damage you have, and whether you have been treated for hepatitis C in the past.

Your doctor may order blood tests during and after your treatment to determine if the treatment is working.

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