Hepatitis C is a virus, or infection, that causes inflammation of the liver.
Anyone can get hepatitis C, but some people are more likely to than others.
You could get hepatitis C through contact with an infected person’s blood.
Most people do not have any symptoms until the hepatitis C virus causes liver damage, which can take 10 or more years to happen.
See a doctor right away if you or a child in your care has symptoms of hepatitis C.
Acute hepatitis C is a short-term infection with the hepatitis C virus.
Chronic hepatitis C is a long-lasting infection with the hepatitis C virus. Chronic hepatitis C occurs when the body can’t get rid of the hepatitis C virus.
A blood test will show if you have hepatitis C.
If you are at higher risk of getting hepatitis C, get tested. Many people with hepatitis C do not know they are infected.
Hepatitis C usually is not treated unless it becomes chronic. Chronic hepatitis C is treated with medicines that slow or stop the virus from damaging the liver.
Tell your doctor and your dentist if you have hepatitis C.
See your doctor right away if you think you have been in contact with the hepatitis C virus. Early diagnosis and treatment of chronic hepatitis C can help prevent liver damage.
Hepatitis C does not always require treatment as the immune response in some people will clear the infection, and some people with chronic infection do not develop liver damage. When treatment is necessary, the goal of hepatitis C treatment is cure. The cure rate depends on several factors including the strain of the virus and the type of treatment given.
The standard of care for hepatitis C is changing rapidly. Until recently, hepatitis C treatment was based on therapy with interferon and ribavirin, which required weekly injections for 48 weeks, cured approximately half of treated patients, but caused frequent and sometimes life-threatening adverse reactions.
Recently, new antiviral drugs have been developed. These medicines, called direct antiviral agents (DAA) are much more effective, safer and better-tolerated than the older therapies. Therapy with DAAs can cure most persons with HCV infection and treatment is shorter (usually 12 weeks) and safer.
Although the production cost of DAAs is low, these medicines remain very expensive in many high- and middle-income countries. Prices have dropped dramatically in some countries (primarily low-income) due to the introduction of generic versions of these medicines.
Much needs to be done to ensure that these advances lead to greater access to treatment globally.
Recommendations on hepatitis C treatment
Assessing for HCV treatment
All adults and children with chronic HCV infection should be assessed for antiviral treatment.
Treatment with direct-acting antivirals (DAAs)
WHO recommends that all patients with hepatitis C be treated with DAA-based regimens, except for a few specific groups of people in whom interferon-based regimens can still be used (as an alternative regimen for patients with genotype 5 or 6 infection and those with genotype 3 HCV infection who also have cirrhosis).
Telaprevir and boceprevir should no longer be used
These 2 first-generation DAAs, which are administered with pegylated interferon and ribavirin, were recommended in the 2014 guidelines. Evidence now shows that they result in more frequent adverse effects and less frequent cures compared with newer DAA-based regimens. Thus, these 2 medicines are no longer recommended by WHO.
WHO recommends preferred and alternative DAA regimens based on genotype and cirrhosis status
The Guideline Development Group reviewed all the available data (over 200 studies) to determine which regimens were most effective and safest to treat each of the 6 different genotypes.
Hepatitis C FAQs for the Public: Treatment
Can acute Hepatitis C be treated?
Yes, acute hepatitis C can be treated. Acute infection can clear on its own without treatment in about 25% of people. If acute hepatitis C is diagnosed, treatment does reduce the risk that acute hepatitis C will become a chronic infection. Acute hepatitis C is treated with the same medications used to treat chronic Hepatitis C. However, the optimal treatment and when it should be started remains uncertain.
Can chronic Hepatitis C be treated?
Yes. There are several medications available to treat chronic Hepatitis C, including new treatments that appear to be more effective and have fewer side effects than previous options. The Food and Drug Administration (FDA) maintains a complete list of approved treatments for Hepatitis C.
Is it possible to get over Hepatitis C?
Yes, approximately 15%–25% of people who get Hepatitis C will clear the virus from their bodies without treatment and will not develop chronic infection. Experts do not fully understand why this happens for some people.
What can a person with chronic Hepatitis C do to take care of his or her liver?
People with chronic Hepatitis C should be monitored regularly by an experienced doctor. They should avoid alcohol because it can cause additional liver damage. They also should check with a health professional before taking any prescription pills, supplements, or over-the-counter medications, as these can potentially damage the liver. If liver damage is present, a person should check with his or her doctor about getting vaccinated against Hepatitis A and Hepatitis B.
The incubation period for hepatitis C is 2 weeks to 6 months. Following initial infection, approximately 80% of people do not exhibit any symptoms.
Those who are acutely symptomatic may exhibit fever, fatigue, decreased appetite, nausea, vomiting, abdominal pain, dark urine, grey-coloured faeces, joint pain and jaundice (yellowing of skin and the whites of the eyes).
Most people do not have any symptoms until the hepatitis C virus causes liver damage, which can take 10 or more years to happen. Others may have one or more of the following symptoms:
When symptoms of hepatitis C occur, they can begin 1 to 3 months after coming into contact with the virus. See a doctor right away if you or a child in your care has symptoms of hepatitis C.
Getting tested
Early diagnosis can prevent health problems that may result from infection and prevent transmission of the virus. WHO recommends screening for people who may be at increased risk of infection.
Populations at increased risk of HCV infection include:
people who inject drugs;
people who use intranasal drugs;
recipients of infected blood products or invasive procedures in health-care facilities with inadequate infection control practices;
children born to mothers infected with HCV;
people with sexual partners who are HCV-infected;
people with HIV infection;
prisoners or previously incarcerated persons; and
people who have had tattoos or piercings.
Screening and Diagnosis
Due to the fact that acute HCV infection is usually asymptomatic, few people are diagnosed during the acute phase. In those people who go on to develop chronic HCV infection, the infection is also often undiagnosed because the infection remains asymptomatic until decades after infection when symptoms develop secondary to serious liver damage.
HCV infection is diagnosed in 2 steps:
Screening for anti-HCV antibodies with a serological test identifies people who have been infected with the virus.
If the test is positive for anti-HCV antibodies, a nucleic acid test for HCV ribonucleic acid (RNA) is needed to confirm chronic infection because about 15–45% of people infected with HCV spontaneously clear the infection by a strong immune response without the need for treatment. Although no longer infected, they will still test positive for anti-HCV antibodies.
After a person has been diagnosed with chronic hepatitis C infection, they should have an assessment of the degree of liver damage (fibrosis and cirrhosis). This can be done by liver biopsy or through a variety of non-invasive tests.
In addition, these people should have a laboratory test to identify the genotype of the hepatitis C strain. There are 6 genotypes of the HCV and they respond differently to treatment. Furthermore, it is possible for a person to be infected with more than 1 genotype. The degree of liver damage and virus genotype are used to guide treatment decisions and management of the disease.
How Hepatitis C Diagnosed
A blood test will show if you have hepatitis C. Blood tests are done at a doctor’s office or outpatient facility. A blood sample is taken using a needle inserted into a vein in your arm or hand. The blood sample is sent to a lab to test for hepatitis C.
If you are at higher risk of getting hepatitis C, get tested. Many people with hepatitis C do not know they are infected.
Your doctor may suggest getting a liver biopsy if chronic hepatitis C is suspected. A liver biopsy is a test to take a small piece of your liver to look for liver damage. The doctor may ask you to stop taking certain medicines before the test. You may be asked to fast for 8 hours before the test.
During the test, you lie on a table with your right hand resting above your head. Medicine is applied to numb the area where the biopsy needle will be inserted. If needed, sedatives and pain medicine are also given. The doctor uses a needle to take a small piece of liver tissue. After the test, you must lie on your right side for up to 2 hours. You will stay 2 to 4 hours after the test before being sent home.
A liver biopsy is performed at a hospital or outpatient center by a doctor. The liver sample is sent to a special lab where a doctor looks at the tissue with a microscope and sends a report to your doctor.
Funding programs that support hepatitis C testing and getting people linked to care and treatment.
Educating doctors, nurses, and other health care providers about hepatitis C, developing clinical tools and issuing updated guidance to help carry out recommended testing.
Working with states and communities to improve reporting of hepatitis C test results in order to get people needed services.
Increasing coverage under the Affordable Care Act so more people will have health insurance for testing and treatment.
State and local public health departments can
Let people know where they can get blood tests for hepatitis C.
Follow-up with health care providers and laboratories for people who have a positive hepatitis C antibody test but have no record of a follow-up test.
Monitor and report people with hepatitis C infection and promote best practices for testing and linking patients to care.
Doctors, nurses, and other health care providers can
Set up systems to make to make sure all patients born from 1945 through 1965 are tested for hepatitis C.
Test patients with other risks for hepatitis C, including blood transfusions before 1992 or injection drug use.
Make sure everyone who has a positive hepatitis C antibody test gets the follow-up blood RNA test and is linked to lifesaving care and treatment if infected.
Baby boomers and all persons at risk can
Ask their doctor, nurse, or other health care provider about getting tested for hepatitis C.
Make sure to get a follow-up test if the antibody test is positive to see if they are still infected with the hepatitis C virus.
“Hepatitis” means inflammation of the liver. Toxins, certain drugs, some diseases, heavy alcohol use, and bacterial and viral infections can all cause hepatitis. Hepatitis is also the name of a family of viral infections that affect the liver; the most common types are Hepatitis A, Hepatitis B, and Hepatitis C.
Hepatitis C is a contagious liver disease that ranges in severity from a mild illness lasting a few weeks to a serious, lifelong illness that attacks the liver. It results from infection with the Hepatitis C virus (HCV), which is spread primarily through contact with the blood of an infected person. Hepatitis C can be either “acute” or “chronic.”
Hepatitis C virus (HCV) causes both acute and chronic infection. Acute HCV infection is usually asymptomatic, and is only very rarely associated with life-threatening disease. About 15–45% of infected persons spontaneously clear the virus within 6 months of infection without any treatment.
The remaining 55–85% of persons will develop chronic HCV infection. Of those with chronic HCV infection, the risk of cirrhosis of the liver is between 15–30% within 20 years.
Acute Hepatitis C virus infection is a short-term illness that occurs within the first 6 months after someone is exposed to the Hepatitis C virus. For most people, acute infection leads to chronic infection.
Chronic Hepatitis C virus infection is a long-term illness that occurs when the Hepatitis C virus remains in a person’s body. Hepatitis C virus infection can last a lifetime and lead to serious liver problems, including cirrhosis (scarring of the liver) or liver cancer.
Hepatitis C is a liver disease caused by the hepatitis C virus: the virus can cause both acute and chronic hepatitis infection, ranging in severity from a mild illness lasting a few weeks to a serious, lifelong illness.
The hepatitis C virus is a bloodborne virus and the most common modes of infection are through unsafe injection practices, inadequate sterilization of medical equipment, and the transfusion of unscreened blood and blood products.
Globally, between 130–150 million people globally have chronic hepatitis C infection.
A significant number of those who are chronically infected will develop liver cirrhosis or liver cancer.
Approximately 700 000 people die each year from hepatitis C-related liver diseases.
Antiviral medicines can cure approximately 90% of persons with hepatitis C infection, thereby reducing the risk of death from liver cancer and cirrhosis, but access to diagnosis and treatment is low.
There is currently no vaccine for hepatitis C; however research in this area is ongoing.
It's estimated that around 215,000 people in the UK have hepatitis C.
About 3.5 million people in the U.S. have the disease. But it causes few symptoms, so most of them don't know.
There are many forms of the hepatitis C virus. The most common in the U.S. is type 1. None is more serious than any other, but they respond differently to treatment.
If left untreated, it can sometimes cause serious and potentially life-threatening damage to the liver over many years.
However, with modern treatments it's often possible to cure the infection and most people with it will have a normal life expectancy.
While some people who get infected with Hepatitis C are able to clear, or get rid of, the virus, most people who get infected develop a chronic, or lifelong, infection. Over time, chronic Hepatitis C can lead to serious liver problems including liver damage, cirrhosis, liver failure, or liver cancer. But many people can benefit from available treatment options that can eliminate the virus from the body and prevent further liver damage.
