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Hepatitis C

(HCV; Hep C)

Definition

Hepatitis C is an infection of the liver. The hepatitis C virus (HCV) causes it.
Hepatitis
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Causes

The hepatitis C virus is spread through contact with the blood of an infected person.
A woman with hepatitis can pass the virus on to her baby during birth. The hepatitis C virus is not spread through food or water.

Risk Factors

Factors that increase your chance of this infection:
  • Injecting illicit drugs, especially with shared needles
  • Receiving a blood transfusion before 1992—this risk is very low in the United States.
  • Receiving blood clotting products before 1987
  • Receiving an HCV-infected organ transplant
  • Long-term kidney dialysis treatment
  • Sharing toothbrushes, razors, nail clippers, or other personal hygiene items that have HCV-infected blood on them
  • Being accidentally stuck by an HCV-infected needle—a concern for healthcare workers
  • Frequent contact with HCV-infected people—a concern for healthcare workers
  • Tattooing
  • Body piercing
  • Having sex with partners who have hepatitis C or other sexually transmitted diseases—this is most common in men who have sex with men.

Symptoms

Eighty percent of people with hepatitis C have no symptoms. Over time, the disease can cause serious liver damage.
Symptoms may include:
  • Fatigue
  • Loss of appetite
  • Jaundice (yellowing of the eyes and skin)
  • Darker colored urine
  • Loose, light, or chalky colored stools
  • Abdominal pain
  • Aches and pains
  • Itching
  • Hives
  • Joint pain
  • Cigarette smokers may suddenly dislike the taste of cigarettes
  • Nausea
  • Vomiting
Chronic hepatitis C may cause some of the above symptoms, as well as:
  • Weakness
  • Severe fatigue
  • Loss of appetite
Serious complications of hepatitis C include:
  • Chronic infection that will lead to cirrhosis (scarring) and progressive liver failure
  • Increased risk of liver cancer

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. You will also discuss your risk factors.
Tests may include:
  • Blood tests—to look for hepatitis C antibodies or genetic material from the virus (antibodies are proteins that your body has made to fight the hepatitis C virus)
  • Liver function studies— to initially determine and follow how well your liver is functioning
  • Ultrasound of the liver—to assess liver damage
  • Liver biopsy —removal of a sample of liver tissue to be examined

Treatment

Hepatitis C is usually treated with combined therapy, consisting of:
  • Interferon—given by injection
  • Ribavirin —given orally
  • Protease inhibitor
  • Nucleotide analog inhibitor—to treat chronic hepatitis C
These medicines can cause difficult side effects. They also have limited success rates.
In unsuccessful cases, chronic hepatitis C can cause cirrhosis and serious liver damage. A liver transplant may be needed, although it does not typically cure hepatitis C.
If you are diagnosed with hepatitis C, follow your doctor's instructions .

Prevention

To prevent becoming infected with hepatitis C:
  • Do not inject illicit drugs. Shared needles have the highest risk. Seek help to stop using drugs .
  • Do not have sex with partners who have sexually transmitted diseases (STDs).
  • Practice safe sex (using latex condoms ) or abstain from sex.
  • Limit your number of sexual partners.
  • Do not share personal items that might have blood on them, such as:
    • Razors
    • Toothbrushes
    • Manicuring tools
    • Pierced earrings
  • Avoid handling items that may be contaminated by HCV-infected blood.
  • Donate your own blood before elective surgery to be used if you need a blood transfusion.
To prevent spreading hepatitis C to others if you are infected:
  • Tell your dentist and physician before receiving check-ups or treatment.
  • Get both a hepatitis A and hepatitis B vaccination.
  • Do not donate blood or organs for transplant.

RESOURCES

American Liver Foundation http://www.liverfoundation.org

Hepatitis Foundation International http://www.hepfi.org

CANADIAN RESOURCES

Canadian Liver Foundation http://www.liver.ca

Health Canada http://www.hc-sc.gc.ca

References

Chang MH, Gordon LA, Fung HB. Boceprevir: A protease inhibitor for the treatment of hepatitis C. Clin Ther . 2012 Sep 10. pii: S0149-2918(12)00490-0. doi: 10.1016/j.clinthera.2012.08.009. [Epub ahead of print]

Hepatitis C. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/hepatitis/HCV/index.htm . Updated March 14, 2011. Accessed October 15, 2012.

Hepatitis C. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us . September 10, 2012. Accessed October 15, 2012.

Sexual transmission of hepatitis C virus among HIV-infected men who have sex with men—New York City, 2005-2010. MMWR Morb Mortal Wkly Rep . 2011 Jul 22;60:945-50.

Sexually transmitted diseases. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/std/default.htm . Updated August 31, 2012. Accessed October 15, 2012.

What is a blood transfusion? National Heart Lung and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/bt/ . Updated January 30, 2012. Accessed October 15, 2012.

What I need to know about hepatitis C. National Digestive Diseases Information Clearinghouse website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/hepc%5Fez/ . Published April 2009. Updated May 10, 2012. Accessed October 15, 2012.

12/9/2013 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: US Food & Drug Administration. FDA news release: FDA approves new treatment for hepatitis C virus. Food & Drug Administration website. Published November 22, 2013. Accessed December 9, 2013.

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