Hepatitis C

What Is It?

Hepatitis C is a viral infection that can inflame and damage the liver. The hepatitis C virus usually is transmitted through contact with infected blood, most commonly by sharing needles during intravenous drug use. Hepatitis C also may be spread through unprotected sexual intercourse, but this is uncommon. It also can be passed to health care workers through an accidental stick with a contaminated needle. Once someone has been exposed to the hepatitis C virus, it usually takes one to three weeks before the virus is detected in his or her blood.

In the past, before an adequate blood test for hepatitis C was available, many people contracted hepatitis C through blood transfusions. Since 1992, however, screening tests to check for hepatitis C in donated blood have decreased the chance of getting the virus through a blood transfusion to about one in 100,000.

Up to 80 percent of people who develop short-term (acute) hepatitis C develop long-term (chronic) hepatitis C. Most of these people, however, are unaware that they harbor this infection because hepatitis C usually does not cause symptoms. After having this silent infection for two to three decades, about 30 percent of people develop cirrhosis, a serious liver disease that can lead to death. A smaller percentage of people with long-term hepatitis C develop liver cancer. About 10,000 people in the United States die from complications of hepatitis C each year.

Symptoms

Many people with hepatitis C do not have any symptoms. However, about 30 percent of infected people develop symptoms, including:

• A general sick feeling (malaise)
• A yellowish discoloration of the skin (jaundice)
• Weakness
• Poor appetite
• Fatigue

Less than 20 percent of people who become infected with hepatitis C are able to rid their bodies of the virus completely. These people rarely suffer any long-term consequences of the disease.

About 30 percent of people with long-term hepatitis C will develop nonspecific symptoms, such as weight loss, a poor appetite, fatigue and aching joints. For the majority of people, however, chronic hepatitis C is a silent disease. Many people have no symptoms for 20 to 30 years after they contract the infection, even though the virus slowly damages their livers. Unless they are tested for hepatitis C, many of these people remain unaware that they are infected until they develop the symptoms of advanced liver disease.

Diagnosis

Your doctor will ask you about symptoms rtelated to acute or chronic hepatitis C or advanced liver disease. He or she will ask if you have any risk factors for hepatitis C, such as a history of intravenous drug use, nasal cocaine use or blood transfusions, especially before 1992. Your doctor will inquire about your sexual history, because people with multiple sexual partners are more likely to develop hepatitis C. In addition, if you have ever worked in the health care field, your doctor will ask if you could have acquired the virus through an accidental needle-stick injury. In rare cases, people on long-term hemodialysis become infected with hepatitis C through contaminated equipment.