Hepatitis C

What is Hepatitis C?

Hepatitis C (HCV) is a viral infection that attacks and inflames the liver. This infection is different from Hepatitis A and B in an important way. Once inside the body, Hepatitis C changes its form to evade discovery and attack by the immune system. Hepatitis C patients do develop antibodies, but they are not curative or protective as in hepatitis A or B. Hepatitis C antibodies may not completely rid the body of the virus.  Therefore, most people infected with the HCV virus will develop chronic hepatitis.

Risk Factors

The virus spreads through infected blood, blood products, and needles. Risk factors include:

• Unsafe use of IV drugs and shared needles
• Use of unsterile tattoo equipment
• Cause is unknown in 40% of cases (community acquired disease)

Symptoms

Most patients with hepatitis C do not have symptoms, especially early in the disease. If there are symptoms, they are usually mild and flu-like. It can take from 2-26 weeks for the disease to develop once the patient is infected with HCV.  If symptoms develop, they may include:

• Fatigue
• Nausea
• Loss of appetite
• Jaundice (yellowing of the eyes and skin)

Tests

• A routine blood test will show an elevation in certain liver enzymes, especially one called the ALT. The physician can then order a specific blood test to determine if the patient has hepatitis C.
• A liver biopsy is usually required to determine how serious the disease may be. Under local anesthesia, providers remove a  small piece of liver tissue with a needle for examination under a microscope. A biopsy can show if cirrhosis is present and how far it has progressed.

Treatments

Medical experts treat Hepatitis C with antiviral medications. In some cases, new medications can eradicate the virus.

Medications

• Interferon (IFN) - This is a synthetic form of a substance the body naturally produces to fight infections and strengthen the immune system.
• IFN combined with ribavirin - This is particularly helpful in treating those patients who have not responded to IFN alone.

Liver Transplantation

• In advanced cases, liver transplantation is now a viable option. Surgeons replace the diseased liver with part or all of a healthy liver from a donor.

Self-Care

• Avoid alcohol
• Discuss the use of over-the-­counter medicines with your physician. Some drugs such as acetaminophen (Tylenol) that may not be normally toxic can worsen liver damage in HCV.
• Maintain a healthy diet
• Talk to your provider about vaccination against hepatitis viruses A and B.

Prevention

There is no vaccine to protect against hepatitis C, as there is with hepatitis A and hepatitis B. People can prevent getting hepatitis C by:

• Not sharing anything that is likely to hold and transmit blood - razors, manicure tools, toothbrushes, and especially IV drug needles
• Avoid ear piercing and tattooing in places where sterile conditions are questionable
• Avoid coming in contact with blood and body fluids from infected individuals

This content was last medically reviewed in May 2022 by Sharlotte Manley, MSN, FNP, Erlanger Gastroenterology.