HEPATITIS C: Hepatitis C Frequently Asked Questions

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What is hepatitis C?

Hepatitis C is a liver disease caused by the hepatitis C virus (HCV), which is found in the blood of persons who have this disease. The infection is spread by contact with the blood of an infected person.

How serious is hepatitis C?

Hepatitis C is serious for some persons, but not for others. Most persons who get hepatitis C carry the virus for the rest of their lives. Most of these persons have some liver damage but many do not feel sick from the disease. Some persons with liver damage due to hepatitis C may develop cirrhosis (scarring) of the liver and liver failure which may take many years to develop. Others have no long term effects.

What can I do now that my hepatitis C test is positive?

Contact your doctor. Additional tests may be needed to check your diagnosis and to see if you have liver damage.

What if I don't feel sick?

Many persons with long-term hepatitis C have no symptoms and feel well, but should still see their doctor. For some persons, the most common symptom is extreme tiredness.

How can I take care of my liver?

# See your doctor regularly.

# Do not drink alcohol.

# Tell your doctor about all medicines that you are taking, even over the counter and herbal medicines.

# If you have liver damage from hepatitis C, you should get vaccinated against hepatitis A.

Is there a treatment for hepatitis C?

Drugs are licensed for the treatment of persons with long-term hepatitis C. About 4-5 out of every 10 patients who are treated get rid of the virus. You should check with your doctor to see if treatment may help you.

How could I have gotten hepatitis C?

# HCV is spread primarily by exposure to human blood. You may have gotten hepatitis C if: you ever injected street drugs, even if you experimented a few times many years ago.

# you were treated for clotting problems with a blood product made before 1987.

# you received a blood transfusion or solid organ transplant (e.g., kidney, liver, heart) from an infected donor.

# you were ever on long-term kidney dialysis.

# you were ever a health care worker and had frequent contact with blood in the work place, especially accidental needlesticks.

# your mother had hepatitis C at the time she gave birth to you.

# you ever had sex with a person infected with HCV.

# you lived with someone who was infected with HCV and shared items such as razors or toothbrushes that might have had blood on them.

How can I prevent spreading HCV to others?

# Do not donate your blood, body organs, other tissue, or sperm.

# Do not share toothbrushes, razors, or other personal care articles that might have your blood on them.

# Cover your cuts and open sores.

# If you have one long-term, steady sex partner, there is a very low chance of giving HCV to that partner and you do not need to change your sexual practices. If you want to lower the small chance of spreading HCV to your sex partner, you may decide to use latex condoms. (The efficacy of latex condoms in preventing infection with HCV is unknown, but their proper use may reduce transmission.) Ask your doctor about having your sex partner tested.

What if I am pregnant?

Five out of every 100 infants born to HCV infected women become infected. This occurs at the time of birth, and there is no treatment that can prevent this from happening. However, infants infected with HCV at the time of birth seem to do very well in the first few years of life. More studies are needed to find out if these infants will have problems from the infection as they grow older.

Hepatitis C is NOT spread by:

# breast feeding

# sneezing

# hugging

# coughing

# sharing eating utensils or drinking glasses

# food or water

# casual contact

If you use or inject street drugs:

# Stop and get into a drug treatment program.

# If you cannot stop, do not reuse or share syringes, water, or drug works.

# Get vaccinated against hepatitis B and hepatitis A.

If you are having sex, but not with one steady partner:

# You and your partners can get diseases spread by having sex (e.g., AIDS, hepatitis B, gonorrhea or chlamydia). Use latex condoms correctly and every time. (The efficacy of latex condoms in preventing infection with HCV is unknown, but their proper use may reduce transmission.) The surest way to prevent the spread of any disease by sex is not to have sex at all.

# Get vaccinated against hepatitis B.

The liver is the largest organ in the body. It is located on the right side of the abdomen (to the right of the stomach) behind the lower ribs and below the lungs. The liver performs more than 400 functions each day to keep the body healthy.

Some of its major jobs include:

# converting food into nutrients the body can use (for example, the liver produces bile to help break down fats)

# storing fats, sugars, iron, and vitamins for later use by the body

# making the proteins needed for normal blood clotting

# removing or chemically changing drugs, alcohol, and other substances that may be harmful or toxic to the body

Hepatitis C Fact Sheet

Hepatitis C virus (HCV) is the most common chronic bloodborne infection in the United States. Hepatitis C accounts for the great majority of what was referred to in the past as non-A, non-B hepatitis. The hepatitis C virus was identified in 1989, and in 1990, a hepatitis C antibody test (anti-HCV) became available to identify individuals exposed to HCV.

Source: Centers for Disease Control and Prevention

Source: USC Liver Transplant Program and Center for Liver Disease

SIGNS & SYMPTOMS

# About 80 percent of those infected have no signs or symptoms. jaundice

# fatigue

# dark urine

# abdominal pain

# loss of appetite

# nausea

CAUSE

# Hepatitis C virus (HCV)

LONG-TERM EFFECTS

# Chronic infection: 75 to 85 percent of infected persons

# Chronic liver disease: 70 percent of chronically infected persons

# Deaths from chronic liver disease: fewer than 3 percent

# Leading indication for liver transplant

TRANSMISSION

# Occurs when blood or body fluids from an infected person enter the body of a person who is not infected.

# HCV is spread through sharing needles or "works" when "shooting" drugs, through needlesticks or sharps exposures on the job, or from an infected mother to her baby during birth.

RECOMMENDATIONS FOR TESTING

PERSONS RISK OF INFECTION TESTING ?

Injecting drug users High Yes

Recipients of clotting factors made before 1987 High Yes

Hemodialysis patients Intermediate Yes

Recipients of blood and/or solid organs before 1992 Intermediate Yes

People with undiagnosed liver problems Intermediate Yes

Infants born to infected mothers Intermediate After 12-18 months old

Healthcare/public safety workers Low Only after known exposure

People having sex with multiple partners Low No*

People having sex with an infected steady partner Low No*

Anyone who wants to get tested should ask their doctor.

PREVENTION

# There is no vaccine to prevent hepatitis C.

# Do not shoot drugs; if you shoot drugs, stop and get into a treatment program; if you can't stop, never share needles, syringes, water, or "works", and get vaccinated against hepatitis A & B.

# Do not share personal care items that might have blood on them (razors, toothbrushes).

# If you are a health care or public safety worker, always follow routine barrier precautions and safely handle needles and other sharps; get vaccinated against hepatitis B. (View current post-exposure prophylaxis recommendations.)

# Consider the risks if you are thinking about getting a tattoo or body piercing. You might get infected if the tools have someone else's blood on them or if the artist or piercer does not follow good health practices.

# HCV can be spread by sex, but this is rare. If you are having sex with more than one steady sex partner, use latex condoms* correctly and every time to prevent the spread of sexually transmitted diseases. You should also get vaccinated against hepatitis B.

# If you are HCV positive, do not donate blood, organs, or tissue.

TREATMENT & MEDICAL MANAGEMENT

# HCV positive persons should be evaluated by their doctor for liver disease.

# Interferon and ribavirin are two drugs licensed for the treatment of persons with chronic hepatitis C.

# Interferon can be taken alone or in combination with ribavirin. Combination therapy is currently the treatment of choice.

# Combination therapy, using pegylated interferon and ribavirin, can get rid of the virus in up to 40 percent of those with genotype 1 and up to 80 percent for those with genotype 2 or 3.

# Drinking alcohol can make your liver disease worse.

STATISTICS & TRENDS

# Number of new infections per year has declined from an average of 240,000 in the 1980s to about 25,000 in 2001.

# Most infections are due to illegal injection drug use.

# Transfusion-associated cases occurred prior to blood donor screening; now occurs in less than one per million transfused unit of blood.

# Estimated 3.9 million (1.8 percent) Americans have been infected with HCV, of whom 2.7 million are chronically infected.

*The efficany of latex condoms in preventing infection with HCV is unknown, but their proper use may reduce transmission.