Hepatitis C

What is hepatitis C?

Hepatitis C is a viral infection of the liver. The liver becomes inflamed.

How does it occur?

Hepatitis C is caused by the hepatitis C virus. The virus is spread mainly through contact with infected blood. Sometimes it is spread through sexual contact. You can get it from:

• receiving infected blood, blood products, or transplanted organs
• long-term kidney dialysis if you unknowingly shared supplies or equipment that had someone else's blood on them
• contact with infected blood on the job if you are a health care worker, especially from accidental needlesticks
• your mother if she had hepatitis C at the time she gave birth to you
• intravenous (IV) drug abuse
• sharing nasal cocaine equipment with other people
• sharing razors or toothbrushes with an infected person
• getting a permanent tattoo with unsterile equipment
• having unprotected sex with someone infected with hepatitis C.

Before 1990 one of the most common ways to get hepatitis C was blood transfusion. However, now blood donors are screened for the virus.

The disease can be spread by people who do not have any symptoms and may not know they carry the virus. These people are called asymptomatic carriers.

What are the symptoms?

You may not have any symptoms of hepatitis until several weeks or months after you are infected with the virus. Or you may never have any obvious symptoms.

If you are one of the few people who have symptoms, the illness usually begins with these flulike symptoms:

• loss of appetite
• fever
• general aching
• tiredness.

Other early symptoms may include:

• itching with or without hives
• painful joints
• a loss of taste for cigarettes if you are a smoker.

Some people develop a chronic form of the disease without ever having had any obvious symptoms. Liver damage can occur slowly without symptoms in the early stages. When symptoms of chronic hepatitis C do begin, they are often persistent fatigue, weakness, and loss of appetite, as well as some of the other symptoms listed above.

How is it diagnosed?

Your health care provider will ask about your medical history and symptoms. Especially important is your history of hepatitis risk factors such as IV drug abuse.

Your health care provider will examine your skin and eyes for signs of hepatitis. Your provider will check your abdomen to see if the liver is enlarged or tender. You may have blood tests to see if your liver is inflamed and if you are infected with the hepatitis C virus.

If your health care provider thinks you may have chronic hepatitis or serious liver damage, or if the diagnosis is uncertain, you may have a liver biopsy. A biopsy is a procedure in which a needle is used to remove a small amount of tissue. This is done through the skin over the liver after the area is numbed with an anesthetic. The sample of tissue is sent to a lab for tests to check for damage to your liver.

How is it treated?

The usual treatment is rest and a healthy diet. In addition, your health care provider will recommend that you avoid alcohol for at least 6 months. Usually it is not necessary to stay at the hospital.

You may be given interferon, a drug that boosts your immune system, or other antiviral drugs.

Doctors are continuing to search for the best ways to treat hepatitis C. As new information becomes available, treatments change. You should discuss possible new treatments with your health care provider.

How long will the effects last?

Symptoms of first infection, when they occur, may last 1 to 6 weeks and then they usually go away completely.

Some people who have hepatitis C develop the chronic form of the disease. This means the virus continues to affect their liver for several months or years. The continued inflammation can damage the liver, resulting in cirrhosis (scarring of the liver) and possible liver failure. Your health care provider may check your blood every few months for signs of chronic liver disease.

Infection with the hepatitis C virus increases your risk for liver cancer.

How can I take care of myself?

• Follow your health care provider's instructions for taking medicine to relieve your symptoms. When the hepatitis C virus is active, you need to avoid taking certain medicines (for example, acetaminophen). Ask your health care provider which medicines you can safely take for your symptoms (such as itching and nausea).
• Follow your health care provider's advice for how much rest you need and when you can return to your normal activities, including work or school. As your symptoms improve, you may gradually increase your level of activity. It is best to avoid too much physical exertion until your health care provider tells you it's OK.
• Eat small, high-protein, high-calorie meals, even when you feel nauseated. Sipping soft drinks or juices, and sucking on hard candy may help you feel less nauseated.
• Do not drink alcohol unless your health care provider says it is safe.
• Ask your health care provider if you need shots to prevent hepatitis A and hepatitis B.
• Contact your health care provider if:
  • Your appetite continues to decrease.
  • You have worsening fatigue.
  • You have vomiting, diarrhea, or abdominal pain.
  • You develop jaundice.
  • You have a new rash.

What can be done to help prevent the spread of hepatitis C?

There are no shots that protect against hepatitis C. If you have hepatitis C, you can help prevent its spread by following these guidelines:

• Do not let others come in contact with your blood; for example, when you have a bloody nose or a cut.
• Do not share razor blades or toothbrushes with others.
• Do not share needles or other drug equipment with others.
• Practice safe sex.
• Do not donate blood.