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 infected blood on them
• contact with infected blood on the job if you are a healthcare worker, especially from accidental needlesticks
• your mother if she had hepatitis C when you were born
• intravenous (IV) drug abuse
• sharing nasal cocaine equipment with other people
• sharing razors or toothbrushes with an infected person
• getting a permanent tattoo with nonsterile 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, and their blood is not used if it is infected.

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.

Hepatitis C cannot spread by breast-feeding, hugging or kissing, food or water, sneezing, coughing, casual contact, or sharing eating utensils or drinking glasses.

What are the symptoms?

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

If you do have symptoms, they may include:

• yellowish skin and eyes (jaundice)
• tiredness
• dark urine
• abdominal pain
• loss of appetite
• nausea.

How is it diagnosed?

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

Your healthcare 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 healthcare 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 healthcare 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 another antiviral drug, such as ribavirin. You may be treated with more than 1 drug. It is also recommended that you get vaccinated against hepatitis A and B to prevent further damage to your liver by these other types of hepatitis.

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 healthcare 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. This can happen even when you do not have any symptoms of the disease. The continued inflammation can damage the liver, resulting in cirrhosis (scarring of the liver) and possible liver failure. Your healthcare 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?

• See your healthcare provider regularly.
• Follow your healthcare provider's instructions for taking medicine to relieve your symptoms. When the hepatitis C virus is active, you need to avoid taking medicines that can further damage the liver (for example, acetaminophen). Ask your healthcare provider which medicines you can safely take for your symptoms (such as itching and nausea).
• Follow your healthcare 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 healthcare 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 healthcare provider says it is safe.
• Ask your healthcare provider if you need shots to prevent hepatitis A and hepatitis B.
• Contact your healthcare 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.
• Clean any blood stains with a mixture of 1 part household bleach to 9 parts water.
• Cover your cuts and open sores.
• Do not share anything that might have blood on it, such as needles, toothbrushes, or razor blades.
• Practice safe sex.
• Do not donate blood, body organs, other tissues, or sperm.

For more information, contact:

American Liver Foundation
Phone: 800-GOLIVER (465-4837)
Web site: http://www.liverfoundation.org
Printed information about liver disease and hepatitis, information specialists