Hepatitis C

What is Hepatitis C?

Hepatitis C is a viral infection that primarily affects the liver and is caused by the hepatitis C virus (HCV). It can lead to both acute and chronic infections, with chronic hepatitis C potentially resulting in severe liver damage, cirrhosis, liver failure, or liver cancer.

Transmission of Hepatitis C

Blood-to-blood contact: HCV is most commonly spread through contact with infected blood.
Sharing needles: Common among people who use injectable drugs.
Needle stick injuries: Risk for healthcare workers.
Blood transfusions and organ transplants: Before 1992, when widespread screening of blood supply began.
Mother to child: Can be passed during childbirth, although the risk is relatively low.

Symptoms of Hepatitis C

Many people with hepatitis C do not show symptoms, especially in the early stages. If symptoms do appear, they may include:

Fatigue
Fever
Loss of appetite
Nausea and vomiting
Abdominal pain, particularly in the upper right side
Dark urine
Joint pain
Jaundice: Yellowing of the skin and eyes

Acute vs. Chronic Hepatitis C

Acute Hepatitis C:
- Short-term illness that occurs within the first six months of exposure to HCV.
- Can clear on its own without treatment, but often progresses to chronic hepatitis C.
Chronic Hepatitis C:
- Long-term infection that can last a lifetime if not treated.
- Can lead to serious liver damage, cirrhosis, or liver cancer.

Causes and Risk Factors

Sharing needles or syringes: Highest risk factor for HCV transmission.
Receiving blood products: Before widespread screening in 1992.
HIV-positive status: Increases risk of contracting hepatitis C.
Being on long-term hemodialysis: Increased risk due to potential exposure to infected blood.
Born to an infected mother
Tattoos or body piercings: If done with unsterile equipment.

Diagnosis

Blood tests:
- Antibody test: Detects antibodies to HCV and indicates past or present infection.
- HCV RNA test: Confirms active infection by detecting the virus in the blood.
Liver function tests: To assess liver health and potential damage.
Imaging tests: Ultrasound, CT scan, or MRI to detect liver damage.
Liver biopsy: In some cases, a sample of liver tissue may be taken to assess the extent of liver damage.

Treatment Options

Antiviral medications:
- Direct-acting antivirals (DAAs): Highly effective in curing hepatitis C, with a treatment duration of 8-12 weeks.
- Combination therapies: Such as sofosbuvir and ledipasvir (Harvoni) or glecaprevir and pibrentasvir (Mavyret).
Lifestyle changes:
- Avoid alcohol: To prevent further liver damage.
- Maintain a healthy diet: Supports liver function.
Monitoring: Regular check-ups to monitor liver function and detect any complications early.

Prevention Strategies

Avoid sharing needles or syringes
Practice safe sex: Use of condoms to reduce the risk of transmission.
Ensure proper sterilization of medical and tattoo equipment.
Screening blood donations: Ensures blood is free of HCV.

Complications of Hepatitis C

Cirrhosis: Long-term liver damage that can lead to scarring.
Liver cancer: Increased risk with chronic infection.
Liver failure: Severe cases can result in the liver losing its ability to function.
Other systemic issues: Such as type 2 diabetes, kidney disease, and cryoglobulinemia (a condition that affects blood vessels).

References & Research

Historical Background

Hepatitis C virus was identified in 1989 by Michael Houghton, Qui-Lim Choo, and George Kuo at Chiron Corporation, along with Daniel Bradley at the CDC. Previously known as "non-A, non-B hepatitis," its discovery enabled blood supply screening and ultimately the development of curative direct-acting antiviral therapies. Harvey Alter, Michael Houghton, and Charles Rice were awarded the 2020 Nobel Prize in Physiology or Medicine for the discovery of HCV.

Key Research Papers

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Research Papers

The following PubMed topic searches retrieve current peer-reviewed literature on Hepatitis C. Each link opens a live PubMed query so you always see the most recent publications.