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Diseases & Topics

Hepatitis C

Hepatitis C is a liver disease caused by the Hepatitis C virus (HCV). Like Hepatitis B virus, Hepatitis C is spread when blood of an infected person enters the body of a person who is not infected. This can occur through sharing needles or "works" when injecting drugs, or through an occupational needle-stick exposure. Before 1992, when widespread screening of the blood supply began in the United States, Hepatitis C was commonly spread through blood transfusions and organ transplants. Recently, outbreaks of Hepatitis C have been linked to reuse of syringes or multidose medication vials and other unsafe injection practices in health care facilities.

The risk of sexual transmission appears to be low in long-term, monogamous relationships. There is no evidence that the Hepatitis C virus can be transmitted by casual contact such as hugging or shaking hands, through foods or water, by sharing eating utensils or drinking glasses, or by coughing, sneezing or kissing. However, babies born to mothers with HCV infection can become infected during birth, especially if the mother also has HIV.

CDC estimates that there were approximately 17,000 new (acute) HCV infections in 2007, although the disease is rarely reported because individuals with new infections usually have no symptoms (are asymptomatic) or have very mild symptoms. When symptoms do occur (in about 20 to 30 percent of exposed persons), they can include fever, abdominal pain, loss of appetite, nausea, vomiting, fatigue, jaundice and dark urine. In those persons who do develop symptoms, the average time period from exposure to symptom onset is four to 12 weeks (range: 2-24 weeks).

The acute form of the infection is a short-term illness that occurs within the first six months after someone is exposed to the virus. For most people, acute infection leads to lifelong (chronic) HCV infection, which can result in severe liver disease, liver damage, liver cancer and even death. An estimated four million Americans are currently living with chronic Hepatitis C infection. Infection with HCV is most prevalent among persons born between 1945 and 1965, the majority of whom were likely infected during the 1970s and 1980s when rates were highest.

People at highest risk for HCV infection include:

  • People who currently inject or ever injected illegal drugs, including those who injected only once many years ago;
  • People who had blood transfusions, blood products, or organ donations before July 1992, when sensitive tests for HCV were introduced for blood screening; and
  • People who received clotting factors before 1987.

Other people at risk for HCV include:

  • Long-term kidney dialysis patients;
  • Healthcare workers, emergency and/or safety workers, and correction officers who have been exposed to the blood of an infected person while on the job (such as through needle-sticks, sharps);
  • Infants born to HCV-infected mothers;
  • People with high-risk sexual behaviors, multiple sexual partners, and/or sexually transmitted diseases; and
  • Those with HIV infection.

The decision to undergo treatment for HCV is a decision best made by the patient and his or her doctor after a series of diagnostic tests is conducted. Most common treatments consist of a combination of oral and injection medicines, the duration of which depends on how well the patient responds. Alcohol use can accelerate cirrhosis (scarring of the liver) and advancement to end-stage liver disease, so infected persons should avoid it.

Prevention

There is no vaccine to prevent HCV infection. Avoiding risky behaviors is the best way to prevent becoming infected. People with HCV infection should NOT be excluded from work, school, child care, play, sports or other settings on the basis of their HCV infection status as Hepatitis C is not spread through casual contact.

Persons with acute HCV infection are generally contagious beginning one or more weeks before the onset of symptoms. The contagious period is indefinite in chronically infected persons. People with HCV infection should avoid sharing personal items that might have blood on them, such as razors and toothbrushes, and any open wounds or cuts on the skin should always be covered to prevent the spread of infectious blood. People with HCV infection cannot donate blood, organs or tissue. There is a low but present risk for transmission of the virus through unprotected sex, so condom use is advised for persons with HCV infection. Those who inject drugs should never share needles or drug "works" with others.

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