What is hepatitis?
“Hepatitis” means inflammation of the liver. Toxins, certain drugs, some
diseases, heavy alcohol use, and bacterial and viral infections can all
cause hepatitis. Hepatitis is also the name of a family of viral infections
that affect the liver; the most common types are hepatitis A, hepatitis
B, and hepatitis C.
What is the difference between hepatitis A, hepatitis
B, and hepatitis C?
Hepatitis A, hepatitis B, and hepatitis C are diseases
caused by three different viruses. Although each can cause similar symptoms,
they have different modes of transmission and can affect the liver differently.
Hepatitis A appears only as an acute or newly occurring infection and does
not become chronic. People with hepatitis A usually improve without treatment.
Hepatitis B and hepatitis C can also begin as acute infections, but in some
people, the virus remains in the body, resulting in chronic disease and
long-term liver problems. There are vaccines to prevent hepatitis A and
B; however, there is not one for hepatitis C. If a person has had one type
of viral hepatitis in the past, it is still possible to get the other types.
What is hepatitis C?
Hepatitis C is a contagious liver disease that ranges in severity from
a mild illness lasting a few weeks to a serious, lifelong illness that attacks
the liver. It results from infection with the hepatitis C virus (HCV), which
is spread primarily through contact with the blood of an infected person.
Hepatitis C can be either “acute” or “chronic.”
Acute hepatitis C virus infection is a short-term
illness that occurs within the first 6 months after someone is exposed
to the hepatitis C virus. For most people, acute infection leads to
chronic infection.
Chronic hepatitis C virus infection is a long-term
illness that occurs when the hepatitis C virus remains in a person’s
body. Hepatitis C virus infection can last a lifetime and lead to serious
liver problems, including cirrhosis (scarring of the liver) or liver
cancer.
How common is acute hepatitis C in the United States?
In 2006, there were an estimated 19,000 new hepatitis C virus infections
in the United States. However, the official number of reported hepatitis
C cases is much lower. Many people who are infected never have symptoms
and therefore never come to the attention of medical or public health officials.
How common is chronic hepatitis C in the United
States?
An estimated 3.2 million persons in the United States have chronic hepatitis
C virus infection. Most people do not know they are infected because they
don’t look or feel sick.
How likely is it that acute hepatitis C will become
chronic?
Approximately 75%–85% of people who become infected with hepatitis C
virus develop chronic infection.
How serious is chronic hepatitis C?
Chronic hepatitis C is a serious disease that can result in long-term
health problems, including liver damage, liver failure, liver cancer, or
even death. It is the leading cause of cirrhosis and liver cancer and the
most common reason for liver transplantation in the United States. Approximately
8,000–10,000 people die every year from hepatitis C related liver disease.
How is hepatitis C spread?
Hepatitis C is spread when blood from a person infected with the hepatitis
C virus enters the body of someone who is not infected.
Today, most people become infected with the hepatitis C virus by sharing
needles or other equipment to inject drugs. Before 1992, when widespread
screening of the blood supply began in the United States, hepatitis C was
also commonly spread through blood transfusions and organ transplants.
People can become infected with the hepatitis
C virus during such activities as
- Sharing needles, syringes, or other equipment to inject drugs
- Needlestick injuries in healthcare settings
- Being born to a mother who has hepatitis C
Less commonly, a person can also get hepatitis
C virus infection through
- Sharing personal care items that may have come in contact with another
person’s blood, such as razors or toothbrushes
- Having sexual contact with a person infected with the hepatitis
C virus
Can hepatitis C be spread through sexual contact?
Yes, but the risk of transmission from sexual contact is believed to
be low. The risk increases for those who have multiple sex partners, have
a sexually transmitted disease, engage in rough sex, or are infected with
HIV. More research is needed to better understand how and when hepatitis
C can be spread through sexual contact.
Can you get hepatitis C by getting a tattoo or
piercing?
A few major research studies have not shown hepatitis C to be spread
through licensed, commercial tattooing facilities. However, transmission
of hepatitis C (and other infectious diseases) is possible when poor infection-control
practices are used during tattooing or piercing. Body art is becoming increasingly
popular in the United States, and unregulated tattooing and piercing are
known to occur in prisons and other informal or unregulated settings. Further
research is needed to determine if these types of settings and exposures
are responsible for hepatitis C virus transmission.
Can hepatitis C be spread within a household?
Yes, but this does not occur very often. If hepatitis C virus is spread
within a household, it is most likely a result of direct, through-the-skin
exposure to the blood of an infected household member.
What are ways hepatitis C is not spread?
Hepatitis C virus is not spread by sharing eating utensils, breastfeeding,
hugging, kissing, holding hands, coughing, or sneezing. It is also not spread
through food or water.
Who is at risk for hepatitis C?
Some people are at increased risk for hepatitis
C, including
- Current injection drug users (currently the most common way hepatitis
C virus is spread in the United States)
- Past injection drug users, including those who injected only one
time or many years ago
- Recipients of donated blood, blood products, and organs (once a
common means of transmission but now rare in the United States since
blood screening became available in 1992)
- People who received a blood product for clotting problems made before
1987
- Hemodialysis patients or persons who spent many years on dialysis for kidney failure
- People who received body piercing or tattoos done with non-sterile
instruments
- People with known exposures to the hepatitis C virus, such as
- Healthcare workers injured by needlesticks
- Recipients of blood or organs from a donor who tested positive
for the hepatitis C virus
- HIV-infected persons
- Children born to mothers infected with the hepatitis C virus
Less common risks include:
- Having sexual contact with a person who is infected with the hepatitis
C virus
- Sharing personal care items, such as razors or toothbrushes, that
may have come in contact with the blood of an infected person
What is the risk of a pregnant woman passing hepatitis
C to her baby?
Hepatitis C is rarely passed from a pregnant woman to her baby. About
4 of every 100 infants born to mothers with hepatitis C become infected
with the virus. However, the risk becomes greater if the mother has both
HIV infection and hepatitis C.
What are the symptoms of acute hepatitis C?
Approximately 70%–80% of people with acute hepatitis
C do not have any symptoms. Some people, however, can have mild to severe
symptoms soon after being infected, including
- Fever
- Fatigue
- Loss of appetite
- Nausea
- Vomiting
- Abdominal pain
- Dark urine
- Clay-colored bowel movements
- Joint pain
- Jaundice (yellow color in the skin or eyes)
How soon after exposure to hepatitis C do symptoms
appear?
If symptoms occur, the average time is 6–7 weeks
after exposure, but this can range from 2 weeks to 6 months. However, many people
infected with the hepatitis C virus do not develop symptoms.
Can a person spread hepatitis C without having
symptoms?
Yes, even if a person with hepatitis C has no symptoms, he or she can
still spread the virus to others.
Is it possible to have hepatitis C and not know
it?
Yes, many people who are infected with the hepatitis
C virus do not know they are infected because they do not look or feel sick.
What are the symptoms of chronic hepatitis C?
Most people with chronic hepatitis C do not have any symptoms. However,
if a person has been infected for many years, his or her liver may be damaged.
In many cases, there are no symptoms of the disease until liver problems
have developed. In persons without symptoms, hepatitis C is often detected
during routine blood tests to measure liver function and liver enzyme (protein
produced by the liver) level.
Can a person have normal liver enzyme (e.g., ALT)
results and still have hepatitis C?
Yes. It is common for persons with chronic hepatitis C to have a liver
enzyme level that goes up and down, with periodic returns to normal or near
normal. Some infected persons have liver enzyme levels that are normal for over a
year even though they have chronic liver disease. If the liver enzyme level
is normal, persons should have their enzyme level re-checked several times
over a 6–12 month period. If the liver enzyme level remains normal, the
doctor may check it less frequently, such as once a year.
Who should get tested for hepatitis C?
Talk to your doctor about being tested for hepatitis
C if any of the following are true:
- You are a current or former injection drug user, even if you injected
only one time or many years ago.
- You were treated for a blood clotting problem before 1987.
- You received a blood transfusion or organ transplant before July
1992.
- You are on long-term hemodialysis treatment.
- You have abnormal liver tests or liver disease.
- You work in healthcare or public safety and were exposed to blood
through a needlestick or other sharp object injury.
- You are infected with HIV.
If you are pregnant, should you be tested for hepatitis
C?
No, getting tested for hepatitis C is not part of routine
prenatal care. However, if a pregnant woman has
risk factors for hepatitis C virus infection, she should speak with her doctor about getting tested.
What blood tests are used to test for hepatitis
C?
Several different blood tests are used to test for hepatitis C. A doctor
may order just one or a combination of these tests. Typically, a person
will first get a screening test that will show whether he or she has developed
antibodies to the hepatitis C virus. (An antibody is a substance found in
the blood that the body produces in response to a virus.) Having a positive
antibody test means that a person was exposed to the virus at some time
in his or her life. If the antibody test is positive, a doctor will most
likely order a second test to confirm whether the virus is still present
in the person's bloodstream.
How is acute hepatitis C treated?
There is no medication available to treat acute hepatitis C infection.
Doctors usually recommend rest, adequate nutrition, and fluids.
How is chronic hepatitis C treated?
Each person should discuss treatment options with a doctor who specializes
in treating hepatitis. This can include some internists, family practitioners,
infectious disease doctors, or hepatologists (liver specialists). People
with chronic hepatitis C should be monitored regularly for signs of liver
disease and evaluated for treatment. The treatment most often used for hepatitis
C is a combination of two medicines, interferon and ribavirin. However,
not every person with chronic hepatitis C needs or will benefit from treatment.
In addition, the drugs may cause serious side effects in some patients.
What are the long-term effects of hepatitis C?
Of every 100 people infected with the hepatitis
C virus, about
- 75–85 people will develop chronic hepatitis C virus infection; of
those,
- 60–70 people will go on to develop chronic liver disease
- 5–20 people will go on to develop cirrhosis over a period of
20–30 years
- 1–5 people will die from cirrhosis or liver cancer
Is it possible to get over hepatitis C?
Yes, approximately 15%–25% of people who get hepatitis C will clear the
virus from their bodies without treatment and will not develop chronic infection.
Experts do not fully understand why this happens for some people.
What can a person with chronic hepatitis C do to
take care of his or her liver?
People with chronic hepatitis C should be monitored regularly by an experienced
doctor. They should avoid alcohol because it can cause additional
liver damage. They also should check with a health professional before
taking any prescription pills, supplements, or over-the-counter medications,
as these can potentially damage the liver. If liver damage is present, a
person should check with his or her doctor about getting vaccinated against
hepatitis A and hepatitis B.
Should a person infected with the hepatitis C virus
be restricted from working in certain jobs or settings?
Recommendations for prevention and control of the hepatitis C virus
infection state that people should not be excluded from work,
school, play, child care, or other settings because they have hepatitis
C. There is no evidence that people can get hepatitis C from food handlers,
teachers, or other service providers without blood-to-blood contact.
What is HIV and hepatitis C virus coinfection?
HIV and hepatitis C virus coinfection refers to being infected with both
HIV and the hepatitis C virus. Coinfection is more common in persons who
inject drugs. In fact, 50%–90% of HIV-infected persons who use injection
drugs are also infected with the hepatitis C virus. To learn more about
coinfection, visit
http://www.cdc.gov/hiv/resources/factsheets/coinfection.htm.
Can I donate blood, organs, or semen if I have
hepatitis C?
No, if you ever tested positive for the hepatitis C virus (or hepatitis
B virus), experts recommend never donating blood, organs, or semen because
this can spread the infection to the recipient.
Is there a vaccine that can prevent hepatitis C?
Not yet. Vaccines are available only for hepatitis A and hepatitis B.
Research into the development of a vaccine is under way.
Can a person get hepatitis C from a mosquito or
other insect bite?
Hepatitis C virus has not been shown to be transmitted by mosquitoes
or other insects.
How long does the hepatitis C virus survive outside
the body?
The hepatitis C virus can survive outside the body at room temperature,
on environmental surfaces, for at least 16 hours but no longer than 4 days.
How should blood spills be cleaned from surfaces
to make sure that hepatitis C virus is gone?
Any blood spills — including dried blood, which can still be infectious
— should be cleaned using a dilution of one part household bleach to 10
parts water. Gloves should be worn when cleaning up blood spills.
