Introduction

Hepatitis C virus (HCV) is one of the most important causes of chronic liver disease in the United States;  ranks second behind alcoholism.  It has become the most common reason for liver transplantation and has been called the silent epidemic in numerous articles in the news media.  Almost 4 million Americans have antibody to HCV virus, indicating ongoing or previous infection with the virus and with 30,000 new cases diagnosed annually.  It causes an estimated 8 to 10 thousand deaths annually in the United States.  The hepatitis C virus has been identified in virtually every country in the world.  An estimated 3% of the world's population - more than 170 million people carry the virus.

Health experts say the number of deaths from HCV may soon surpass the number attributed to AIDS.  Hepatitis C, like the AIDS virus, mutates frequently, hindering the development of a vaccine.

Mode of Transmission

At present, injection drug use is the most common risk factor contracting the disease.  However, many people acquire hepatitis C without any known exposure to blood or drug use.  In adults, HCV infection acquired through transfusion persist in up to 70-80% of patients.  Many people infected in this way will subsequently have severe liver disease, such as chronic hepatitis or cirrhosis, within 20 years after infection.  It is uncertain whether the long-term outcome of HCV infection in children is similar to that in adults.

The major high-risk groups for hepatitis C are

• People who had blood transfusions before June 1992.

• People who have frequent exposure to blood products.

• Health care workers who suffer needle-stick accidents.

• Injection drug users, including those who used drugs briefly many years ago.

• Infants born to HCV-infected mothers.

With the implementation of blood-donor screening, new HCV infections Children will be acquired primarily through mother-to-infant transmission.  Given the number of women  of child bearing age with chronic HCV infection, there may be a considerable number of infections by this route in newborns.  There are currently no recommendations to screen women for HCV infection either before or during pregnancy.

Other groups who appear to be at slightly increased risk for hepatitis C are

• People with high risk sexual behavior, multiple partners, and sexually transmitted diseases.

• And by getting tattoo or body piercing with unsterilized, dirty tools.

• People who use cocaine, particularly with intranasal administration, using shared equipment.

Hepatitis C virus is not spread by

• Casual contact including hugging and kissing an infected person. 

• Breast-feeding

• Coughing

• Sharing eating utensils or drinking glasses

• Food and water

Many people who are at risk for hepatitis C are at risk for hepatitis A and B. Check with your doctor to see if you should get hepatitis A and B vaccines.

Symptoms

Many people with hepatitis C don't have symptoms. However, hepatitis C is serious for some persons, but not for others.  Most persons who get hepatitis C carry the virus for the rest of their lives.  Most of these persons have some liver damage but many do not feel sick from the disease.  Some people may develop cirrhosis of the liver and liver failure which may take many years to develop.  Others have no long term effects.

About 85% of people infected with HCV go on to develop chronic hepatitis.  About 20% develop cirrhosis, an incurable liver disease, within 20 years.  And up to half of those cases progress to end-stage liver disease or liver cancer.  Due to long incubation period, the annual number of HCV related deaths will quadruple in 20 years, due primarily to the aging of people already infected.

However, some people with hepatitis C feel like they have flu.

So, you might

• Feel tired.

• Feel sick to your stomach.

• Have a fever.

• Not want to eat.

• Have stomach pain.

• Have diarrhea.

• Muscle and join pains.

Some people have

• Dark yellow urine.

• Light-colored stools.

• Yellowish eyes and skin.

Similarly, the physical exam is likely to be normal or show only mild hepatomegaly or tenderness.  Some people have vascular spiders or palmar erythema.

If you have symptoms, or think you have hepatitis C, go to a doctor.

Hepatitis C Preventive Measures:

Hepatitis is a medical term that means inflammation of the liver, an organ that sits behind your lower ribs on the right side of your abdomen.  Among its many functions, the liver detoxifies harmful substances and purifies the blood, metabolizes nutrients, drugs and other materials and manufactures proteins and enzymes needed by the body.

Since there is no effective vaccine for hepatitis C, the only way to prevent potential serious liver damages is to avoid becoming infected.

That means:

• Don't ever shoot drugs.  If you shoot drugs, stop and get into a treatment program.  If you can't stop, never reuse or share syringes, water or drug works, and get vaccinated against hepatitis A and B.

• Do not share tooth brushes, razors, or other personal care articles.  They might have blood on them.

• If you are a health care worker, always follow the routine barrier precautions and safely handle needles and other sharps.  Get vaccinated against hepatitis B.

• Consider the health risk if you are thinking about getting a tatto or body piercing.  You can get infected if:

• The tools that are used have someone else's blood on them

• The artist or piercer doesn't follow good health practices, such as washing hands and using disposable gloves.

 NIH Publication No 97-4229 Oct. 1997
The text is updated: 20 Nov. 1999

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