What Is Hepatitis C?

Hepatitis C refers to liver inflammation caused by the hepatitis C virus (HCV). Among the five known hepatitis viruses, HCV is the only one without an available vaccine.
The virus is mainly spread through contact with infected blood. An infection can be short-term (acute) or develop into a long-term (chronic) condition, sometimes lasting a lifetime. Thankfully, effective treatments exist to manage symptoms and prevent severe liver damage.

Types of Hepatitis C

HCV Strains

There are at least seven major genotypes (strains) of HCV, numbered 1 through 7. Each genotype has subtypes, with genotype 1 being the most common in the United States, accounting for 60–70% of cases.
Your specific genotype will determine the most effective treatment approach.

Acute vs. Chronic Hepatitis C

  • Acute Hepatitis C:
    A short-term infection occurring shortly after exposure. Many people have no symptoms. Some cases resolve naturally within six months without treatment.

  • Chronic Hepatitis C:
    Around 80–85% of acute cases progress to chronic infection. Chronic hepatitis C often remains asymptomatic for years but can eventually cause liver damage. Many cases are discovered through routine blood testing or blood donation screenings.

Causes of Hepatitis C

Hepatitis C is caused by the hepatitis C virus, discovered in 1989.
Transmission occurs when HCV-positive blood enters another person’s bloodstream, such as through shared needles or contaminated medical equipment.
The virus attacks liver cells, and while the immune system tries to eliminate it, the virus often replicates faster than the body can respond.

Risk Factors for Hepatitis C

You are at a higher risk if you:

  • Share needles or drug paraphernalia

  • Get tattoos or piercings with unsterilized equipment

  • Work in healthcare and are exposed to blood

  • Share personal items like razors

  • Have multiple sexual partners or unprotected anal sex

  • Have HIV or other STIs

  • Were born to an HCV-positive parent

  • Received a blood transfusion or organ transplant before July 1992

  • Underwent maintenance hemodialysis

  • Were treated for hemophilia before 1987

It is now rare to contract HCV from blood transfusions or organ transplants in the U.S.

Symptoms of Hepatitis C

Most people with acute hepatitis C show no symptoms.
If symptoms appear, they may include:

  • Dark urine or pale stools

  • Fever and fatigue

  • Joint pain

  • Abdominal pain

  • Nausea and vomiting

  • Loss of appetite

  • Jaundice (yellowing of skin and eyes)

In chronic hepatitis C, symptoms are usually mild or absent but can involve:

  • Fatigue

  • Depression

  • Abdominal pain

  • Nausea

  • Weight loss

  • Muscle or joint pain

Without treatment, chronic hepatitis C can lead to cirrhosis or liver cancer.

Diagnosis of Hepatitis C

Screening

The CDC recommends that all adults get screened for hepatitis C at least once in their lifetime. Pregnant individuals and those at higher risk should be screened regularly.

Screening includes:

  • Antibody Test: Checks for past or current infection.

  • HCV RNA Test: Confirms active infection.

Acute vs. Chronic Infection

Acute infections are usually recent and may clear on their own.
Chronic infections persist and require ongoing monitoring and treatment.

Additional Diagnostic Tests

  • Genotype Testing: Identifies the virus strain to guide treatment.

  • Liver Ultrasound (Transient Elastography): Evaluates liver stiffness.

  • Liver Biopsy: Assesses liver damage or scarring.

  • Other Tests: Check for other liver diseases or infections like HIV, hepatitis A, or hepatitis B.

Treatment for Hepatitis C

The CDC recommends treatment for all hepatitis C cases.
The first-line treatment involves direct-acting antivirals (DAAs), which are oral medications that target different parts of the virus's replication process.

Types of DAAs:

  • NS3/4A protease inhibitors

  • NS5A inhibitors

  • NS5B polymerase inhibitors

Treatment typically lasts 8 to 12 weeks and has a 90% cure rate.
Your healthcare provider will select the right combination based on the genotype, liver condition, and other health factors.

Prevention of Hepatitis C

There is currently no vaccine for hepatitis C.
However, you can lower your risk by:

  • Avoiding needle sharing

  • Practicing safe sex

  • Ensuring proper sterilization in tattoo and piercing establishments

  • Not sharing personal hygiene items

  • Following standard precautions if handling blood or bodily fluids

If you have hepatitis C, it’s important to:

  • Inform sexual partners and healthcare providers

  • Avoid donating blood, organs, or tissues

  • Take care of your liver health (avoid alcohol, maintain a healthy diet, stay physically active)

A Quick Review

Hepatitis C is a serious viral infection affecting the liver, mainly spread through contact with infected blood.
Many cases are asymptomatic, making screening essential for early detection.
Modern treatments offer high cure rates, and with proper care and prevention strategies, individuals can avoid serious liver complications.