What are the other Names for this Condition? (Also known as/Synonyms)

• Type C Viral Hepatitis Infection
• Viral Hepatitis C Infection
• Viral Hepatitis Infection, Non-A, Non-B

What is Hepatitis C Infection? (Definition/Background Information)

• Hepatitis C Infection is a viral infection that causes inflammation and injury to the liver. It is caused by the hepatitis C virus (HCV)
• Hepatitis C is transmitted on physical contact with the virus. It can be transferred from one individual to another:
  • Via sexual contact
  • Through contact with infected blood (such as during a blood transfusion)
  • Through contact with other types of bodily fluids
• Some cases of Hepatitis C Infection can be very mild and only cause symptoms for a few weeks. Other types become a serious, lifelong condition. This can be life-threatening, especially if liver scarring (liver cirrhosis) or liver cancer occurs
• Currently, there is no vaccine for Hepatitis C Infection; research is being undertaken to develop effective preventative vaccines

Who gets Hepatitis C Infection? (Age and Sex Distribution)

• Hepatitis C Infection can occur in individuals of all ages, race, or ethnic group
• Both males and females can be affected

What are the Risk Factors for Hepatitis C Infection? (Predisposing Factors)

Common risk factors of Hepatitis C Infection include:

• Intravenous drug use (sharing needles)
• Exposure to infected or contaminated bodily fluids, especially blood. Such a transmission can be accidental or due to negligence from:
  • Use of contaminated intravenous needles
  • Blood transfusions or blood product received before 1992
  • Exposure to contaminated tattoo needles
  • Exposure to contaminated acupuncture needles
  • Needlestick (injury from a needle point)
  • Other injuries with contaminated blood
• Infected mother passing on the infection to her unborn child (vertical transplacental transmission of infection)
• Long-term kidney dialysis increases the risk, due to potential use of contaminated equipment
• Unprotected sex

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one's chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Hepatitis C Infection? (Etiology)

• Hepatitis C Infection is caused by a virus called the hepatitis C virus (HCV). This virus is transmitted through exposure to infected blood (most common method) and other bodily fluids
• This can occur due to the use of infected needles, sharing needles with an infected person, or while receiving a blood transfusion of infected blood, etc.
• It can also occur in infants born to HCV-infected mothers
• In rare cases, it can be caused by sharing personal items (such as razor blades) that have been contaminated

What are the Signs and Symptoms of Hepatitis C Infection?

When individuals are first infected with the hepatitis C virus, no symptoms may be present. As the virus persists in their body, symptoms begin to arise. Incubation time usually ranges from 2 weeks to 6 months.

Signs and symptoms of Acute Hepatitis C Infection may include:

• Fever
• Fatigue
• Jaundice (yellowing of the skin), icterus (yellowing of the eyes)
• Dark urine, pale stools
• Abdominal pain
• Nausea and vomiting
• Loss of appetite
• Hepatomegaly (enlargement of the liver)

How is Hepatitis C Infection Diagnosed?

Hepatitis C Infection is typically not suspected until symptoms begin to arise or if the physician observes any liver abnormalities during routine screenings. If the physician believes that an individual has Hepatitis C Infection, they will conduct a variety of tests to confirm their suspicion. These may include:

• Physical examination with evaluation of medical history
• A blood test with abnormal levels of various proteins is a good indicator of Hepatitis C Infection. If high levels of aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase, and bilirubin are present, it may indicate that the liver is damaged or injured
• Another test that can be conducted is enzyme-linked immunoassay (ELISA). In this test, hepatitis C antibody levels are measured in the body by drawing blood. If high antibody levels are noted, then Hepatitis C Infection may be present
• In order to determine if liver damage is due to Hepatitis C Infection, further blood tests are conducted. In these blood tests, viral protein and RNA levels are measured. If a high level of viral RNA is present, Hepatitis C Infection is the most likely cause
• To ensure the extent of liver damage, a liver biopsy is conducted. A sample of liver tissue is removed from the body and sent to a pathologist in order to confirm the extent of fibrosis in the liver

Most patients with Chronic Hepatitis C Infection do not have symptoms, but are diagnosed by their physicians during a blood test for abnormal liver enzymes or during blood donations.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Hepatitis C Infection?

Hepatitis C Infection can lead to chronic liver injury, causing a variety of complications in the body:

• One of the most common complications is fibrosis or liver scarring. If this worsens, it can lead to cirrhosis, which is the final and most severe stage of liver injury
• Individuals with Hepatitis C Infection are at a much higher risk of developing liver cancer. Due to all the damage that the hepatitis C virus causes to the liver, it is more likely that liver cancer may develop. This can be potentially life-threatening

How is Hepatitis C Infection Treated?

• Hepatitis C Infection is typically treated using antiviral medications that target the hepatitis C virus. These medications help remove the virus and reduce the risk of cirrhosis (scarring) and liver cancer. These medications include:
  • Pegylated interferon alfa, which is administered intravenously
  • Ribavirin, which is administered orally- This cannot be used on pregnant women, as it poses risks for their health and their infant’s health
  • Direct Acting Agents (DAA) are newer oral medications that are used in combination with ribavirin, with or without interferon, for treatment of Hepatitis C
• In case of severe liver damage, including advanced liver cirrhosis and liver cancer, a liver transplant is recommended. If the liver has suffered severe damage and poses many complications and health issues, it is easier and better for the patient to receive a new liver

However, liver transplantation is not a cure for Hepatitis C Infection. Eventually, the new liver can also be infected by the virus, and Hepatitis C Infection can develop again in the liver. Therefore, these patients are treated for Hepatitis C before or after a liver transplant.

How can Hepatitis C Infection be Prevented?

Currently, there are no vaccines or other preventative medicines against Hepatitis C Infection.

• It is important to practice safe sex and avoid exposure to infected blood and other bodily fluids. This will reduce one’s risk of contracting Hepatitis C Infection
• If you experience any of the signs and symptoms listed above, it is important to contact your healthcare provider immediately, before the symptoms worsen. This will help in preventing serious liver damage through early treatment measures
• Every individual with risk factors listed above should be tested for Hepatitis C in order to prevent transmission to their partners and family members

The U.S. Preventive Services Task Force (USPSTF) recommends Hepatitis C testing for all adults born between 1945 and 1965.

What is the Prognosis of Hepatitis C Infection? (Outcomes/Resolutions)

• Many individuals with Hepatitis C Infection experience very mild symptoms and are able to continue on with their normal lives. This is because they achieve a sustained virologic immune response by the human body, due to which the viral load is not detectable in their blood
• While a sustained virologic immune response is not a cure for Hepatitis C Infection, it is the most favorable outcome in individuals with the condition. A sustained virologic response means that the body is launching a good defensive response to the viral infection
• Other patients experience worsening symptoms including cirrhosis (liver scarring), liver failure, and in severe cases, liver cancer. These can be potentially deadly, if proper management of the condition is not undertaken

Additional and Relevant Useful Information for Hepatitis C Infection:

Hepatitis C Infection is also known as Non-A, Non-B Hepatitis (NANBH) Infection.