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Hepatitis C is a viral infection that affects the liver, transmitted primarily through blood contact with an infected person. It matters because it can cause serious liver damage and long-term health problems if left untreated, though modern medicines can now cure most people who have it.
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Hepatitis C is an infectious disease caused by the hepatitis C virus (HCV) that primarily affects the liver; it is a type of viral hepatitis. During the initial infection period, people often have mild or no symptoms. Early symptoms can include fever, dark urine, abdominal pain, and jaundice. The virus persists in the liver, becoming chronic, in about 70% of those initially infected. Early on, chronic infection typically has no symptoms. Over many years, however, it often leads to liver disease and occasionally cirrhosis. In some cases, those with cirrhosis will develop serious complications such as liver failure, liver cancer, or dilated blood vessels in the esophagus and stomach.
HCV is spread primarily by blood-to-blood contact associated with injection drug use, poorly sterilized medical equipment, needlestick injuries in healthcare, and transfusions. In regions where blood screening has been implemented, the risk of contracting HCV from a transfusion has dropped substantially to less than one per two million. HCV may also be spread from an infected mother to her baby during birth. It is not spread through breast milk, food, water, or casual contact such as hugging, kissing, and sharing food or drinks with an infected person. It is one of five known hepatitis viruses: A, B, C, D, and E. Diagnosis is by blood testing to look for either antibodies to the virus or viral RNA. In the United States, screening for HCV infection is recommended in all adults age 18 to 79 years old. There is no vaccine against hepatitis C. Prevention includes harm reduction efforts among people who inject drugs, testing donated blood, and treatment of people with chronic infection. Chronic infection can be cured more than 95% of the time with antiviral medications such as sofosbuvir or simeprevir. Peginterferon and ribavirin were earlier generation treatments that proved successful in <50% of cases and caused greater side effects. While access to the newer treatments was expensive, by 2022 prices had dropped dramatically in many countries (primarily low-income and lower-middle-income countries) due to the introduction of generic versions of medicines. Those who develop cirrhosis or liver cancer may require a liver transplant. Hepatitis C is one of the leading reasons for liver transplantation. However, the virus usually recurs after transplantation.