---

Hepatitis C: Questions and Answers

What is hepatitis C?

Hepatitis C is an inflammation of the liver caused by the hepatitis C virus. Approximately four million Americans are infected, with about 30,000 new infections each year. The hepatitis C virus can infect a person who has been exposed to an infected person's blood. The virus can stay in the body, usually for a lifetime, and eventually can cause chronic, serious liver diseases.

What behaviors could put me at risk?

You are at risk if you share needles, razors, toothbrushes or other items that could be contaminated with blood. You are at risk if you received a blood transfusion prior to 1992 or clotting factors before 1987. You are at risk if you work with contaminated blood or are exposed to blood. Chronic dialysis is also a risk factor. Although the likelihood of infection from sexual contact is low, it is possible. Thus, if you have sex with an infected partner or if you have had multiple partners, you do have a risk factor for hepatitis C.

Should I be tested?

You should be tested for hepatitis C if you:

• received blood products or a solid organ transplant before 1992 or clotting factors before 1987
• were notified that you received blood from a donor who later tested positive for Hepatitis C*
• injected drugs
• received chronic hemodialysis
• are a health care or public service worker and have been exposed to Hepatitis C - contaminated blood
• have signs or symptoms or liver disease (e.g. abnormal liver enzyme tests)

Your child should be tested if you are a mother who had hepatitis C when the child was born.

What can be done to prevent hepatitis C?

Practicing good hygiene and safer sexual behaviors is a good first step. You can help avoid infection by using these precautions:

• Don't share toothbrushes, razors, or other personal care items that may be contaminated with blood.

• Don't ever inject drugs. If you are unable to stop, don't ever share needles, syringes, or “works,” and get vaccinated against hepatitis A and hepatitis B.

• If you are a healthcare worker, always follow barrier protection recommendations and handle sharps with care.

• Consider the potential health risks of tattooing and body piercing, if done by a practitioner who may use tools or solutions contaminated by someone else's blood or who doesn't wash their hands. No data exists in the United States which indicates that persons with tattooing alone are at increased risk for Hepatitis C; however, there is a potential risk with any percutaneous (through the skin) exposure.

• Hepatitis C isn't spread very often by sex, but it has happened. If you have had multiple sexual partners, get immunized against hepatitis B and use latex condoms correctly and consistently to decrease the likelihood of other dangerous diseases such as HIV. If you have only one long-term steady partner, no change in sexual practices is required, but ask your clinician about testing your partner for Hepatitis C.

• The risk of perinatal (during birth) infection is 4%. If the mother has both Hepatitis C and HIV, the risk can be as high as 19%. There is no evidence that the virus is transmitted through breast milk, but the mother should consider abstaining from breast feeding if the nipples are cracked or bleeding. * There is no evidence that Hepatitis C can be transmitted by mosquitoes or other arthropods.

What are the symptoms of hepatitis C?

Hepatitis C is less likely than the other hepatitis viruses to cause serious illness at first (only one quarter of the people infected actually develop symptoms); but about 85% of those infected develop chronic liver disease. At least 20% of those with chronic infection develop cirrhosis of the liver and one to five percent will get hepato-cellular carcinoma.

Early symptoms of viral hepatitis include:

• fatigue
• tenderness in the upper right abdomen
• loss of appetite
• nausea, vomiting & diarrhea
• dark urine
• malaise

Later symptoms may include:

• jaundice - abnormally yellow skin and eyes caused by bile entering the blood
• darkened urine
• light-colored or gray stool

How is it diagnosed?

Although health providers use information about a person's symptoms, health history and behaviors to help make a diagnosis, only blood tests for the presence of antibody or virus can confirm the diagnosis and pinpoint which type of hepatitis a person has.

How is hepatitis C treated?

There are medications that are used to treat some people with hepatitis C. These drugs can decrease the amount of virus present while they are being taken, and occasionally these drugs can cure. They are wonder drugs for the fortunate people that they help, but they don't work for everyone. If you have hepatitis C, you need to stay current on treatment options, as there is continued research and excellent reason to remain optimistic about future treatments.

Also:

• Stop using alcohol
• See your clinician regularly
• Don’t start any new medications, supplements, or herbals without your clinician’s knowledge.

* Since improvements in blood bank testing, the chance of contracting Hepatitis C from transfusion is less than 1 per 2 million units transfused.

Hepatitis C is a leading indication for liver transplants.

Resources:

Hepatitis C FAQs for the Public, CDC web site: http://www.cdc.gov/hepatitis/C/cFAQ.htm

Hep C Connection web site: http://www.hepc-connection.org/

Hepatitis Foundation International web site: http://www.hepfi.org/

American Liver Foundation web site: http://www.liverfoundation.org/

References

Bonis P & Chopra, S. Patient information: Hepatitis C. UpToDate (18.1). January, 2010.

"Hepatitis C Information for Health Professionals."The Centers for Disease Control and Prevention (CDC), Division of Viral Hepatitis & the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. 8 July 2008. http://www.cdc.gov/hepatitis/HCV/HCVfaq.htm