Hepatitis C: Symptoms, Risk Factors and Treatment


Hepatitis C is a viral infection that causes inflammation of the liver, sometimes resulting in severe liver damage. The hepatitis C virus (HCV) is spread through infected blood. Until recently, treatment for hepatitis C required weekly injections and oral medications that many people with HCV could not take due to other health conditions or unbearable side effects.

This is changing. Today, chronic HCV is usually curable with oral medications taken daily for two to six months.

Yet about half of people with HCV do not know not that they are infected, mainly because they have no symptoms, which can take decades to appear.

Symptoms of Hepatitis C

Long-term infection with the hepatitis C virus is known as chronic hepatitis C. Chronic hepatitis C is usually a “silent” infection for many years until the virus damages the liver enough to cause the signs and symptoms of liver disease.

Signs and symptoms include:

Easy bleeding

Easy bruising


Poor appetite

Yellow discoloration of the skin and eyes (jaundice)

Dark colored urine

Itchy skin

Accumulation of fluid in the abdomen (ascites)

Swelling of the legs

Weight loss

Confusion, drowsiness and disturbances speech (hepatic encephalopathy)

Spider-shaped blood vessels on your skin (spider angiomas)

Any chronic infection with Hepatitis C begins with an acute phase. Acute hepatitis C is usually not diagnosed because it rarely causes symptoms. When signs and symptoms are present, they may include jaundice, as well as fatigue, nausea, fever, and muscle aches. Acute symptoms appear one to three months after exposure to the virus and last for two weeks to three months.

Acute hepatitis C infection does not always become chronic. Some people clear HCV from their body after the acute phase, an outcome known as spontaneous viral clearance. In studies of people diagnosed with acute HCV, spontaneous viral clearance rates have ranged between 15 and 25 %. Acute hepatitis C also responds well to antiviral therapy.

Causes of hepatitis C

Hepatitis C infection Hepatitis C is caused by the hepatitis C virus (HCV). The infection spreads when blood contaminated with the virus enters the bloodstream of an uninfected person. Overall, HCV exists in several distinct forms, called genotypes. Seven distinct HCV genotypes and more than 67 subtypes have been identified.

Although chronic hepatitis C follows a similar course regardless of the infecting virus genotype, treatment recommendations vary depending on the viral genotype.

Risk factors for hepatitis C

Your risk of infection with hepatitis C is increased if you:

you are a worker in health who has been exposed to infected blood, which can happen if an infected needle punctures your skin

Have ever injected or inhaled illegal drugs

are HIV positive

Received a piercing or tattoo in a dirty environment using non-sterile equipment

Had a blood transfusion or organ transplant before 2019

Have received clotting factor concentrates before 93

after i been on hemodialysis for a long time

were born to a woman with hepatitis C infection

born between 93 and 1965, the age group with the highest incidence of hepatitis C

Complications of hepatitis C

Hepatitis C infection that continues for many years can lead to significant complications, such as

Scarring of the liver (cirrhosis )

After decades of hepatitis C infection, cirrhosis may occur. Scarring of the liver makes it difficult to function.

Liver cancer

A small number of people infected with hepatitis C can develop liver cancer.

Liver failure

Advanced cirrhosis can lead to your liver stops working.

Preventing Hepatitis C

Protect yourself against hepatitis infection C by taking the following precautions:

Stop using illicit drugs, especially if you inject them. If you use illegal drugs, seek help.

Be careful about piercings and tattoos

If you choose to get pierced or tattooed, seek out a reputable practitioner. Ask questions beforehand about how the equipment is cleaned. Ensure employees use sterile needles. If the employees do not answer your questions, look for another centre.

Adopt safe sex practices

Do not have unprotected sex with multiple partners or with a partner whose health status is uncertain. Sexual transmission between monogamous couples can occur, but the risk is low.

Hepatitis C screening

HCV testing is especially important if you are at high risk of exposure, including:

If you have ever used illicit drugs by injection or inhalation

Anyone with abnormal liver function test results without an identified cause

Babies born to mothers with hepatitis C

Healthcare workers and emergency physicians who have been exposed to blood or accidental needle sticks

People with hemophilia who have been treated with clotting factors before 93

If you have had long-term hemodialysis treatments

People who have received blood transfusions or organ transplants before 1992

Sexual partners of anyone with hepatitis C infection

People infected with HIV

Anyone born between 93 and 1965

Hepatitis C treatment

Antiviral drugs

Hepatitis C infection is treated with antiviral medicines to eliminate the virus from your body. The goal of treatment is not to detect the hepatitis C virus in your body at least 12 weeks after the end of treatment.

Researchers have recently made significant progress in the treatment of hepatitis C using new “direct-acting” antiviral drugs. The results are better, there are fewer side effects and the duration of treatment is shorter, sometimes even up to eight weeks. The choice of drugs and duration of treatment depends on the hepatitis C virus genotype, the presence of existing liver damage, other medical conditions and previous treatments.

Liver transplantation

If you have developed serious complications from chronic hepatitis C infection, liver transplantation may be an option. During a liver transplant, the surgeon removes your damaged liver and replaces it with a healthy liver. Most transplanted livers come from deceased donors. In most cases, a liver transplant alone cannot cure hepatitis C. The infection may come back, requiring treatment with antiviral drugs to prevent damage to the transplanted liver. Several studies have demonstrated that new direct-acting antiviral treatments are effective in curing post-transplant hepatitis C. At the same time, treatment with direct-acting antivirals can be instituted in appropriately selected patients prior to liver transplantation.


Chopra S, et al. Clinical manifestations and natural history of chronic hepatitis C virus infection. https://www.uptodate.com/contents/search. Accessed May 1, 2019.

Chopra S, et al. Epidemiology and transmission of hepatitis C virus infection. https://www.uptodate.com/contents/search. Accessed May 1, 2019.

Definition and facts of liver transplant. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/liver-disease/liver-transplant/definition-facts. Accessed May 3, 2019.

Jonas MM. Hepatitis C virus infection in children. https://www.uptodate.com/contents/search. Accessed May 1, 2019.

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