What is hepatitis?
Hepatitis is inflammation of the liver. When the liver is inflamed, it can become swollen and painful. In severe cases of hepatitis, the liver can stop functioning, which can be life-threatening.
Hepatitis has many causes, including viruses (a type of germ), bacteria, drugs, chemicals, and alcohol. In rare instances, the body’s own immune system can even attack the liver. In the United States, the most common types of viral hepatitis are hepatitis A, hepatitis B, and hepatitis C. These viruses are similar in that they all affect the liver and may cause similar symptoms. They are different in how they are transmitted, how long the infection lasts, and how they are treated. There are also some differences in prevention methods. Hepatitis A and B are vaccine-preventable, but hepatitis C is not. A healthcare provider can test a person’s blood for infection with the hepatitis A, B, and C viruses.
What is hepatitis C?
Hepatitis C is an infection caused by the hepatitis C virus. While some people will clear (get rid of) the virus without treatment, most people who get the infection will develop chronic (long-term) infection and can pass it on to others. Some of these people will feel very sick and may develop liver damage such as cirrhosis (scarring of the liver) or liver cancer. Others with chronic infection can remain healthy for many years without symptoms, or might develop symptoms or complications slowly. Some people infected decades ago may not know it. There is no vaccine to prevent hepatitis C infection, but it can be cured once someone is infected.
How is it spread?
The hepatitis C virus is spread by direct contact with blood, or body fluids containing blood, from a person who has hepatitis C infection. This can happen through:
- Sharing equipment used to inject drugs
- Sharing personal items that have blood on them, such as glucose monitors, toothbrushes, nail clippers, or razors
- Perinatal exposure, when a baby is born to a parent with hepatitis C
- Blood transfusions and organ transplants that took place prior to 1992, when widespread screening of the blood supply began
- Getting tattoos or body piercings in informal settings or with non-sterile equipment
- Poor infection control in health care facilities and residential care facilities
- Having sex, although this is rare. Factors that may increase risk of transmission include having anal sex, fisting, having multiple sex partners, or having HIV or other sexually transmitted infections.
The hepatitis C virus is not spread by casual contact such as hugging, or through sneezing, coughing, or sharing food and drinks.
What are the symptoms of hepatitis C?
Many adults with hepatitis C have few or no symptoms. When symptoms occur, they can include tiredness, loss of appetite, nausea, vomiting, abdominal pain, fever, and muscle or joint pain. Hepatitis C can also cause jaundice (which shows up as yellowing of the skin and eyes and dark urine) and clay or gray colored stools. Years later, cirrhosis may occur in some who are infected, when scar tissue replaces healthy liver cells.
How soon do symptoms of hepatitis C appear?
When first infected with hepatitis C virus, most people have no symptoms at all, or may have only mild symptoms. For those who do develop symptoms, the symptoms usually appear six weeks to six months after infection. Many people with chronic hepatitis C infection do not develop symptoms until years, sometimes even decades, later. The longer people live with hepatitis C infection, the more likely they are to develop serious, life-threatening liver disease.
How is hepatitis C diagnosed?
Hepatitis C is diagnosed with a blood test (called an antibody test) to show if the person has ever been exposed to the virus. If that test is positive, a second, different blood test is done. This second test (sometimes called a viral load, RNA, or PCR test) will show if the person currently has hepatitis C virus in the body.
What are the testing recommendations for hepatitis C?
- Once in a lifetime testing for everyone 18 years of age and older
- One-time testing for:
- Pregnant people, during each pregnancy
- People with HIV infection or chronic hepatitis B infection
- People who ever injected drugs, even if it was just once or many years ago
- People who have ever received tattoos in an informal setting or with non-sterile equipment
- People whose birth parent had hepatitis C infection
- People who received blood transfusions or organ transplants before 1992
- People with abnormal liver tests or liver disease
- People who have been exposed to blood on the job, through a needle-stick or other injury
- Routine testing for:
- People who currently inject drugs and share needles, syringes, or other equipment
- People receiving hemodialysis
How is hepatitis C treated?
More than 95% of people with hepatitis C infection can be cured with 8-12 weeks of oral medication. Prompt treatment after diagnosis can prevent liver damage, cirrhosis, and liver cancer. People with hepatitis C should avoid drinking alcohol or taking any medications or dietary supplements that may be harmful to the liver. Hepatitis A and B vaccines are also recommended to help protect the liver from other viruses that can cause damage. Ask your healthcare provider about treatment options and steps you can take to protect your liver.
You can get infected again after you have been successfully treated and cured, so it is important to protect yourself against re-infection. However, if you have hepatitis C, you should talk to a healthcare provider about getting treated even if you might get exposed to the virus again.
How can I prevent hepatitis C?
Since there is no vaccine for hepatitis C, the best way to prevent hepatitis C is to avoid contact with the blood of people who have hepatitis C. This includes:
- Never sharing equipment used to inject drugs with anyone. This includes anything that can have blood in it or on it, like needles, cottons, cookers, ties, water, etc. Sterile syringes are available at syringe service programs in Massachusetts or can be purchased over the counter in most pharmacies by anyone 18 years of age or older.
- Only getting tattoos or piercings at places using sterile equipment and supplies.
- Never sharing personal items like glucose monitors, razors, toothbrushes, or nail clippers.
- Using latex condoms and lube during vaginal or anal sex, which will reduce the risk of sexual transmission.
Where can you get more information?
- Your doctor, nurse, or health care clinic
- Syringe service programs, which provide access to sterile needles and syringes, as well as testing for hepatitis C, HIV, sexually transmitted infections, overdose education, and Narcan (naloxone)
- A local substance use disorder treatment program
- The Massachusetts Department of Public Health website at www.mass.gov/hepc
- The Centers for Disease Control and Prevention (CDC) website at: www.cdc.gov/hepatitis
- Your local board of health
- The Massachusetts Department of Public Health (DPH), Division of Epidemiology at (617) 983-6800
- The Massachusetts Department of Public Health has produced educational materials on hepatitis C. These materials are designed for individuals who have lived experience with, or would like to learn more about hepatitis C. These materials are appropriate for anyone because they have been designed to represent and be inclusive of a range of populations in Massachusetts. Posters, brochures, pocket-sized information cards, and fact sheets may be ordered from the Health Promotion Clearinghouse.