Understanding Hepatitis C

What is hepatitis C?

Hepatitis C is a viral infection that can cause liver disease and inflammation (swelling and scarring) of the liver. There are several types of hepatitis.  The most common are hepatitis A, hepatitis B, and hepatitis C.

What causes hepatitis C?

Hepatitis C infection is caused by a virus. It is passed from person to person through contact with infected blood.

What are the signs and symptoms of hepatitis C?

Most people have no physical complaints or changes in health when infected with hepatitis C. For most people, hepatitis C does not cause any symptoms unless it has damaged their liver. If liver damage occurs, you may have some or all of the following symptoms:

• Feeling tired
• Muscle soreness
• Upset stomach
• Stomach pain
• Fever
• Loss of appetite
• Diarrhea
• Dark-yellow urine
• Light-colored stools
• Yellowish eyes and skin (called jaundice)

Is hepatitis C a serious illness?

Hepatitis C is serious for some people but not for others. Most of the people who get hepatitis C carry the virus for the rest of their lives. Most will have some liver damage, but many do not feel sick from the disease. Some people with liver damage due to hepatitis C may develop scarring of the liver and liver failure, which may take many years to develop. Others have no long‑term effects. Hepatitis C can also cause kidney disease. It is important to talk with your healthcare provider about your risk for kidney disease if you are infected with the hepatitis C infection.

How can I get hepatitis C?

Anyone can get infected with the hepatitis C virus. However, you may have an increased chance of getting hepatitis C if you:

• Were born between 1945-1965
• Inject illegal drugs
• Received blood transfusions or solid organ transplants before 1992

Less commonly, hepatitis C may be spread by:

• Passing from an infected mother to her baby during childbirth
• Having sex with an infected person
• Living with an infected person and sharing items such as razors and toothbrushes
• Exposure to sharp instruments that came into contact with infected blood, such as:
  • Needles used for tattooing
  • Needles used for body piercing
  • Needles used for acupuncture

If you have to come into contact with needles, it is important that these needles be carefully cleaned and disinfected before use, or disposable needles should be used. You should always ask anyone using a needle on you if it was properly sterilized and, if possible, to use a new needle on you.

While it is important to know how you can get hepatitis C, you should also know that you cannot get hepatitis C from:

• Shaking hands or holding hands with someone infected with hepatitis C
• Being coughed or sneezed on
• Hugging an infected person
• Sitting next to an infected person
• Sharing spoons, forks, and other eating utensils
• Drinking water or eating food

It is important to see your healthcare provider right away if you have symptoms of hepatitis C.

Can I get hepatitis C from a blood transfusion?

The chances are small because of better testing of blood donors, which became available in 1992.

If I have kidney failure, can I get hepatitis C through my dialysis treatment?

The chance of getting hepatitis C through your treatment is small because of strict standard health precautions used in dialysis units today. However, there have been some reports that hepatitis C has been spread between patients in hemodialysis units where supplies or equipment may have been shared between patients. If you are a long-term hemodialysis patient, you should be tested for hepatitis C when you have your regular blood tests.

In the unlikely chance that you get hepatitis C for any reason – or if you already have it – you should discuss treatment options with your healthcare provider.  Today, there are treatments that have been shown to be safe and effective for people on dialysis.

How is hepatitis C diagnosed?

Blood tests are available to check for hepatitis C. People who are at increased risk should be tested. Your healthcare provider may do a combination of tests to make the diagnosis. It is important to see a healthcare provider if you have any of the symptoms listed above or believe you may have been in contact with blood infected with the hepatitis C virus.

What is the treatment for hepatitis C?

Drugs are available to treat hepatitis C. The medicines used to help treat a hepatitis C infection are called antiviral drugs. Your healthcare provider will look at your symptoms and find the best treatment plan for you. Your healthcare provider may give you a combination of drugs to help treat your hepatitis C infection. The goal of your treatment is to rid your body of the hepatitis C virus and slow damage to your liver. If damage has been done to your liver from the hepatitis C virus or liver cancer has developed, your healthcare provider may recommend a liver transplant.

How can I prevent hepatitis C?

Right now, there is no vaccine available for hepatitis C. However, researchers are working to develop a vaccine, and it may be available in the future. In the meantime, the following steps can help to prevent hepatitis C:

• Do not inject illegal drugs
• Do not share toothbrushes, razors or other personal care articles that might have infected blood on them
• Follow safe sex guidelines
• If you are considering getting tattoos or body piercing, make sure the tattoo artist or piercer follows good health practices such as washing hands and using disposable gloves
• Get vaccinated against hepatitis B

It is important to remember the sooner you find that you have hepatitis C, the easier it will be for your healthcare provider to treat it. It is important to limit your exposure to the hepatitis C virus and to get checked for the virus during your regular visits with your healthcare provider. If you are told you have hepatitis C it is important to talk with your healthcare provider about your chances of developing kidney disease.

If I am on dialysis, what should my dialysis care team be doing to prevent the spread of infections in the dialysis unit?

Your nurse or patient care technician should:

• Wear clean gowns, disposable gloves and face shields or masks and protective eyewear when starting your dialysis treatment and later when disconnecting you from the machine.
• Wear disposable gloves and face shields or masks and protective eyewear when doing any procedures involving your access.
• Change gloves after beginning a treatment, before touching any environmental surface such as dialysis machines, charts and phones, and after each patient contact
• Wash hands when entering patient areas, before putting on gloves and after removing them.
• Clean and disinfect the treatment area between patient shifts.
• Maintain separate areas for "clean" (e.g., medication prep) and "soiled" (e.g., blood samples) items.
• Use a separate room and a dedicated dialysis machine and avoid dialyzer reuse for patients who are positive for hepatitis B.
• Do a blood test for hepatitis B and C on all new patients and do routine follow-up testing on susceptible patients.