What is Hepatitis C?

Hepatitis C is an infection of the liver resulting from the hepatitis C virus (HCV). Most people who are infected with HCV (approximately 80%) develop a chronic condition. Some people who are infected (about 20%) are able to get rid of the virus shortly after infection (usually within the first six months). Chronic HCV can cause liver damage, cirrhosis (scarring of the liver), liver failure, or liver cancer, as well as other conditions outside of the liver, although these outcomes usually occur over a period of several years.

Transmission

HCV is passed from one person to another when the blood of a HCV-infected person enters the body of someone who is not infected. Today, most people become infected with HCV by sharing needles, syringes, or any other equipment to inject drugs. Before widespread screening of the blood supply in 1992, HCV was also spread through blood transfusions and organ transplants. While uncommon, poor infection control has resulted in outbreaks in healthcare settings. Vertical (parent-to-baby) transmission occurs about 5% of the time a HCV-positive parent gives birth to their child. The likelihood of vertical transmission increases to about 10% if the parent is co-infected with HIV and HCV.

Although heterosexual transmission of HCV is rare, there appears to be an increased risk of sexual transmission among people living with HIV, particularly among HIV-positive men-who-have-sex-with-men (MSM). Having other sexually transmitted diseases, having sex with multiple partners, or having “rough” sex that involves blood also appears to increase the risk of sexual transmission of HCV.

Also rare, though possible, is transmission through shared glass pipes used to smoke stimulants such as crack or methamphetamines or through shared straws used to snort drugs. This could potentially happen if microscopic particles of blood from an HCV-infected individual is on the straw or pipe and then introduced to the bloodstream of a second person through a sore, burn, or capillaries in the nasal passages.

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Symptoms

In about 85% of cases, HCV does not immediately cause symptoms. In the other 15% of cases, symptoms occur two weeks to six months after getting it. Acute hepatitis is usually mild and can include: jaundice (yellowing of the eyes, tongue or skin), stomach or joint pain, dark urine, tiredness, itchiness, loss of appetite, nausea or vomiting.

Symptoms of chronic HCV vary. Some may experience weight loss, brain fog, headaches, fatigue, depression or achiness. Others may experience no symptoms at all.

Testing

The only way to know if you have HCV is to get tested. An antibody test determines if a person has ever been infected with HCV. Antibodies are like a virus’s footprints, they tell us if the virus has ever been in the body, but not if it is still there. If the antibody test is reactive (indicates that HCV antibodies or footprints are in the body), then that person needs a second test, a blood test, that looks for the virus itself.

This second test is most often called a “viral load” or “PCR” test. Rapid antibody tests are completed in twenty minutes and are available to individuals at high risk of HCV (people who inject drugs, people who smoke stimulants) in several community settings in San Francisco.

Most community-based settings also offer confirmatory blood draws if the antibody test is reactive. The CDC recommends one-time testing for all Baby Boomers, individuals born from 1945 through 1965. While anyone can get HCV, people born during these years are five times more likely to have HCV than other adults. If you were born during these years, SFDPH encourages you to ask your doctor for a test.

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Treatment

HCV can be treated and cured! Almost everyone living with HCV can now be cured with a 1-3 tablets, once-a-day regimen in as little as eight-to-twelve weeks. These new medications are remarkably well-tolerated, and most people report very mild or no side effects. In order to access HCV treatment, it is necessary to see your doctor to discuss treatment options. Access to treatment continues to improve as new medication regimens are made available by private health insurers and public health programs like the VA Medical Centers, the AIDS Drug Assistance Program, Medicaid, and MediCal.

“We can’t treat Hep C
if we don’t know we have it.”

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