Hepatitis C is an inflammation of the liver caused by the hepatitis C virus (HCV). Many people who have hepatitis C don’t know they are infected because they usually don’t look or feel sick, though some do. While Hepatitis C is sometimes an acute (short-term) illness, most of the time it becomes a chronic illness that is serious and lifelong.
Over time, the virus damages the liver and, unless properly treated or cured, it can lead to life-threatening complications like cirrhosis (liver scarring) and liver cancer. Hepatitis C is the most common reason for liver transplantation in the United States.1
Hepatitis C is a liver infection that is symptomless 80% of the time. When it does present symptoms, they can mimic the flu. About 3.2 million people in the US have Hepatitis C and 3 out of 4 who are infected don’t even know they have it.
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Most people newly infected with hepatitis C do not have any symptoms. If they do, symptoms tend to appear between 2-12 weeks after infection and can be general and mild, making it hard to recognize without specific testing.
When signs and symptoms are present, early (acute) hepatitis C symptoms include:
Although some people notice hepatitis C symptoms within two weeks of exposure, it can take much longer for someone with the virus to develop symptoms, until after their liver has become really damaged.
For chronic hepatitis C, symptoms are rare. Most people with a chronic hepatitis C virus infection show no symptoms for years, even decades. Unfortunately, this means that the infection often goes unrecognized. Most people find out they have hepatitis C when they’re diagnosed with advanced liver disease.
When liver damage is severe, signs and symptoms can include:
Yes, a person with hepatitis C can transmit the hepatitis C virus to other people, even if they have no symptoms. Transmission can occur when infected blood enters the body (most commonly through sharing needles or syringes or through birth to a mother with hepatitis C, but sometimes through sexual contact or unregulated tattooing/piercing).
Sometimes hepatitis C infection can be short and mild, lasting a few weeks or months. But the majority of acute hepatitis C infections—about 75-80%—turn chronic. The liver inflammation and damage chronic hepatitis C can cause over years and decades may lead to serious problems that can eventually be fatal.
The hepatitis C virus gradually damages the liver, which causes hard scar tissue to replace healthy liver tissue in a process called fibrosis. Over time, continual damage can become permanent liver damage.
Eventually, liver damage can lead to cirrhosis, which is severe scarring of the liver. A liver with extensive scar tissue can’t function properly. Scarring blocks blood flow through the organ, impairing the liver’s ability to perform essential functions a person needs to survive—like filtering harmful substances in the blood and breaking down or converting certain substances.
10-20% of people infected with HCV develop cirrhosis over a period of 20-30 years. Left untreated, cirrhosis can worsen and lead to liver failure.
Liver failure is a life-threatening condition when the liver stops working. When it’s caused by long-term liver damage that has progressed over months or years, it’s called chronic liver failure or end-stage liver disease.
In the United States, cirrhosis caused by the hepatitis C virus is the most common reason for liver transplants. During a liver transplant, doctors surgically remove the diseased liver and replace it with a healthy liver from another person (a donor).
Having hepatitis C increases the risk of developing liver cancer. A small number of people with cirrhosis go on to develop liver cancer.
As a result of severe liver disease, a damaged liver isn’t able to filter toxins from the bloodstream. When toxins build up, they can reach the brain and lead to reduced brain function, or hepatic encephalopathy. Hepatic encephalopathy can cause confusion, forgetfulness, changes in mood, or lethargy. In its advanced stages, hepatic encephalopathy can progress to coma.
People living with HIV have a higher risk of contracting hepatitis C, if exposed. This is because HIV attacks the immune system and affects its ability to defend the body. Having HIV can cause viral hepatitis to progress faster.
According to the Centers for Disease Control and Prevention (CDC), in the United States, about 25% of people with HIV are coinfected with HCV.2 Because both viruses are spread by blood, injection drug is a risk factor for both HIV and hepatitis C.
A pregnant woman with hepatitis C can transmit the virus to her baby. The CDC estimates that approximately 6 in 100 babies born to mothers with hepatitis C will be infected by the hepatitis C virus. The risk is greater if the mother also has HIV.
If you’re concerned you’ve been exposed, are showing hepatitis C symptoms, or were born between 1945 and 1965, getting tested for hepatitis C can help you know if you have been infected. A quick blood test can detect the presence of hepatitis C antibodies in the blood, even before serious liver damage has occurred. Early detection, monitoring, and treatment can help you prevent potential liver damage. In fact, in recent years, hepatitis C treatment has drastically improved, making the infection easier to manage and, in most cases, curable.
Medically Reviewed by Kaci Durbin, MD, MBA, FACOG on August 12, 2022Written by Taysha on January 22, 2020