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Common Signs and Symptoms of Hepatitis C

What are the symptoms of Hep C?

A Hep C infection progresses through three stages: normal Hep C, acute Hep C and chronic Hep C. The symptoms of each stage are cumulative, so any symptoms of normal Hep C will likely also be found in acute Hep C as well. Chronic Hep C can include a latent or dormant stage where no symptoms present. This dormant period is usually followed by sudden onset liver inflammation and scarring.

Normal Hep C is the first stage and often includes:

  • Fatigue
  • Muscle aches
  • Tenderness in the abdomen
  • Light-colored bowel movements
  • Dark urine
  • Yellowish tinge in the eyes and skin

20-30% of acute Hep C infections will show symptoms. These can include all of the symptoms listed above with the addition of:

  • Nausea
  • Low-grade fever
  • Chills
  • Appetite loss
  • Mood swings
  • Itching
  • Fluid accumulation in the feet
  • Vomiting blood

The final stage of Hep C is chronic Hep C. This phase occurs in 75-85% of Hep C carriers and can include all of the symptoms of acute Hep C or no symptoms at all for several years. After this asymptomatic period, Hep C symptoms reappear suddenly with liver inflammation and scarring.

What is Hep C?

Hepatitis C Virus (HCV) is a blood-borne infection that causes inflammation of the liver. Acute Hep C infections were reported at 1 case per 100,000 population for 2016, although the actual infection rate is estimated to be almost 14 cases per 100,000 population. The CDC estimates 2.4 million current Hep C infections in the United States. There are seven different genotypes of HCV infection, all requiring different treatment regimens. Type 1 HCV is responsible for roughly 70% of cases in the US. Read more here.

Who is at high risk of a Hep C infection?

Any person who has used injection drugs, now or in the past, is at high risk for HCV. Persons with HIV infection and children of women with HCV are also at high risk.

How is Hep C transmitted?

HCV is transmitted through contact with the blood of an infected person. The most common sources of HCV transmission are:

  • Shared injection drug needles
  • Accidental injuries with infected needles (most common in medical professionals)
  • Birth (if the mother carries Hep C)

It is possible but less likely to contract HCV through unprotected sexual intercourse with an infected partner or shared use of razor blades and toothbrushes. Tattoos and piercings from needles that have not been sterilized properly can transmit the virus if they have been used on an infected person.

How long does it take for Hep C symptoms to appear?

On average, HCV symptoms appear 2-12 weeks after exposure, but it can take up to 26 weeks.

What are the long-term consequences of an untreated Hep C infection?

The Hep C virus damages the liver of an infected person, resulting in serious liver inflammation and scarring. Depending on how long the infection goes untreated, it can cause liver cirrhosis, liver cancer and eventually death.

What impact does Hep C have on pregnancy and expectant mothers?

There is a 4-7% chance of transmission from HCV-positive mother to child during childbirth. Women who have been exposed or are at high risk of HCV should be tested and treated during pregnancy. There are no prophylactic measures that can be taken to prevent transmission during birth. If a child is suspected of being infected they should be tested after 18 months (the mother’s anti-HCV may prevent accurate results before this time).

HCV is transmitted through blood only, so infected mothers are able to breastfeed if they choose. These women should use caution if they have dry or cracked nipples that could expose the infant to contaminated blood. Read more about STDs and pregnancy here.

How can I prevent a Hep C infection?

The best way to prevent Hep C infections is avoiding activities that pose a high risk. Avoiding injection drug use will significantly lower your chances of contracting HCV. Using condoms for protection during intercourse with an infected partner will also lower the risk.

Who should test for Hep C?

Anyone who has used injection drugs should test for HCV. In addition, persons exposed to HCV (medical professionals following needlestick injuries, blood recipients from HCV positive donors, etc.) and anyone born to an HCV positive mother should be tested.

How is a Hep C test administered?

An HCV test is taken using a finger prick to collect a blood sample. Samples can be tested either for the HCV antibody (will come back positive 4-10 weeks after infection) or for HCV RNA (will come back positive 2-3 weeks after infection. myLAB Box test kit looks for the HCV antibody. This test will detect antibodies in 97% of HCV-positive persons 6 months after exposure.

Can a Hep C infection resolve on its own?

Roughly 15-25% of HCV infections are resolved by the body without treatment. This happens most frequently in young women with a type 1 HCV infection. However, the Hep C virus reproduces and changes in response to the body’s immune reaction, often resulting in chronic infection.

How is acute Hep C treated?

The first step following a positive HCV test result is to visit a doctor to test for liver disease and determine the best method for treatment. In most cases, persons with acute Hep C are not treated unless the virus is still present after 6 months.

How is chronic Hep C treated?

Treatment for a chronic HCV infection varies by the genotype and severity of infection, but all genotypes can be cured. Typically, treatment involves an 8-12 week course of oral medication and is successful in 90% of patients. Treatment is considered successful when the virus can no longer be detected 12 weeks after the conclusion of treatment.

Is a Hep C reinfection possible?

It is possible to be reinfected with the same or a different strain of HCV following initial infection and treatment. Rapid changes in the virus make most immune responses ineffective, leaving people vulnerable to reinfection.

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