Hepatitis C

In this section:

• What is hepatitis C?
• How common is hepatitis C?
• Who is more likely to get hepatitis C?
• Should I be screened for hepatitis C?
• What are the complications of hepatitis C?
• What are the symptoms of hepatitis C?
• What causes hepatitis C?
• How do doctors diagnose hepatitis C?
• How do doctors treat hepatitis C?
• How do doctors treat the complications of hepatitis C?
• How can I protect myself from hepatitis C infection?
• How can I prevent spreading hepatitis C to others?
• Is a hepatitis C vaccine available?
• What should I eat and drink if I have hepatitis C?
• Clinical Trials for Hepatitis C

What is hepatitis C?

Hepatitis C is a viral infection that causes liver inflammation and damage. Inflammation is swelling that occurs when tissues of the body become injured or infected. Inflammation can damage organs.

Viruses invade cells in your body. Many viruses cause infections that can spread from person to person. The hepatitis C virus spreads through contact with an infected person’s blood.

Although no vaccine is available, you can take steps to protect yourself from hepatitis C. If you have hepatitis C, talk with your doctor about treatment. Medicines can cure most cases of hepatitis C.

Hepatitis C can cause an acute or chronic infection.

Acute hepatitis C

Acute hepatitis C is an infection that only lasts a short time, and then the virus goes away. An infection may be diagnosed weeks or months after you encounter the hepatitis C virus.¹

Chronic hepatitis C

Chronic hepatitis C is a long-lasting infection. Chronic hepatitis C occurs when the hepatitis C virus stays in your body and doesn’t go away. More than half of the people with acute hepatitis C will develop chronic hepatitis C.¹

Early diagnosis and treatment of chronic hepatitis C can prevent liver damage. Without treatment, chronic hepatitis C can cause chronic liver disease, cirrhosis, liver failure, or liver cancer.

How common is hepatitis C?

Hepatitis C is less common in the United States than in some other parts of the world.

Hepatitis C worldwide

Hepatitis C infections are more common in some countries in Eastern Europe, Africa, the Middle East, and Asia. In countries where hepatitis C is most common, researchers estimate that between 2% and 6% of the population is infected.²

Hepatitis C in the United States

Researchers estimate that less than 1% of the United States population is infected with hepatitis C.²

The number of new acute hepatitis C infections declined in 2022. There were 4,848 new infections reported, with most occurring in people who inject drugs.³ However, many hepatitis C cases aren’t reported because people often have no symptoms.

In the United States, hepatitis C is the most common chronic viral infection found in blood and spread through contact with blood.⁴ New screening efforts and more effective hepatitis C treatments are helping health care professionals identify and cure more people with the disease. The number of people with chronic hepatitis C in the United States is decreasing because effective therapies are available. However, researchers estimate chronic hepatitis C still affects more than 2 million people.¹

Who is more likely to get hepatitis C?

Hepatitis C is more common in people who

• inject drugs or have injected drugs in the past
• are infected with HIV
• have been on kidney dialysis
• received donated blood, blood products, or an organ before 1992
• have hemophilia and received clotting factor before 1987
• have been in contact with blood or needles and syringes at work
• were born to a mother with hepatitis C
• were born in a country where hepatitis C is common

In the United States, injecting drugs is the most common way that people get hepatitis C.⁵

Should I be screened for hepatitis C?

Screening is testing for a disease in people who have no symptoms. Doctors use blood tests to screen for hepatitis C. Many people who have hepatitis C don’t have symptoms and don’t know they are infected. Screening tests can help doctors diagnose and treat hepatitis C before it causes serious health problems.

Doctors typically recommend hepatitis C screening for⁵

• all adults at least once in their life
• pregnant women during each pregnancy
• people who are at risk for hepatitis C infection
• anyone who asks to be screened for hepatitis C

Doctors typically recommend hepatitis C screenings at least once for all adults.

What are the complications of hepatitis C?

Hepatitis C may lead to serious complications. Early diagnosis and treatment can help prevent complications.

Acute hepatitis C complications

Acute hepatitis C typically doesn’t cause serious complications. However, more than half of people with acute hepatitis C will develop chronic hepatitis C.¹ Chronic hepatitis C can lead to serious complications if left untreated.

Chronic hepatitis C complications

Chronic hepatitis C can lead to

• cirrhosis, a condition in which scar tissue replaces healthy liver tissue and prevents your liver from working normally. Scar tissue also partially blocks the flow of blood through the liver. As cirrhosis gets worse, the liver begins to fail.
• liver failure, in which your liver is badly damaged and stops working properly. Liver failure is also called end-stage liver disease. People with liver failure may need a liver transplant.
• liver cancer. People with cirrhosis have a higher chance of developing liver cancer. Your doctor may suggest blood tests and an ultrasound or another type of imaging test to check for liver cancer. Finding cancer at an early stage improves the chance of curing the cancer.

What are the symptoms of hepatitis C?

Most people infected with hepatitis C have few or no symptoms. Some people with an acute hepatitis C infection may have symptoms 2 to 12 weeks after they encounter the virus.¹ These symptoms may include

• darker urine color and lighter stool color
• fatigue, or feeling tired
• fever
• pain in joints or abdomen
• loss of appetite, nausea, or vomiting
• yellowish eyes and skin, called jaundice

People with chronic hepatitis C likely will have few or no symptoms until complications such as cirrhosis develop, which could be decades after they were infected. For this reason, screening can help find hepatitis C infections in people without symptoms. Some symptoms of cirrhosis include

• fatigue, or feeling tired
• itchy skin
• weight loss
• confusion or difficulty thinking
• edema, or swelling of the ankles
• ascites, or swelling of the abdomen

What causes hepatitis C?

The hepatitis C virus causes hepatitis C. The hepatitis C virus spreads through contact with an infected person’s blood. Contact can occur by

• sharing needles or other materials used for injecting drugs with an infected person
• getting an accidental stick with a needle that was used on an infected person
• being tattooed or pierced with tools that were not kept sterile—free from all viruses and other microorganisms—and were used on an infected person
• having contact with the blood or open sores of an infected person
• using an infected person’s razor, toothbrush, or nail clippers
• being born to a mother with hepatitis C
• having unprotected sex with an infected person
• having dental or medical procedures with needles or other tools that aren’t properly cleaned in countries where hepatitis C is common

You can’t get hepatitis C from

• being coughed or sneezed on by an infected person
• drinking water or eating food
• hugging an infected person
• shaking hands or holding hands with an infected person
• sharing spoons, forks, and other eating utensils with an infected person
• sitting next to an infected person

A baby can’t get hepatitis C from breast milk.⁶ However, you should avoid breastfeeding if your nipples are cracked or bleeding.

How do doctors diagnose hepatitis C?

Doctors diagnose hepatitis C based on your medical history, a physical exam, and blood tests. If you have hepatitis C, your doctor may perform additional tests to check your liver.

Medical history

Your doctor will ask about your symptoms. They will also ask whether you have any history of blood transfusions, injection drug use, and other risk factors.

Physical exam

During a physical exam, your doctor will typically examine your body to check for signs of liver damage, such as

• changes in skin color
• swelling in your lower legs, feet, or ankles
• tenderness or swelling in your abdomen

Blood tests

Your doctor may order one or more blood tests to diagnose hepatitis C. A health care professional will take a blood sample from you and send the sample to a lab.

Certain types of blood tests for hepatitis C can show

• whether you had contact with the hepatitis C virus at some point
• whether you still have the hepatitis C virus
• how much of the virus is in your blood
• what form of hepatitis C you have

Your doctor may also order blood tests while you are getting treatment. Blood tests can show whether the treatment is changing the amount of virus in your blood.

Your doctor may order one or more blood tests to diagnose hepatitis C.

Additional tests

If you have chronic hepatitis C, you could have liver damage. Before starting treatment, doctors will test for liver damage and other infections, such as HIV and hepatitis B. Your doctor may recommend ongoing testing to check for signs of complications.

Tests may include

• blood tests.
• elastography, a special test that measures the stiffness of the liver. An increase in liver stiffness may be a sign of fibrosis, or scarring.
• ultrasound or other imaging test to check for cirrhosis.
• liver biopsy, in which a doctor uses a needle to take a small piece of tissue from the liver.

Doctors typically use a liver biopsy only if other tests don’t provide enough information about liver damage or disease. Talk with your doctor about which tests are right for you.

How do doctors treat hepatitis C?

Doctors treat hepatitis C with antiviral medicines that attack the virus.

If the hepatitis C virus doesn’t go away on its own within 6 months, you will likely need treatment. Doctors treat hepatitis C with antiviral medicines that attack the virus.

Antiviral medicines can cure more than 95% of people with chronic hepatitis C in 8 to 12 weeks.⁷ However, some people may need to take antiviral medicines for longer.

Hepatitis C medicines are usually well tolerated, but they may cause side effects in some people. Talk with your doctor about the possible side effects of hepatitis C treatment.

Check with your doctor before taking any other prescription or over-the-counter medicines. For safety reasons, talk with your doctor before using dietary supplements, such as vitamins, or any complementary or alternative medicines or medical practices. Some of these could lead to liver damage and may interact with hepatitis C medicines.

Cost of hepatitis C medicines

Medicines for hepatitis C can be costly. Most government and private health insurance prescription drug plans provide some coverage for these medicines. Talk with your doctor about your health insurance coverage for hepatitis C medicines.

Drug companies, nonprofit organizations, and some states offer programs that can help pay for hepatitis C medicines. If you need help paying for medicines, talk with your doctor. Learn more about financial help for hepatitis C medicines.

How do doctors treat the complications of hepatitis C?

If hepatitis C leads to cirrhosis, see a doctor who has experience treating people with liver diseases. Doctors can treat the health problems related to cirrhosis with medicines. You may also need minor medical procedures or surgery. If you have cirrhosis, you have a higher chance of developing liver cancer. Your doctor may order blood tests and an ultrasound or another type of imaging test to check for liver cancer.

If hepatitis C leads to liver failure or liver cancer, you may need a liver transplant.

How can I protect myself from hepatitis C infection?

If you don’t have hepatitis C, you can help protect yourself from hepatitis C infection by

• not sharing needles or other materials used to inject drugs
• wearing gloves if you must touch another person’s blood or open sores
• making sure your tattoo artist or body piercer uses sterile tools and unopened ink
• not sharing personal items such toothbrushes, razors, or nail clippers

Hepatitis C can spread from person to person during sex, but the chances are low. Some people have a higher risk of getting hepatitis C during sex. Higher risk groups include men who have sex with men and people who have multiple sex partners, have HIV or other sexually transmitted diseases, or engage in rough sex. Talk with your doctor about your risk of getting hepatitis C through sex and about safe sex practices. For example, using a latex or polyurethane condom may help prevent the spread of hepatitis C.

Don’t share drug needles or other drug materials.

If you had hepatitis C in the past, you can get hepatitis C again. Follow the steps above and talk with your doctor about how to protect yourself from another hepatitis C infection.

If you think you may have been exposed to the hepatitis C virus, see your doctor as soon as possible. Early diagnosis and treatment can help prevent liver damage.

How can I prevent spreading hepatitis C to others?

If you have hepatitis C, follow the steps above to avoid spreading the infection. Tell your sex partner you have hepatitis C and talk with your doctor about safe sex practices.

You can also protect others from infection by telling your doctor, dentist, and other health care professionals that you have hepatitis C. Don’t donate blood or blood products, semen, or tissue.

Is a hepatitis C vaccine available?

Researchers are still working on a vaccine for hepatitis C. If you have hepatitis C, talk with your doctor about vaccines for infections that could further damage your liver, such as hepatitis A and hepatitis B.

What should I eat and drink if I have hepatitis C?

If you have hepatitis C, choose healthy foods and drinks. Talk with your doctor about healthy eating. You should also avoid alcohol because it can cause more liver damage.

Clinical Trials for Hepatitis C

NIDDK conducts and supports clinical trials in many diseases and conditions, including liver diseases. The trials look to find new ways to prevent, detect, or treat disease and improve quality of life.

What are clinical trials for hepatitis C?

Clinical trials—and other types of clinical studies—are part of medical research and involve people like you. When you volunteer to take part in a clinical study, you help doctors and researchers learn more about disease and improve health care for people in the future.

Researchers are studying many aspects of hepatitis C, such as

• the progression and outcomes of hepatitis C
• better hepatitis C prevention and treatment for people who inject drugs
• treatment for hepatitis C during pregnancy

Find out if clinical studies are right for you.

Watch a video of NIDDK Director Dr. Griffin P. Rodgers explaining the importance of participating in clinical trials.

What clinical studies for hepatitis C are looking for participants?

You can view a filtered list of clinical studies on hepatitis C that are federally funded, open, and recruiting at ClinicalTrials.gov. You can expand or narrow the list to include clinical studies from industry, universities, and individuals; however, NIH does not review these studies and cannot ensure they are safe for you. Always talk with your health care provider before you participate in a clinical study.

How is NIDDK- and NIH-funded research advancing the understanding of hepatitis C?

NIDDK and NIH have conducted and supported many research projects to learn more about hepatitis C, including

• the molecular structure of the hepatitis C virus
• interferon alpha, the first treatment for chronic hepatitis C
• the hepatitis C virus that was grown in a lab, which helped to develop new hepatitis C treatments

References