15664 Hepatitis C

Overview

Hepatitis C is a viral infection that causes inflammation of the liver. Over time, it can lead to liver damage, but modern treatments can cure most people. Many people do not know they have it because symptoms may not appear for years.

Hepatitis C affects millions of people around the world. In the UK, it is less common than it used to be, but still around 100,000 people are living with it.

Anyone can get hepatitis C, but it is more common in people who inject drugs, people who had blood transfusions before 1992, and people born to a mother with hepatitis C. It affects both men and women of all ages.

Symptoms

Common symptoms

• No symptoms at all (in most people)
• Feeling very tired
• Mild fever or flu-like symptoms
• Poor appetite and weight loss
• Nausea or upset stomach
• Muscle and joint aches
• Yellowing of the skin or eyes (jaundice)
• Dark urine or pale stools

Symptoms in children

• Most children have no symptoms
• If symptoms appear, they are similar to adults, such as tiredness or jaundice
• Growth or development is usually normal

Symptoms in older adults

• Tiredness and weakness are more common
• Confusion or difficulty concentrating can happen if the liver is damaged
• Swelling in the legs or abdomen may occur with advanced liver disease

Causes

Main causes

• The hepatitis C virus is spread through blood-to-blood contact
• Sharing needles, syringes, or other drug equipment
• Unsterile tattoos, piercings, or medical procedures
• Blood transfusions or organ transplants before 1992 (before screening was routine)
• Mother-to-baby transmission during childbirth
• Rarely, through sexual contact with someone who has hepatitis C

Risk factors

• Injecting drugs or sharing drug equipment
• Receiving blood products before 1992
• Long-term kidney dialysis
• Having HIV infection
• Working with needles or blood (healthcare workers)
• Being born to a mother with hepatitis C

When to see a doctor

See a doctor urgently if:

• If you have symptoms like jaundice (yellowing of the skin or eyes) or dark urine
• If you think you have been exposed to hepatitis C, even without symptoms

Book a routine appointment if:

• If you have had any risk factor, such as sharing needles or a blood transfusion before 1992
• If you are pregnant, ask your maternity team about hepatitis C testing
• If you have a partner with hepatitis C

Diagnosis

A blood test is used to check for antibodies to the hepatitis C virus. If the antibody test is positive, a second blood test checks for the actual virus to confirm an active infection.

Tests that may be done

• Hepatitis C antibody blood test
• PCR test to detect the virus's genetic material
• Liver function blood tests
• Liver stiffness scan (FibroScan) or ultrasound to check for liver damage

What to expect at your appointment

Your GP or specialist will explain the results and what they mean. If you have hepatitis C, they will refer you to a specialist service for treatment. You may also get advice on protecting your liver and preventing passing on the virus.

Treatment

Hepatitis C is now highly curable. Treatment usually involves a course of oral antiviral tablets taken once or twice a day for 8 to 12 weeks. Cure rates are very high, and most people complete treatment with few side effects.

Self-care at home

• Avoid alcohol completely, as it can worsen liver damage
• Do not share razors, toothbrushes, or nail clippers with others
• Keep all medical and dental appointments
• Tell your healthcare providers about your hepatitis C status
• Cover any cuts or sores with a waterproof dressing

Medical treatments

Doctors use direct-acting antiviral medications that target the virus and stop it from multiplying. The exact combination and length of treatment depend on the type of hepatitis C, your liver health, and any other conditions. Always take treatment exactly as prescribed and finish the full course, even if you feel fine.

When is surgery considered?

Surgery is not a treatment for hepatitis C itself. However, if the infection has caused severe liver cirrhosis or liver failure, a liver transplant may be considered. Transplant surgery is a complex option for advanced cases, and you would be assessed by a specialist team.

Living with this condition

While living with hepatitis C, it is important to attend regular check-ups and take any prescribed treatment fully. You can reduce the risk of passing the virus to others by not sharing needles or personal items that may have blood on them.

Lifestyle tips

• Stop alcohol, as it speeds up liver damage
• Do not smoke (smoking worsens liver disease)
• Avoid recreational drugs, and if you inject, never share equipment
• Get enough rest and manage stress
• Talk to your doctor before taking any herbal remedies or supplements, as some can harm the liver

Diet and exercise

Eat a balanced diet rich in fruits, vegetables, whole grains, and lean proteins. Limit fatty foods and sugary drinks. Aim for regular physical activity, such as walking, swimming, or cycling, to help keep your liver healthy and maintain a healthy weight.

Mental health and emotional wellbeing

A hepatitis C diagnosis can cause anxiety, fear, or sadness. You may also worry about telling others or being judged. These feelings are normal. Talk to your healthcare team about counselling or support groups. Your mental health is just as important as your physical health.

Prevention

Yes, hepatitis C is preventable. The most important steps are to avoid sharing needles or drug equipment, ensure any tattoos or piercings use sterile needles, practice safe sex (especially with new partners), and avoid sharing personal items that may have blood on them.

Vaccines

There is currently no vaccine for hepatitis C. However, your doctor may recommend vaccines for hepatitis A and hepatitis B to protect your liver from additional infections.

Screening programmes

Screening is recommended for people in high-risk groups, pregnant women in some areas, blood donors, and anyone with a possible exposure. Ask your doctor if you are unsure whether you should be tested.

Complications

If left untreated

• Chronic (long-lasting) hepatitis C infection
• Liver fibrosis (scarring of the liver)
• Cirrhosis (severe, irreversible liver damage)
• Liver failure
• Liver cancer

Long-term outlook

The outlook for hepatitis C is very good. With modern treatment, nearly everyone can be cured, and the liver often recovers if damage is not too advanced. Even people with some liver damage can live long, healthy lives with support and proper care. It is never too late to seek help.

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