What causes hepatitis C?

Hepatitis C is a condition that causes inflammation of the liver. If left untreated, it can eventually lead to severe disorders like liver cirrhosis, liver failure, or liver cancer, significantly reducing lifespan. Worldwide, roughly 30% of people with hepatitis C will clear the virus naturally within six months of infection with no treatment. The remaining 70% develop chronic hepatitis, with up to 30% of them advancing to liver cirrhosis. It is critical to understand what causes hepatitis C, typical disease progression, diagnosis, and treatment, to evaluate how long after a hepatitis C diagnosis one generally will live. The impact on your lifespan is dependent on how your disease progresses and the effectiveness of timely treatment.
The cause of hepatitis C is the hepatitis C virus (HCV). HCV may cause acute and chronic infections. An acute HCV infection does not lead to a life-threatening disease and usually goes away after six months without any treatment. On the other hand, a chronic HCV infection can cause severe conditions, like liver cirrhosis, within 20 years after initial infection. HCV infection can mimic other causes of inflammation of the liver, such as excess consumption of alcohol, certain medications, and toxic substances.
What are the main symptoms of hepatitis C?
Hepatitis C does not show symptoms in most people until after two to three months of infection. The symptoms you are likely to get with acute hepatitis C include:
- Fatigue
- Fever
- Joint pain
- Loss of appetite
- Jaundice ( yellowing of skin and eyes)
- Nausea and vomiting
- Pale colored stool
- Abdominal pain
When you get infected with chronic hepatitis C, it may not show any symptoms until years later. Chronic Hepatitis C can lead to the development of liver conditions like cirrhosis and liver cancer. Liver disorders caused by hepatitis C can take decades to develop. They occur slowly without any symptoms and may not get recognized until a doctor screens you during a blood transfusion or routine blood test.
How do you get hepatitis C?
Hepatitis C spreads through contact with the body fluids of an infected person. You can get hepatitis C by the following methods:
- Sex with an infected person. Hepatitis C can spread through unprotected sexual contact with someone living with the condition. That includes males who have sex with other males.
- Birth. Children born to mothers with hepatitis C are at risk of being born with it.
- Tattoos and body piercing. You can get hepatitis C when getting a tattoo or body piercing with unsterilized equipment. Avoid getting tattoos in an unlicensed facility to avoid such occurrences.
- Sharing sharp objects. Sharing objects such as razor–blades, needles, or toothbrushes with a person with hepatitis C can cause infection.
- Blood transfusions or organ transplants. Although it's rare today, blood transfusion or transplant of an organ that has not been well screened can spread hepatitis C.
- Unsterilized injection equipment. Syringes, needles, and any other equipment used during the preparation and injection of drugs can spread hepatitis C.
Hugging, kissing, holding hands, breastfeeding, coughing, or sharing food, water, and utensils cannot spread hepatitis C.
Even after the successful treatment and cure of hepatitis C, you can still get re-infected. That is more likely to happen if you continue to share sharp objects with an infected person. Also, persons with kidney failure on maintenance hemodialysis are at a higher risk of infection and re-infection than the general population. If that is the case, consider getting tested regularly.
How is hepatitis C diagnosed?
New infections of hepatitis C are asymptomatic, meaning the person does not show any symptoms. Hence few people get diagnosed when the condition is in the early stage. Even people who develop chronic hepatitis C infection remain asymptomatic until liver damage occurs. Two types of laboratory tests are most common for diagnosing Hepatitis C:
- Serological tests. First, serological tests for anti-hepatitis C virus antibodies identify people who have had exposure to hepatitis C.
- Nucleic acid test (NAT) for HCV ribonucleic acid (RNA). NAT testing confirms the presence of the virus in those with a positive serological test. This test helps identify chronic infection since acute infections generally are cleared by the body's immune system without treatment. Some people can still test positive for anti–HCV antibodies from previous exposures, even if they are not currently infected.
When chronic infections are confirmed, a liver biopsy or a non–invasive test determines the extent of damage to the liver (liver cirrhosis). That will help to determine the best treatment and management.
Early diagnosis is vital for the successful treatment of hepatitis C. If you get tested and diagnosed in the early stages, you can get treatment and recover within eight to twelve weeks.

SLIDESHOW
What Is Viral Hepatitis? How You Catch Hepatitis A, B, and C See SlideshowWhat is the treatment for hepatitis C?
If recently infected with hepatitis C, you may not need treatment unless your infection turns chronic. That's because the immune response of some people can cure the condition naturally.
Your doctor may wait until the acute infection becomes a chronic illness before treating the disease. The WHO (World Health Organization) recommends that you start therapy with pan-genotypic direct-acting antiviral agents (DAAs). DAAs cure most hepatitis C infections for people above 12 years of age. This treatment takes about 12 weeks depending on whether cirrhosis is present.
Potential complications of hepatitis C
Without early diagnosis and treatment, hepatitis C may cause the development of the following conditions:
- Liver cirrhosis. At the beginning of the disease, your liver can function normally. Cirrhosis occurs when the liver cells break down, and scar tissue replaces healthy liver tissue. As liver cirrhosis worsens, the scar tissue blocks blood flow in the liver, and eventually, the liver fails.
- Liver cancer. When chronic hepatitis C causes cirrhosis or severe liver damage, you will be at risk of developing liver cancer (hepatocellular carcinoma), even after treatment. Liver ultrasound, blood tests, and imaging tests are tests your doctor may recommend to check for liver cancer. When found in the early stages, there are treatments. Your doctor may recommend a liver transplant if the liver is severely damaged.
- Liver failure. Liver failure is a progressive condition that happens over months or years until the liver fails due to a lack of functioning cells. It's also called end-stage liver disease.
Early diagnosis and treatment are vital for successful treatment and a longer lifespan. Lack of treatment will affect one's lifespan. Studies show that about 20% of people with chronic hepatitis C develop liver cirrhosis within 20 years, with roughly 20% of those developing hepatocellular carcinoma, both of which cause premature death.
When hepatitis C causes advanced liver issues, consider talking to a specialist about your condition. Your doctor may recommend treatment with medications or surgery, depending on the extent of the liver damage. A liver transplant can be an option when damage is extreme.
Impact on lifespan
A 2000-2011 study of the lifespan impact of chronic hepatitis C in New York City (NYC) found that people with hepatitis C died at an average age of 60 years, while those without hepatitis C infection lived to an average age of 78 years. Co-infection with human immunodeficiency virus (HIV) further reduced the average lifespan to 52 years.
While this study only evaluated people in NYC, these findings supported previous studies showing a high risk of premature death for people with hepatitis C. Also, the death rate of people living with hepatitis C was higher than that of the general population, with life expectancy reducing as their age increases.
With proper diagnosis, early intervention, and effective treatment, life expectancy for those living with hepatitis C increases. If you test positive for HCV, you must continue to follow up with your doctor to ensure your best outcome.
Centers for Disease Control and Prevention: "Hepatitis C Questions and Answers for the Public."
Clinical Infectious Diseases: "Deaths Among People With Hepatitis C in New York City, 2000–2011."
MedlinePlus: "Hepatitis C."
National Institute of Diabetes and Digestive and Kidney Disease: "Hepatitis C."
World Health Organization: "Hepatitis C."
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