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Hepatitis C FAQs

Reviewed by Jay W. Marks, MD

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Q:What kind of disease is caused by hepatitis C?

A:Liver disease.

Hepatitis viruses target the liver, and the most common of these viruses are the hepatitis A, B, C and E viruses. This is not to say that the hepatitis viruses don't infect tissues other than the liver, but the tissue that is most seriously affected by infection is the liver.

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Q:The term "hepatitis" refers to inflammation of what?

A:The liver.

When the hepatitis viruses infect the liver, they cause inflammation. They cause cells of the immune system to harm the liver, where the cells release chemicals that attract other cells of the immune system and injure—and even kill—the liver cells.

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Q:Is hepatitis C contagious?

A:Yes.

All viruses that infect people are contagious, that is, they can be transmitted to other people. What varies is the route by which the infection spreads and how easily the virus can be transmitted, i.e., how contagious it is. In the case of hepatitis C, the virus is spread primarily through infected blood from person to person.

Personal items such as razors, nail clippers, and toothbrushes that can harbor small amounts of blood also can transmit hepatitis C; however, these methods of spread are unusual.

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Q:Who has the highest rates of hepatitis C infection?

A:People who share needles to inject street drugs have the highest rates of hepatitis C infection.

Hepatitis C may be spread through any activity in which blood is transferred from one person to another. Infection is more likely with transmission of larger amounts of blood or repeated transmission of smaller amounts of blood.

In the past, blood transfusion was the most common way of transmitting hepatitis C; however, blood for transfusion now is screened for the hepatitis C virus before it is transfused, and transfusion-related transmission of hepatitis C is rare.

The most common means of transmission of hepatitis C now is via needles that are shared by people injecting illicit drugs. The frequent sharing of needles (with their small amounts of blood) and the large reservoir of hepatitis C virus among injection drug abusers, allows for frequent transmission of the virus.

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Q:In most people, what are symptoms of hepatitis C when initially infected?

A:Most people do not experience symptoms.

More than 80% of people who become infected with the hepatitis C virus do not have recognizable symptoms or the symptoms are so mild and vague that they don't realize they are infected. A small percentage of people will have more rapidly progressive disease that 4-12 weeks later can cause jaundice (yellowing of the skin and eyes), abdominal pain (due to an enlarged liver), nausea, loss of appetite, and fatigue. Despite a lack of symptoms, the infection usually becomes chronic with progressive destruction and scarring of the liver, and symptoms do not arise until decades later after the long-term complications of chronic hepatitis C infection have set in, i.e., cirrhosis or liver cancer.

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Q:What is cirrhosis?

A:Cirrhosis is the extensive scarring of the liver that occurs when there is chronic inflammation in the liver.

Cirrhosis can occur no matter what the cause of the inflammation; however, chronic hepatitis, including hepatitis C, and alcoholism are the two leading causes of cirrhosis, but fatty liver which is associated with obesity, insulin resistance, and diabetes as well as hepatitis B, also are causes of cirrhosis. Patients with hepatitis C should not drink alcohol because the alcohol appears to accelerate the development of cirrhosis.

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Q:Are there diseases that accelerate the progression of hepatitis?

A:Co-infection with the HIV virus appears to accelerate the liver disease of hepatitis C and leads to earlier development of cirrhosis.

In addition, medications used to treat hepatitis C are less effective in patients with HIV infection or AIDS.

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Q:What is true about chronic hepatitis C?

A:Chronic hepatitis C is never cleared from the body, can lead to liver cancer and is a long-term illness.

Hepatitis C becomes a chronic illness in 80% of infected persons. Chronic infection frequently - though not inevitably - leads to cirrhosis and its complications -- liver failure, liver cancer, and gastrointestinal bleeding.

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Q:There is a vaccination against hepatitis C. True or False?

A:False.

There is no vaccine against hepatitis C. Vaccines are available for hepatitis B and A, and it is recommended that persons with chronic hepatitis C infection be vaccinated against these two other hepatitis viruses since infection with either virus could severely compromise an already damaged liver.

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Q:How many Americans are living with chronic hepatitis C?

A:About 3 million people in the US are infected chronically with hepatitis C, although most of them do not know it.

There are about 17,000 new infections each year; however, the rates of infection were highest in the 1970s and 1980s.

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Q:Annually, hepatitis C kills more people than HIV. True or False?

A:True. Hepatitis C kills more people than HIV/AIDS.

Because most of the people who die never know until late in their disease that they are infected with the hepatitis C virus, it is important to identify infection as early as possible before symptoms or complications of liver disease develop. Treatment can prevent the development of cirrhosis, its complications, and death.

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