GI Conditions
      Back to home
      1. VCT Resource Library
      2. GI Conditions

      Hepatitis C

      Brief Overview: According to NIDDK, “Hepatitis C is a viral infection that causes liver inflammation and damage. The hepatitis C virus spreads through contact with an infected person’s blood. Hepatitis C can cause an acute or chronic infection. 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. 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.”

      Prevalence: The prevalence of Hepatitis C is estimated to be ~3% worldwide.

      Etiology: Hepatitis C is caused by the Hepatitis C virus. Hepatitis C is transmitted through contact with infected blood. Common routes of infection include sharing needles or syringes, receiving blood transfusions before 1992, or other healthcare exposures. Rarely, it may be spread through sexual contact or from mother to child.

      Risk Factors:

      • Acute Hepatitis C infection
      • Hepatitis B
      • Injection drug use – sharing needles, syringes, other drug paraphernalia
      • Infected needles for tattooing, piercings, acupuncture
      • Sharing straws for intranasal drug use
      • Unprotected sex with an infected person
      • Sharing toothbrushes, razors, etc. that could have contaminated blood on them
      • Getting stuck with a sharp object that has contaminated blood on it (this might happen in a healthcare setting or first-responder setting)
      • Blood transfusion in the US prior to 1992
      • Born to a mother with Hepatitis C
      • HIV
      • Kidney dialysis
      • Being born between 1945-1965 (Baby Boomers)

      Commonly Associated Conditions:

      • Hematologic diseases
      • Renal disease
      • Autoimmune disorders – thyroiditis
      • Dermatologic conditions – porphyria cutanea tarda, lichen planus
      • Diabetes

      Common Medications:

      • Antiviral therapy – choice of antiviral will be tailored to your specific circumstances

      Common Labs, Imaging, and Tests:

      • Labs: Hepatitis C antibody test, Hepatitis C RNA, CMP HIV testing, Hepatitis B virus infection testing, pregnancy testing, Hepatitis C genotype test
      • Transient elastography – to measure scarring in the liver
      • Liver ultrasound, liver biopsy

      Common Symptoms:

      • Typically, asymptomatic
      • Fatigue
      • Sleep disturbance
      • Nausea, diarrhea, abdominal pain, loss of appetite
      • Weight loss
      • Myalgia, arthralgia
      • Dark urine

      Common Treatments:

      • Antiviral therapy
      • Substance use treatment, if indicated
      • Counseling, treatment for depression, if indicated
      • Treatment of any associated conditions

      Physical Findings:

      • Typically, normal physical exam
      • Hepatomegaly may be present

      Potential Complications and Contraindications:

      • Cirrhosis
      • Hepatocellular carcinoma
      • May lead to need for liver transplant
      • Drug-drug interactions
      • Re-infection is possible
      • Avoid hepatotoxic medications

      General Health and Lifestyle Guidance:

      • Avoid alcohol
      • Smoking cessation
      • Avoid recreational drug use
      • Avoid hepatotoxic medications, supplements. Talk to your healthcare provider first before taking any OTC medications, supplements, vitamins, or herbal remedies.
      • Stay up to date on all age-appropriate vaccinations (Hep A vaccine, Hep B vaccine, flu vaccine, pneumonia vaccine, Tdap, etc.). Ask your healthcare provider what vaccines are recommended for you.
      • Make sure to take all prescribed medications exactly as directed by your healthcare provider.
      • If you have Hepatitis C, practice safe sex practices. Make sure to tell your dentist, and all healthcare providers that you have Hepatitis C. Do not share needles, syringes, toothbrushes, razors, etc. with anyone. Do not donate blood semen, or tissue.
      • Work with your healthcare provider to manage any associated conditions
      • Work with your healthcare provider/dietician to determine if any dietary modifications are recommended

      Suggested Questions to Ask Patients:

      • Have you ever been tested or treated for hepatitis C?
      • Do you know how you may have been exposed?
      • Have you had any previous liver imaging or testing?
      • Are you taking any supplements, over-the-counter medications, or other prescriptions?

      Suggested Talking Points:

      • According to UpToDate, “Hepatitis C is the only chronic viral infection in humans that can be cured in this way, without any trace of the virus in the blood, liver, or elsewhere in the body. However, being cured of hepatitis C does not make a person immune to the virus. A person who has been treated and cured of hepatitis C can be reinfected after a repeat exposure to the virus.”
      • Make sure to report any new, worsening, or persistent symptoms, and any medication side effects, to your healthcare provider

      Sources: