Diagnosing Hepatitis C

Learn more about recognizing symptoms, testing and diagnosis, risk and prevention.

What Causes Hepatitis C?

Because HCV infection usually produces no symptoms or very mild symptoms during the early stages, many people don’t know they have it until liver damage shows up – sometimes decades later – during routine medical tests. Some people who get HCV have it for a short time (up to six months) and then get better on their own. This is called acute Hepatitis C. But most people (about 75% – 85%) will go on to develop chronic (or long-term) Hepatitis C, meaning it doesn’t go away.

Whereas Hepatitis A generally gives rise to acute hepatitis, Hepatitis C results in chronic hepatitis in most patients. An easy reminder is C for chronic in Hepatitis C and A for acute in Hepatitis A.

Understanding Your Liver

In order to understand your Hepatitis C infection, it helps to have a basic understanding of how your liver works.  You only have one liver and it’s one of the largest and most important organs in your body.  Your liver is located behind the lower right part of your ribs, which help protect it. Your liver does the following important jobs to keep you healthy:

  • It acts like a filter to clean your blood by breaking down things such as alcohol, drugs (prescription, over-the counter and street drugs) and other harmful chemicals, and removes wastes.
  • It stores nutrients that you need – such as vitamins, fat and sugar from food – as well as other chemicals, and releases them into your bloodstream when your body needs them.
  • It produces some very important chemicals, like the ones needed to make your blood clot and heal after an injury, as well as a greenish fluid called bile that helps with the digestion of fats.

So what does all this have to do with Hepatitis C?  Hepatitis means inflammation, or swelling, of the liver.  When the liver is inflamed, it has a harder time doing its job.  Hepatitis C is just one thing that can cause inflammation of the liver.  Other things that can cause this include alcohol, some medications, and certain diseases.

Complications of Chronic Hepatitis C

Unless successfully treated with medication, chronic Hepatitis C infection can cause other serious health problems, such as cirrhosis, liver cancer and liver failure. However, with recent advances in Hepatitis C treatment we now have higher cure rates, shorter treatment times, and all-oral treatment regimens for most people.  If you’re at risk for Hepatitis C, speak to your healthcare provider today about getting tested.


Fibrosis is the first stage of liver scarring.  When scar tissue builds up and takes over most of the liver, this is a more serious problem called cirrhosis.  Many people assume cirrhosis means liver disease from alcohol, but anything that damages your liver over many years can cause it to form scar tissue.  As hard scar tissue replaces soft, healthy normal tissue the liver can no longer work well or work at all.  It can take a long time – about 20 to 30 years – for liver damage to lead to cirrhosis.
In the early years, people with cirrhosis often have no symptoms.  But over time, they can experience the following:

  • tiredness
  • weight loss
  • nausea
  • abdominal pain
  • severe itching
  • jaundice (yellow discoloration of the skin and eyes)

Eventually, people can have complications such as fluid in the abdomen and difficulty thinking clearly.  We used to hear that cirrhosis could not be reversed, but research in a number of liver diseases – including Hepatitis C – found that scarring of the liver can be improved with treatment of the disease that initially led to the damage.

Liver Cancer

Like all organs in your body, your liver can get cancer. When this happens, some of the cells in your liver reproduce faster than they should, leading to tumors and other problems.  People with Hepatitis C are at risk for liver cancer once they get to the level of cirrhosis.  As such, it’s important for you to have some type of test to determine if you have cirrhosis.  Remember that people with cirrhosis can feel fine and have no symptoms in the early stage.

Liver Failure

When someone has advanced liver disease and their liver is severely damaged it may no longer be able to function. The person may have yellow skin and eyes (jaundice), have fluid in their legs or abdomen (ascites), have bleeding from their stomach or esophagus (varices), or be confused (hepatic encephalopathy).  At this point, a liver transplant may be considered.

Without treatment, chronic Hepatitis C can be very serious.  But recent advances have made treatment shorter in duration, less difficult to tolerate and more effective.  It’s an exciting and hopeful time for people with Hepatitis C as treatment is rapidly changing for the better.

Who is at risk?

Your risk of infection with HCV is increased if you:

  • Shared needles to inject drugs or straws to inhale them
  • Had tattoos or body piercings in an unclean environment using unsterile equipment
  • Worked in a place where you came in contact with infected blood or needles, for example, healthcare workers
  • Received a blood transfusion or organ transplant before July 1992
  • Received a blood product for clotting problems made before 1987
  • Needed to have your blood filtered by a machine (hemodialysis) for a long period of time because your kidneys weren’t working
  • Were born to a mother with HCV
  • Had unprotected sex with multiple partners
  • Have or had a sexually transmitted disease
  • Have HIV

Who should get tested for Hepatitis C?

Talk to your doctor about getting tested for Hepatitis C if you:

  • Are a current or former drug user who used needles to inject, even if you only did this one time or did it many years ago
  • Have a sex partner who has chronic Hepatitis C or have had many sex partners
  • Had your blood filtered by a machine (hemodialysis) for a long period of time because your kidneys weren’t working
  • Received a blood transfusion or organ transplant from a donor before July 1992
  • Received a blood clotting factor to treat a bleeding disorder (like hemophilia) before 1987
  • Are a healthcare worker and were exposed to blood through a needle stick or had other contact with blood or bodily fluids
  • Have HIV
  • Have evidence of liver disease, such as abnormal liver tests
  • Were born between 1945 and 1965.  The Centers for Disease Control and Prevention (CDC) recommends a one-time screening for all baby boomers.

Learn more, use the Centers for Disease Control’s Hepatitis Risk Assessment tool.

What the CDC Recommends

Were you born between 1945 and 1965? If so, then you’re a member of the Hepatitis C generation. The CDC (Center for Disease Control) recently recommended that all people born between during this time have a 1-time screening test for Hepatitis C. We now have new drugs that can treat and cure Hepatitis C so you should go get tested today.

Read the CDC Hepatitis C Fact Sheet

The life you save may be your own! Please contact your local healthcare provider.

Signs & symptoms

Most people (about 70% – 80%) with an acute Hepatitis C infection do not experience any symptoms or show signs of the infection.  If Hepatitis C symptoms do occur, they usually appear within two weeks to six months after being exposed to the Hepatitis C virus (HCV). If you do develop symptoms related to Hepatitis C, they’re generally mild and flu-like and may include:

  • Feeling very tired
  • Sore muscles
  • Joint pain
  • Fever
  • Nausea or poor appetite
  • Stomach pain
  • Itchy skin
  • Dark urine
  • A yellow discoloration of the skin and whites of the eyes, called jaundice.

Since most people with acute Hepatitis C go on to develop chronic Hepatitis C – meaning the virus has remained in your body for 6 months or longer – and still have no Hep C symptoms, it’s common to have the infection for 15 years or longer before being diagnosed.

Watch HCV – The Silent Killer (video)

How is Hepatitis C transmitted or spread?

Hepatitis C is transmitted or spread when the blood from a Hepatitis C-infected person enters the bloodstream of someone who is not infected. Today, most people become infected with HCV by sharing needles or other equipment to inject drugs. Before 1992, when screening donated blood and organs for Hepatitis C was not standard in the United States, the disease was commonly spread through blood transfusions and organ transplants.

Hepatitis C can be transmitted through sex between a man and a woman, but the risk is low. Therefore, condoms are not routinely recommended for monogamous, heterosexual couples. The risk of Hepatitis C transmission is higher with unprotected anal sex between two men; using condoms will decrease this risk. All people with multiple sex partners should use condoms to reduce the risk of getting Hepatitis C and/or HIV.

Hepatitis C may be spread if there is a breakdown in the skin or lining of the mouth.  Therefore, sharing of toothbrushes, razor blades and nail clippers is not recommended.

Is Hepatitis C contagious?

Hepatitis C transmission happens only through exposure to an infected person’s blood. It is not contagious like the common cold. You cannot get, or give, Hepatitis C by:

  • Kissing
  • Hugging
  • Holding hands
  • Casual contact
  • Sneezing
  • Coughing
  • Sharing eating utensils
  • Sharing food or drink
  • Breastfeeding (unless nipples are cracked and bleeding)

How Can I Prevent Getting Hepatitis C?

There is no vaccine to prevent Hepatitis C, but there is research being done to develop one.  Currently, vaccines are only available for Hepatitis A and Hepatitis B.

Remember that Hepatitis C is transmitted or spread when the blood from a Hepatitis C-infected person enters the bloodstream of someone who is not infected.  If you don’t have Hepatitis C, you can reduce your risk of becoming infected by doing the following:

  • If you’re injecting drugs, try to get into a treatment program.  If you continue to use drugs, don’t share needles or other equipment with anyone else.  Many cities have needle exchange programs that provide free, sterile needles.
  • Make sure all equipment has been sterilized if you’re getting body piercings or a tattoo.
  • If you’re a healthcare worker follow your institution’s safety precautions.  For example, wear protective clothing and gloves and dispose of contaminated sharp objects properly.
  • If you have more than one sex partner or are a man having sex with other men, use condoms for intercourse.

Watch The Stigma of HCV (video)

What About Sex and Hepatitis C?

Hepatitis C can be spread through sexual intercourse, but the risk is considered to be low.  It is extremely rare among monogamous couples, meaning couples who only have sex with one another.  The risk increases if you:

  • Have multiple sex partners
  • Engage in rough sex
  • Have a sexually transmitted disease
  • Are infected with HIV

There is no evidence that Hepatitis C is spread by oral sex.

To reduce the chance of getting or giving Hepatitis C through sexual contact, follow these guidelines:

  • Decrease the number of people you have sex with or have sex with only one person.
  • Use latex condoms every time you have sex, particularly if you have:
  • More than one partner
  • Rough sex that might make one of you bleed
  • Sex during your or your partner’s menstrual period
  • Sex when you or your partner has an open sore on either of your genitals

What Happens if Someone has Hepatitis C and HIV?

When someone has both Hepatitis C and HIV, it is often referred to as HCV-HIV co-infection.  This means that you have two infections in your body at the same time.  HIV, the term for human immunodeficiency virus, is the virus that causes AIDS.  You can find more detailed information about HIV and AIDS on several Web sties, including:

HCV-HIV co-infection is fairly common. Overall, about one-third of all Americans infected with HIV also have Hepatitis C.  And the rate of co-infection is much higher among injection drug users.  More than half of people who have HIV and use injection drugs are also infected with Hepatitis C.

People that are co-infected can be effectively treated.  However, since there are two infections to deal with managing them is more complicated. There is no cure for HIV, but it can be controlled.  Hepatitis C can be treated successfully.  Working closely with a doctor who specializes in managing co-infections will give you the best chance for successful treatment.

There are specific risks associated with co-infection.  Having HIV, in addition to Hepatitis C, does the following:

  • Quickens Hepatitis C disease progression
  • Triples the risk for liver disease, liver failure and liver-related death
  • Increases the chance that Hepatitis C will be sexually transmitted
  • Increases the chance that a mother will infect her unborn child with Hepatitis C

Can Hepatitis C Be Cured?

Unlike Hepatitis A and Hepatitis B, a vaccine for Hepatitis C is not available.

However, treatment options are available and Hepatitis C may be cured (or cleared from the body).

Learn more about your treatment options and speak to your healthcare provider today.

The Hepatitis C virus is considered “cured” if the virus is not detected in your blood when measured with a blood test 3 months after treatment is completed. This is called a sustained virologic response (SVR) and data suggest that you will stay virus free indefinitely.

Try to keep yourself as healthy as possible, keep your medical appointments and get regular check-ups. Remember that you could become re-infected if you expose yourself to high-risk situations such as injection drug use, and so do everything possible to avoid these situations. Speak with a substance abuse counselor if needed.

Watch HCV: The Relief of a Cure (video)

Watch Hepatitis C Hidden Truths #3 “HOPE FOR A CURE” (video)

Last updated on March 17th, 2023 at 11:29 am

cross linkedin facebook pinterest youtube rss twitter instagram facebook-blank rss-blank linkedin-blank pinterest youtube twitter instagram