When you think of epidemic diseases, illnesses like the flu, AIDS and Ebola likely come to mind — but perhaps not hepatitis C. Hepatitis C is often called the “silent epidemic,” due to lack of public awareness and the fact that the illness often goes undiagnosed for many years. The hepatitis C virus, or HCV, is transmitted through contact with infected blood. It primarily infects and damages the liver. While some people recover from the infection in a few months, hepatitis C more commonly persists if left untreated. Once a lifelong diagnosis for many, hepatitis C is a curable illness for most people now that effective antiviral medicines are available to combat the disease.
Hepatitis C infection occurs when HCV-infected blood enters the body of an uninfected person. The virus travels through the bloodstream and infects liver cells. It hijacks their internal machinery to produce large numbers of new viruses that go on to infect other liver cells. As the immune system fights the infection, liver cells are damaged or killed and the liver becomes inflamed. The term “hepatitis” means liver inflammation.
Acute Hepatitis C
Acute hepatitis C is the initial phase of the illness, which includes the first six months after infection. Although the immune system is actively battling HCV during this time, 60 to 70 percent of people with acute hepatitis C experience no symptoms, according to the Centers for Disease Control and Prevention. When symptoms do occur, they are often nonspecific — meaning they could be caused by any number of illnesses. Examples include low fever, lack of energy, stomach pain, nausea, vomiting and poor appetite. Some people experience hepatitis-specific signs and symptoms, such as dark urine, light-colored stools and yellowing of the skin and whites of the eyes. If symptoms do occur, they usually develop one to three months after infection and last for two weeks to three months.
Approximately 15 to 25 percent of people with acute hepatitis C spontaneously recover from the illness and clear HCV from their body without treatment, according to the CDC. Spontaneous recovery is more common in women than men. Notably, people who develop hepatitis symptoms during the initial phase of the illness are also more likely to spontaneously recover than those who experience no symptoms. Researchers believe the development of acute hepatitis C symptoms signals that the immune system is winning the fight against the infection — potentially leading to spontaneous recovery.
Chronic Hepatitis C
Approximately 75 to 85 percent of people infected with HCV do not spontaneously clear the infection within six months and are considered to have chronic hepatitis C. As with the acute phase of the illness, most people with chronic hepatitis C don’t experience noticeable symptoms — often for as long as 15 years. But lack of symptoms doesn’t mean HCV infection is harmless. Untreated hepatitis C slowly damages and scars the liver. This scarring — known as fibrosis — accumulates over time and may eventually lead to cirrhosis and liver failure. Hepatitis C is the leading cause of liver cirrhosis in the United States and the most common reason for liver transplantation. Hepatitis C is also the leading cause of liver cancer. The CDC reports that 3.2 million people in the U.S. have chronic hepatitis C, and approximately 22,000 new HCV infections occur each year.
Testing and Hope
No one wants to have hepatitis C, but treatment advancements have brought hope to many who once feared the illness would take their lives. Being tested for hepatitis C is the first step to recovery, as the CDC estimates at least 50 percent of people with hepatitis C are unaware they have the illness. Talk with your doctor about whether you should be screened for hepatitis C or if you’ve been previously diagnosed but have not yet considered treatment.
- Centers for Disease Control and Prevention: Hepatitis C Information for Health Professionals
- Journal of Viral Hepatitis: Spontaneous Viral Clearance Following Acute Hepatitis C Infection: A Systematic Review of Longitudinal Studies
- Hepatology: An Update on Treatment of Genotype 1 Chronic Hepatitis C Virus Infection: 2011 Practice Guideline by the American Association for the Study of Liver Diseases
- JAMA: Treatment of Hepatitis C, A Systematic Review
- World Journal of Gastroenterology: Adaptive Immune Response During Hepatitis C Virus Infection
- Hepatitis C Online: Diagnosis of Acute HCV Infection
- Canadian Journal of Gastroenterology: Factors Associated With Spontaneous Clearance of Hepatitis C Virus Among Illicit Drug Users
- Hepatology: Awareness of Infection, Knowledge of Hepatitis C, and Medical Follow-Up Among Individuals Testing Positive for Hepatitis C: National Health and Nutrition Examination Survey 2001-2008
- Hepatitis C Online: Natural History of Hepatitis C Infection