Disease Fact Sheet Series:
Hepatitis C is a liver disease
caused by the hepatitis C virus (HCV) which is found in the blood of
persons who have this disease.
How is the virus spread?
HCV is spread primarily by exposure to human blood from an
infected person. It can also be spread sexually or perinatally from an
infected mother to her infant. Blood products, organs, tissues, semen
and vaginal secretions from an infected person are sources for
potential HCV infection transmission. HCV is not spread by casual
contact such as hugging, sneezing, coughing or sharing food. However,
sharing razors or toothbrushes with an infected person could spread
HCV.
Who should be tested for hepatitis C?
- Persons who ever injected illegal drugs, including those who
injected once or a few times many years ago.
- Persons who were treated for clotting problems with a blood
product made before 1987.
- Persons who were notified that they received blood from a donor
who later tested positive for hepatitis C.
- Persons who received a blood transfusion or solid organ transplant
before July 1992.
- Long-term hemodialysis patients.
- Persons who have signs or symptoms of liver disease (e.g.,
abnormal liver enzyme tests).
- Healthcare workers and others (e.g., family members) after
significant exposures (e.g., needle sticks or splashes to the eye)
while caring for or assisting an HCV-infected person.
- Children born to HCV-positive women.
- Sexual partners of HCV infected persons, although the risk of
transmission is low.
What are the signs and symptoms of HCV infection?
Most (90%) HCV infections are
not symptomatic. A few individuals experience elevated (seven times
the normal range) or fluctuating levels of the liver enzyme alanine
aminotransferase, loss of appetite, fatigue, nausea and vomiting,
vague abdominal pain and jaundice. Of persons infected with HCV, 15%
may develop cirrhosis over a period of 20 to 30 years, and 5% may die
from the consequences of long term infection (liver cancer or
cirrhosis).
How soon do signs or symptoms occur?
Persons with acute illness usually develop symptoms 6-7 weeks
after exposure. Hepatitis C antibody (anti-HCV) can be found in 7 out
of 10 persons when symptoms begin and in about 9 out of 10 persons
within 3 months after symptoms begin.
When and for how long is a person able to transmit
HCV?
Some persons carry the virus in
their blood and may remain contagious for years. A chronic carrier
state may develop in as many as 75-85% of infected persons.
Are there treatments for hepatitis C?
The FDA has approved three drugs to treat HCV infection. Patients
are advised to consult their medical providers about treatment
options. Immune globulin (IG) is not effective for post exposure prophylaxis of hepatitis C.
Are there sensitive and specific tests for
diagnosing hepatitis C?
There are several blood tests that can be done to diagnose HCV
infection. The enzyme immunoassay (EIA) is usually done first. The
recombinant immunoblot assay (RIBA) is a supplemental test used to
confirm a positive EIA test. Both the EIA and the RIBA detect anti-HCV
in serum or plasma. Anti-HCV does not tell whether the infection is
new (acute), chronic (long-term) or is no longer present.
The presence or absence of virus (HCV RNA) in the
blood is detected with qualitative reverse transcriptase polymerase
chain reaction test (RT-PCR). PCR and other tests to directly detect
virus are not yet licensed but are widely used in clinical practice. A
single positive PCR test indicates infection with HCV. A single
negative PCR test does not prove that a person is not infected. Virus
may be present in the blood and not found by PCR. Also, a person
infected in the past who has recovered may have a negative test. When
hepatitis C is suspected and the PCR is negative, the PCR should be
repeated 6 months later.
How can the spread of HCV be prevented?
Persons who are infected with HCV should take the following
precautions to prevent transmitting hepatitis C:
- Do not donate blood, body organs, semen (sperm), ova, or other
tissue.
- Do not share toothbrushes, razors or other sharp personal care
articles.
- Cover cuts and open sores.
- Do not share needles or works with others and use only clean
needles and works. Staff in a public health department can provide
information on how to obtain clean needles, e.g., through needle
exchange or a local pharmacy, and how to enter a drug treatment
program.
- The rate of transmission of HCV between regular sexual partners
is low. Partners who want to lower the chance of transmitting HCV
should use latex condoms.
Persons having sex with multiple partners should use a latex condom
correctly every time to prevent the transmission of sexually
transmitted diseases to susceptible partners.
For more information, contact your
Local
Public Health Department
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Last Revised: March 20, 2008
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