Hepatitis C

Reviewed by: HU Medical Review Board | Last reviewed: September 2019

Hepatitis C (HCV) is a blood-borne virus (a virus in the bloodstream). Hepatitis C is one type of hepatitis virus. Other hepatitis viruses include hepatitis A and B, among others. All of the hepatitis viruses cause inflammation and damage to the liver.

Like HIV, hepatitis C is a chronic, or long-term virus. However, unlike HIV, hepatitis C currently has a cure available. If not treated, hepatitis C can cause fibrosis and cirrhosis of the liver (scarring of the liver), which can eventually lead to liver failure or liver cancer.

Hepatitis C is transmitted through blood-to-blood contact with blood infected with the virus. Blood transfusions and organ transplants before the 1990’s, injection drug use, sexual contact where blood is transferred (such as rough sex where vaginal or anal tearing occurs, or sexual contact where open sores are present), and mother-to-child transmission during pregnancy or childbirth are some of the most common methods of transmission.1

How is hepatitis C related to HIV?

Many risk factors and methods of transmission are the same for HIV and hepatitis C since they are both transmitted in blood. Injection drug use is a common method of transmission of both HIV and hepatitis C, as is sexual contact in which blood or open sores are present.

When an individual has both hepatitis C and HIV, it is called HIV/HCV coinfection. It is thought that having HIV can make an individual’s HCV become serious faster; however, HCV can still be treated and cured regardless of HIV status. Some estimates suggest that as many as a quarter (25 percent) of people with HIV also have hepatitis C.1,2

Signs of hepatitis C

Hepatitis C is similar to HIV in that some, but not all, of those who have the virus will show symptoms soon after they are infected (during the acute phase). If an individual has symptoms of an acute infection, they may include:

  • Fever
  • Loss of appetite
  • Nausea
  • Vomiting
  • Tiredness

Chronic HCV, like HIV, does not have symptoms until it is very far progressed. It may be discovered during routine blood work if liver function tests come back abnormal. In the case of HCV, the infection is advanced when the liver is severely damaged or begins to fail. If the liver is failing, an individual may notice:

  • Tiredness
  • Abdominal pain or fluid in the abdomen
  • Dark-colored urine
  • Clay-colored bowel moments
  • Joint pain
  • Yellowing of the skin or whites of the eyes (jaundice)
  • Rash or itchy skin
  • Confusion or trouble concentrating and thinking1

Treatment of hepatitis C

There are a variety of new antiviral medications used to treat HCV, as well as older medications called interferons and ribavirin. The newest class of medications, called direct-acting antivirals, have very high cure rates and treatment length varies from 8 to 24 weeks on average. Not all HCV medications can be used alongside HIV medications though. Your healthcare provider will determine the appropriate medication combinations and dosing schedule for you based on your individual situation.1

Prevention of hepatitis C

Prevention of hepatitis C includes avoiding or reducing behaviors that can lead to the spread of the virus. This includes decreasing injection drug use, practicing safer drug use by sterilizing equipment and not sharing with others, using barrier protection (such as condoms) during sex or abstaining from sexual activities when sores or cuts are present, only getting tattoos and piercings at facilities that use sterile equipment, and not sharing personal items such as razors or toothbrushes (items that may come in contact with someone else’s blood).

If you think you may have come into contact with hepatitis C, talk with your healthcare provider about testing for the virus.1

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