Hepatitis C Fact Sheet
What is Hepatitis C?Hepatitis C is a blood-borne, infectious disease of the liver, which can lead to serious liver problems, including cirrhosis (scarring of the liver) and liver cancer. Hepatitis C virus (HCV) is the leading cause of liver transplants in the United States.1
Approximately 75 to 85 percent of people exposed to the hepatitis C virus (HCV) develop chronic infection, a long-term illness that occurs when HCV remains in a person's body. Of those, approximately 60 to 70 percent of people will develop chronic liver disease, and up to 20 percent will develop cirrhosis, if HCV remains untreated.1 Chronic liver disease due to HCV is marked by inflammation of the liver tissue with gradual damage or scarring of liver tissue (fibrosis). Over many years, some patients may develop cirrhosis where the scarring involves most of the liver. Patients with cirrhosis are at increased risk for developing liver cancer.2
There are at least six major known strains, or genotypes, of HCV and over 50 subtypes. Genotype refers to the genetic make-up of an organism or a virus. Genotype 1 is the most common form of HCV in the United States and accounts for about 75 percent of cases. Patients with genotypes 2 and 3 represent only 10 to 20 percent of the HCV population in the United States.3
How Common is Hepatitis C?An estimated 4 million people in the United States have HCV infection. Often dubbed the "silent disease," HCV infects approximately 17,000 people each year, and many are asymptomatic for years after initial infection. Every year, the disease causes an estimated 8,000 to 10,000 deaths in the United States.1,4 Chronic viral hepatitis infections are three to five times more frequent than HIV infection in the United States.4
The rate of HCV infection is higher among African Americans.4 The HCV-related mortality rate among Latinos is nearly twice the rate among non-Latino whites. HCV in Latinos causes more aggressive inflammatory activity and fibrosis, greater disease progression and greater risk of cirrhosis than in non-Latino whites or African-Americans.5
How is HCV Spread?HCV is spread primarily through contact with infected blood. Common routes of infection include:3,6,7
- Receiving blood, blood products and organs before June 1992
- The use of shared or unsterilized needles and injection equipment (e.g. injection drug use)
- Birth to an HCV-infected mother
- Hemodialysis for kidney failure
- Accidental exposure to a needle contaminated with infected blood
- Sexual contact with an HCV-infected person
- Intranasal cocaine use through shared paraphernalia
- Use of unsterilized and infected needles or ink for tattooing and piercing
- Sharing infected personal items (e.g., razors, toothbrushes) and other household items that may have blood on them
Whar are the Symptoms?Patients with chronic HCV infection generally experience no signs or symptoms during early stages of infection. When symptoms do occur, they are generally mild, nonspecific and intermittent.
- Nausea or poor appetite
- Muscle and joint pains
- Tenderness in the area of the liver
- Dark urine
- Clay-colored stool
When do Symptoms Develop?Many patients experience no symptoms and, for those who do, symptoms may not show up for years or even decades. Chronic liver disease in HCV-infected people usually progresses slowly without detection. Many times, HCV infection is not recognized until it is identified when people are screened for blood donations or through routine examinations.6 HCV is not routinely screened for in regular examination, so it's important that someone who may have been exposed talk to a doctor. When left undiagnosed, HCV can lead to serious liver problems, including cirrhosis and liver cancer, and is the most common reason for liver transplantation in the United States.1
What Should People do if They Think They Have Been Exposed to HCV?People concerned about being exposed to HCV should consult their health care professional about screening for HCV infection. Common tests include:1,9,10
- Antibody detection tests: The antibody detection test determines the presence of antibodies of the virus, indicating exposure to HCV. An antibody is a substance found in the blood that the body produces in response to a virus. A doctor will likely order a second test to confirm whether the virus is still present in the bloodstream.
- Virus detection tests: The virus detection test identifies whether the virus is still present, indicating an active infection of HCV. This test may also be used after treatment to determine if the virus has been eliminated from the body.
- Liver biopsy: A liver biopsy is a procedure to remove a small piece of the liver so it can be examined with a microscope for signs of damage or disease. A liver biopsy is not necessary for diagnosis but is used to determine the severity of the disease and permanent damage. It is also helpful in determining the cause of the damage.
Can HCV be Treated?Currently, there is no vaccine against HCV. Sustained virological response (SVR) may be achieved using the current treatment options. This means that HCV is no longer detected in the blood six months after treatment is completed.6
What are the Treatment Options for HCV?Currently, the standard of care for the treatment of HCV is pegylated interferon in combination with ribavirin. This combination therapy is typically a 24-week (for genotypes 2 and 3) or 48-week (for genotypes 1 and 4) course. Research has shown that combination therapy with pegylated interferon and ribavirin can result in undetectable levels of HCV in 40-50 percent of people with genotype 1 and 70-80 percent of people with genotypes 2 and 3.11,12,13,14
Are There New Treaments Currently under Investigation for HCV?There are two new types of compounds currently under development by several pharmaceutical and biotechnology companies in the United States.
- Protease inhibitors: Protease inhibitors are compounds that interfere with the ability of certain enzymes to break down proteins. Protease inhibitors can keep a virus from making copies of itself within an infected cell.
- Polymerase inhibitors: Polymerase inhibitors are molecules that bind to polymerase enzymes, which are responsible for the formation of new RNA from an existing strand of RNA. By binding to the HCV RNA-dependent polymerase enzymes, these inhibitors prevent the formation of new RNA.15
Where Can One Find More Information About HCV?For more information about HCV, please visit www.HepCFight.com where people with HCV, their family and friends will find various online resources.
1 Centers for Disease Control. "Hepatitis C FAQs for the Public," available online at http://www.cdc.gov/hepatitis/C/cFAQ.htm. Last accessed March 7, 2010.
2 University of Maryland Medical Center. "Liver Disease," available online at http://www.umm.edu/liver/chronic.htm. Last accessed April 1, 2010.
3 National Digestive Diseases Information Clearinghouse. "Chronic Hepatitis C: Current Disease Management," available online at http://digestive.niddk.nih.gov/ddiseases/pubs/chronichepc/. Last accessed February 16, 2010.
4 Colvin, HM, Mitchell, AE. Hepatitis and Liver Cancer: A National Strategy for Prevention and Control of Hepatitis B and C. http://www.nap.edu/openbook.php?record_id=12793&page=1. Accessed March 7, 2010.
6 Center for Disease Control and Prevention. "Hepatitis C Information for Health Professionals," available online at http://www.cdc.gov/hepatitis/HCV/HCVfaq.htm. Last accessed on February 16, 2010.
7 New York Department of Health and Mental Hygiene. "Hepatitis C." http://home2.nyc.gov/html/doh/html/cd/cdhepc-fs4a.shtml. Last accessed on April 2, 2010.
8 Mayo Clinic. "Hepatitis C Symptoms," available online at http://www.mayoclinic.com/health/hepatitis-c/DS00097/DSECTION=symptoms. Last accessed on March 7, 2010.
9 Lab Tests Online. "Hepatitis C. The Test," available online at http://www.labtestsonline.org/understanding/analytes/hepatitis_c/test.html. Last accessed March 8, 2010.
10 National Digestive Diseases Information Clearinghouse. "Liver Biopsy," available at http://digestive.niddk.nih.gov/ddiseases/pubs/liverbiopsy/. Last accessed on March 8, 2010.
13 Manns MP. et al. Peginterferon alfa-2b Plus Ribavirin Compared With Interferon Alfa-2b Plus Ribavirin for Initial Treatment of Chronic Hepatitis C: A Randomised Trial. The Lancet 2001; 358: 958-965.