Hepatitis C 

Introduction 

Hepatitis C

Professor Howard Thomas explains what hepatitis C is, how you can become infected and why it's important to detect it early.

The liver

Your liver is your body’s ‘factory’. It carries out hundreds of jobs that are vital for life, including:

  • storing glycogen (carbohydrate that produces short-term energy)
  • making bile, which helps to digest fats
  • making substances that clot the blood
  • processing and removing any alcohol, toxins and drugs

You only have one liver, but it is very tough. It keeps going when it is badly damaged, and it can continue repairing itself up until it becomes severely damaged.

Hepatitis C is an infection of the liver caused by the hepatitis C virus.

It can cause inflammation (swelling) and fibrosis (scarring) of the liver tissue, and sometimes significant liver damage.

Many people do not realise they have been infected with the virus because they may not have any symptoms, or they may have flu-like symptoms that can easily be mistaken for another illness.

You can become infected with hepatitis C if you come into contact with the blood or, less commonly, body fluids of an infected person (see below). Drug users sharing needles are at particular risk.

There is currently no vaccine to prevent hepatitis C. This is because the hepatitis C virus mutates (changes into a different strain) very easily, which makes it hard to create a vaccine, and the virus has different genotypes (genetic variants).

How do you become infected?

The hepatitis C virus is present in the blood and, to a much lesser extent, the saliva and semen or vaginal fluid of an infected person. It is particularly concentrated in the blood, so it is usually transmitted through blood-to-blood contact.

The most common way you can become infected is by sharing contaminated needles to inject drugs. See Causes for other ways hepatitis C is spread.

Hepatitis C is a notifiable condition. This means that when the condition is diagnosed, the doctor making the diagnosis must inform the local authority.

How common is it?

It is estimated that about 200,000 to 500,000 people are infected with hepatitis C in England and Wales. Many people do not know they are infected.

Outlook

The course of hepatitis C is unpredictable.

About one in five people with hepatitis C will fight the infection and naturally clear it from their bodies within two to six months, experiencing no long-term effects. 

Of the rest, some will remain well and never develop liver damage, but many will develop mild to moderate liver damage (with or without symptoms). Alcohol consumption is known to speed up the progression of liver damage. People infected with HIV also show a faster development of liver damage.

In a few people, their liver damage will progress to cirrhosis (severe scarring of the liver) over 20-30 years. If you have cirrhosis, you have a greater risk of developing liver cancer.

Cirrhosis may also lead to liver failure. In this case, a liver transplant may be the only option.

Treatment with interferon and ribavirin can clear the infection in approximately half of those who are infected, but there are significant side effects (see Treatment).

Last reviewed: 29/12/2009

Next review due: 29/12/2011

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Comments are personal views. Any information they give has not been checked and may not be accurate.

monkey600 said on 31 December 2011

This article is seriously out of date regarding treatments available. Why has it not been reviewed by the date set above?
It seems to me that the NHS want to keep secret the new drug treatments available and their much improved success rates as they cost a lot of money, and yet again the Hep C sufferers just roll over and take it.
Your symptoms page is also very incomplete.

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