McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
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What is hepatitis C?

Hepatitis C is inflammation of the liver caused by the hepatitis C virus. When the liver is infected with a virus, it becomes inflamed and usually becomes tender and swollen. The infection may destroy patches of liver tissue.

If you are infected with hepatitis C, you may develop chronic (ongoing) liver disease. The continued inflammation can damage the liver, resulting in cirrhosis (destruction and scarring of the liver) and possible liver failure. Hepatitis C also increases the risk of liver cancer.

How does it occur?

The hepatitis C virus is spread mainly through contact with infected blood. You can get it from:

• receiving infected blood, blood products, or solid organs
• long-term kidney dialysis if you unknowingly shared supplies or equipment that had someone else's blood on them
• contact with infected blood on the job if you are a health care worker, especially from accidental needlesticks
• your mother if she had hepatitis C at the time she gave birth to you
• intravenous (IV) drug abuse
• sharing razors or toothbrushes with an infected person
• getting a permanent tattoo
• having unprotected sex with someone infected with hepatitis C.

Before 1990 one of the most common ways to get hepatitis C was blood transfusion. However, now blood donors can be screened for the virus.

Hepatitis C can be spread by people who do not have an active infection. They are called asymptomatic carriers.

What are the symptoms?

Symptoms may appear 2 weeks to 6 months after you are infected. More than half of the people with hepatitis C have no symptoms.

The disease may begin with typical symptoms of infection:

• loss of appetite
• weight loss
• fever
• general achiness
• fatigue.

Other early symptoms may include:

• itching hives
• pain in some of the joints
• in smokers, a loss of taste for cigarettes.

Symptoms you may have several days after the early symptoms are:

• nausea and vomiting
• foul breath and bitter taste in the mouth
• dark urine
• yellowish skin and eyes (jaundice)
• pain just below the ribs on the right side, especially when you put pressure on the area
• bowel movements that are whitish or light yellow and may be looser than normal.

Some people develop a chronic form of the disease without any obvious symptoms, even though damage to the liver may be occurring. The symptoms of chronic hepatitis may be persistent fatigue, weakness, and loss of appetite, as well as some of the other symptoms listed above.

Many people who have hepatitis C do not remember having any flulike or hepatitislike illness.

How is it diagnosed?

Your health care provider will ask about your medical history and symptoms. Especially important is your history of hepatitis risk factors such as IV drug abuse.

Your provider will examine you. He or she may find that your liver is enlarged and tender. You may have a blood test to see if you are infected with the hepatitis C virus.

To confirm the diagnosis and to see how much liver damage may have occurred, you may have a liver biopsy. A biopsy is a procedure in which a needle is used to remove a small amount of tissue. This is done through the skin over the liver after the area is numbed with an anesthetic. The sample of tissue is sent to a lab for tests.

How is it treated?

Your health care provider will recommend getting rest, having a healthy diet, and avoiding alcohol and certain medicines for at least 6 months. Usually it is not necessary to stay at the hospital.

Doctors are continuing to search for the best ways to treat hepatitis C. Antiviral drugs, such as interferon, may be used. As new information becomes available, treatments change. Ask your health care provider for the most current treatment available to you.

How long will the effects last?

Symptoms may last 1 to 6 weeks and are usually followed by complete recovery. Relapse is common, however. It can be triggered by drinking too much alcohol or exerting yourself before you are fully recovered. It may also be caused by another infection. Relapses are usually milder than the initial infection and respond well to rest.

A third to one half of people infected with hepatitis C develop chronic hepatitis, that is, hepatitis that lasts at least 6 months. As many as 35% develop chronic liver disease, including cirrhosis. Your health care provider may check your blood every few months for signs of chronic liver disease.

In some cases hepatitis C may cause liver cancer.

How can I take care of myself?

• Avoid taking medicines that are metabolized in the liver. Ask your health care provider which drugs these are.
• Rest in bed according to your health care provider's instructions. As your symptoms improve, you may gradually increase your level of activity. Ask your provider when you can return to your normal activities. Avoid strenuous activities for several months.
• Eat small, balanced meals, even when you feel nauseous. Some foods may not appeal to you, especially in the early stages of the disease. Drinking juices or soft drinks after letting them go flat, or eating hard candy, may help you feel less nauseous.
• Don't drink alcohol.
• Follow your health care provider's instructions for taking medicines to relieve your symptoms.
• If you are a woman taking antiviral drugs, avoid getting pregnant during your treatment.
• Ask your health care provider if you need shots to prevent hepatitis A and hepatitis B.
• See your health care provider if:
  • Your appetite continues to decrease.
  • You have worsening drowsiness, confusion, or irritability.
  • You have vomiting, diarrhea, or abdominal pain.
  • You develop jaundice.
  • You have a rash or your skin itches.

What can be done to help prevent the spread of hepatitis C?

There are no shots that protect against hepatitis C. If you have hepatitis C, you can help prevent its spread by following these guidelines:

• Do not let others come in contact with your blood; for example, when you have a bloody nose or a cut.
• Do not share needles, razor blades, and toothbrushes with others.
• Avoid high-risk sexual activity.
• Do not donate blood.

This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.