Hepatitis C (infectious liver inflammation type C)

Reviewed by Dr Janice Main, senior lecturer and honorary consultant physician in infectious diseases and general medicine

What is type C hepatitis?

Hepatitis is the Latin word for liver inflammation. Type C hepatitis is caused by a virus called hepatitis C virus. It was previously referred to as non-A-non-B hepatitis. Other types of viral hepatitis include hepatitis A, and hepatitis B.

What causes type C hepatitis?

Through contact with an infected person's blood.

Through sexual contact, but the risk is very small.

Transmission from mother to child is rare.

The virus can be contracted by accidental pricking with a contaminated needle - this mainly concerns healthcare workers.

Type C hepatitis is common in intravenous drug users due to their sharing of contaminated needles. It is also seen in haemophiliacs and people who have had blood transfusions or treatment with blood products. Since 1991 all blood has been tested for type C hepatitis and the risk of transmission through blood is now insignificant.

About one third of all cases of type C hepatitis come from an unidentifiable source.

What are the symptoms of type C hepatitis?

The incubation period, from the time of exposure to the virus until the onset of the disease, is one to six months. Early symptoms include poor appetite, lack of interest in food, nausea, aching muscles and joints, and light fever.

Later symptoms include yellowing of skin, mucous membranes, and white portions of the eyes (jaundice, icterus); light-coloured stools; and dark urine. Once the late symptoms have developed, in most cases the patient quickly begins to get better. The disease typically lasts two to eight weeks.

Only 1 in 10 patients with acute hepatitis has symptoms. The remaining nine have no symptoms whatsoever. In 8 out of 10 patients, the infection becomes chronic.

Patients with chronic type C hepatitis may not have any symptoms at all or experience only mild symptoms such as tiredness, periodical pressure below the right ribs caused by the enlarging liver, and aching muscles and joints.

Approximately one third of the patients develop cirrhosis over a number of years, which can lead to liver failure and other serious complications. On average, cirrhosis develops about 20 years after the virus has been contracted.

How can type C hepatitis be prevented?

Avoid sharing needles and syringes.

Avoid sharing razors and toothbrushes with an infected person.

Unfortunately, there is no vaccine to prevent hepatitis C virus infection.

What can be done at home?

Abstain from all alcohol intake if blood tests have shown that the disease is active.

Refrain from drinking alcohol daily if you have chronic type C hepatitis.

If you have chronic hepatitis, you should be examined regularly by your doctor.

Eat a healthy, well-balanced diet.

How is type C hepatitis diagnosed?

The diagnosis is made on the basis of a blood sample which will demonstrate the presence of genetic segments from the hepatitis C virus, or antibodies against the hepatitis C virus in the patient's blood.

A blood test for liver function can determine the severity of the disease - to what extent the liver is affected by the virus.

In the case of chronic hepatitis, the severity of the illness can be assessed through a tissue sample from the liver.

Future prospects

Most patients with acute type C hepatitis have fully recovered after four to eight weeks.

Very few patients (1 in 300) develop liver failure in connection with acute hepatitis and subsequently risk dying from the disease.

The infection becomes chronic in four out of five patients.

The most serious complications of chronic type C hepatitis are cirrhosis and in rare cases, liver cancer.

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