Hawai‘i State Department of Health

Hepatitis C

Hepatitis C virus (HCV) is a bloodborne virus transmitted primarily through direct contact with HCV-infected blood. Prior to the blood supply getting tested for HCV in 1992, blood and blood product transfusions were the most common transmission routes. Today, the sharing of injection equipment, needles and syringes is the most common mode of transmission. Treatments are available to fight chronic HCV, which occurs in up to 85% of HCV infections and may cause long-term liver disease. Hepatitis C is the most common, chronic bloodborne disease in the U.S. and is the number one reason for liver transplants. About 4 million people in the U.S. and 23,000 people in Hawai‘i have been infected with hepatitis C. There is no vaccine for preventing infection with HCV.

People with risk factors (see below) should be tested for hepatitis C, especially if they have ever used a needle to inject drugs, steroids, hormones or other substances. The STD/Prevention Branch offers hepatitis C testing for people who do not have insurance or are unable to receive the test through their doctor.

For more information about the hepatitis C test, click here.

For people living with hepatitis C, there are many things you can do to take care of yourself and your liver - finding out you have hepatitis C is not death sentence. Many people live with hepatitis C for many years before they have symptoms, and some people may never get sick from their hepatitis C. Other people may get very sick from hepatitis C and get liver damage such as cirrhosis (scarring). Find a doctor who knows about hepatitis C and make a list of questions you need answered. You will need some more tests to find out how your liver is doing and how far your hepatitis C has progressed. There are treatments available to fight hepatitis C and you should gather information to decide if treatment is right for you. It is important to get vaccinated against hepatitis A and B, reduce your alcohol intake (it is very hard on the liver) and to take care of yourself. Find a support group in your area and get support from people in your life as it is hard to deal with hepatitis C alone. There are many websites and hotlines available to support you. For more resources on living with hepatitis C, click here

Hepatitis C Fact Sheet from the Centers for Disease Control and Prevention

SIGNS & SYMPTOMS

80% of persons have no signs or symptoms.

jaundice
fatigue
dark urine

abdominal pain
loss of appetite
nausea

CAUSE

Hepatitis C virus (HCV)

LONG-TERM EFFECTS

Chronic infection: 55%-85% of infected persons
Chronic liver disease: 70% of chronically infected persons
Deaths from chronic liver disease: 1%-5% of infected persons may die
Leading indication for liver transplant

TRANSMISSION

Recommendations for testing based on risk for HCV infection

Occurs when blood or body fluids from an infected person enters the body of a person who is not infected.
HCV is spread through sharing needles or "works" when "shooting" drugs, through needlesticks or sharps exposures on the job, or from an infected mother to her baby during birth.

Persons at risk for HCV infection might also be at risk for infection with hepatitis B virus (HBV) or HIV.

Recommendations for Testing Based on Risk for HCV Infection

PERSONS	RISK OF INFECTION	TESTING RECOMMENDED?
Injecting drug users	High	Yes
Recipients of clotting factors made before 1987	High	Yes
Hemodialysis patients	Intermediate	Yes
Recipients of blood and/or solid organs before 1992	Intermediate	Yes
People with undiagnosed liver problems	Intermediate	Yes
Infants born to infected mothers	Intermediate	After 12-18 mos. old
Healthcare/public safety workers	Low	Only after known exposure
People having sex with multiple partners	Low	No*
People having sex with an infected steady partner	Low	No*

*Anyone who wants to get tested should ask their doctor.

PREVENTION

There is no vaccine to prevent hepatitis C.
Do not shoot drugs; if you shoot drugs, stop and get into a treatment program; if you can't stop, never share needles, syringes, water, or "works", and get vaccinated against hepatitis A & B.
Do not share personal care items that might have blood on them (razors, toothbrushes).
If you are a health care or public safety worker, always follow routine barrier precautions and safely handle needles and other sharps; get vaccinated against hepatitis B.
Consider the risks if you are thinking about getting a tattoo or body piercing. You might get infected if the tools have someone else's blood on them or if the artist or piercer does not follow good health practices.
HCV can be spread by sex, but this is rare. If you are having sex with more than one steady sex partner, use latex condoms* correctly and every time to prevent the spread of sexually transmitted diseases. You should also get vaccinated against hepatitis B.
If you are HCV positive, do not donate blood, organs, or tissue.

TREATMENT & MEDICAL MANAGEMENT

AASLD Practice Guideline: Diagnosis, Management, and Treatment of
Hepatitis C

HCV positive persons should be evaluated by their doctor for liver disease.
Interferon and ribavirin are two drugs licensed for the treatment of persons with chronic hepatitis C.
Interferon can be taken alone or in combination with ribavirin. Combination therapy, using pegylated interferon and ribavirin, is currently the treatment of choice.
Combination therapy can get rid of the virus in up to 5 out of 10 persons for genotype 1 and in up to 8 out of 10 persons for genotype 2 and 3.
Drinking alcohol can make your liver disease worse.

STATISTICS & TRENDS

Number of new infections per year has declined from an average of 240,000 in the 1980s to about 30,000 in 2003.
Most infections are due to illegal injection drug use.
Transfusion-associated cases occurred prior to blood donor screening; now occurs in less than one per million transfused unit of blood.
Estimated 3.9 million (1.8%) Americans have been infected with HCV, of whom 2.7 million are chronically infected.

Click here to download a PDF version of this fact sheet from the Centers for Disease Control and Prevention.