What are the causes, risk factors, preventive measures, signs and symptoms, and treatment options for Hepatitis C (HCV) infection?

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Last updated: February 20, 2025View editorial policy

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From the Guidelines

Hepatitis C infection can be effectively managed and cured with modern treatments, and it is crucial to prioritize early diagnosis and treatment to prevent liver damage and potential complications. Hepatitis C is a viral infection of the liver that can lead to serious complications if left untreated. Here's a comprehensive overview:

Cause and Risk Factors

Cause: Hepatitis C is caused by the hepatitis C virus (HCV), which spreads through contact with infected blood 1. Risk factors:

  • Intravenous drug use
  • Receiving blood transfusions or organ transplants before 1992
  • Being born to a mother with hepatitis C
  • Unsterile tattoo or piercing procedures
  • Healthcare workers exposed to infected blood
  • Having HIV

Preventive Measures

Preventive measures:

  • Avoid sharing needles or personal items that may have blood on them
  • Practice safe sex
  • Get tested if you're at risk
  • There is no vaccine for hepatitis C

Signs and Symptoms

Signs and symptoms: Many people don't experience symptoms initially. When symptoms do occur, they may include:

  • Fatigue
  • Fever
  • Nausea
  • Abdominal pain
  • Loss of appetite
  • Jaundice (yellowing of skin and eyes)

Treatment

The standard treatment for hepatitis C involves direct-acting antiviral (DAA) medications, such as Sofosbuvir/velpatasvir (Epclusa) or Glecaprevir/pibrentasvir (Mavyret), which have cure rates of over 95% for most genotypes of HCV 1. The specific regimen and duration depend on the virus genotype, liver condition, and previous treatments. It's crucial to complete the full course of treatment as prescribed. Regular follow-up appointments and blood tests will be necessary to monitor liver function and confirm the virus has been eliminated, as guided by the EASL position paper on clinical follow-up after HCV cure 1. Early diagnosis and treatment are key to preventing liver damage and potential complications like cirrhosis or liver cancer. If you suspect exposure or are at risk, consult a healthcare provider for testing and potential treatment options.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Causes and Risk Factors

  • Hepatitis C virus (HCV) is a blood-borne virus that can be transmitted through unsafe injection drug use and unsterile medical procedures (iatrogenic infections) 2, 3
  • The virus is primarily spread through blood-to-blood contact 3
  • Major risk factors for HCV infection include unsafe injection drug use and unsterile medical procedures in countries with high HCV prevalence 2

Preventive Measures

  • There is no effective vaccine available for HCV infection, making treatment-as-prevention strategies and effective screening programs crucial for controlling the pandemic 2, 3, 4
  • Practicing safe injection drug use and ensuring sterile medical procedures can help prevent the spread of HCV 2, 3
  • Patients with cirrhosis must be taught to practice liver wellness following HCV cure to lower the risk of progression of their liver disease 5

Signs and Symptoms

  • HCV infection can cause progressive liver damage, leading to liver cirrhosis and hepatocellular carcinoma 2, 3, 6
  • Chronic HCV infection can lead to liver fibrosis, cirrhosis, and hepatocellular carcinoma 6, 5
  • Patients with cirrhosis may experience complications such as ascites, hepatic hydrothorax, bleeding varices, hepatic encephalopathy, and hepatorenal syndrome 5

Treatment Options

  • Direct-acting antiviral agents (DAAs) have become available, which target three proteins involved in crucial steps of the HCV life cycle: the NS3/4A protease, the NS5A protein, and the RNA-dependent RNA polymerase NS5B protein 2, 3
  • Combination therapies using two or three DAAs can cure HCV infection in >90% of patients, including populations that have been difficult to treat in the past 2, 3
  • Treatment with DAAs can improve response rates for patients with cirrhosis, although rates are still slightly lower than those for patients without cirrhosis 5
  • Anti-inflammatory/hepatoprotective agents with anti-HCV effects may be used in conjunction with DAAs to treat advanced HCV infection and reduce the risk of liver injury and disease progression 6

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Hepatitis C virus infection.

Nature reviews. Disease primers, 2017

Research

Hepatitis C Virus.

Trends in microbiology, 2019

Research

Hepatitis C.

Lancet (London, England), 2015

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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