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Hepatitis C Virus (HCV) Infection in Adults

Hepatitis C is a viral infection of the liver. It is mainly transmitted through blood. The liver is responsible for fighting against infections, stopping bleeds, removing waste from the body, and storing energy for later use. When liver cells are damaged by HCV, they may become injured and leave scar tissues. A buildup of scar tissues is called cirrhosis. Cirrhosis prevents the liver from delivering its basic functions and is the leading cause for liver transplants in the U.S. Most people with hepatitis C do not show symptoms of liver disease for many years after becoming infected. Screening is recommended for people at risk of developing HCV.

Who is at risk for developing HCV?

Baby boomers – People born from 1945 to 1965 have the highest incidence of hepatitis C. The Center for Disease Control recommends that these people have blood tests to detect the virus as part of their standard care.

Current or former injection drug users –This includes people who used only once.

Recipients of clotting factor concentrates made before 1987 – After this point, more advanced methods for manufacturing those products were developed.

Recipients of blood transfusions or solid organ transplants before July 1992 – Better tests for blood donors became available at that time.

People with kidney failure – These people may be at a higher risk because of undergoing dialysis and blood transfusions.

People with known exposures to HCV – This includes:

  • Health care workers after needle sticks involving HCV-positive blood
  • Recipients of blood or organs from a donor who tested HCV-positive.

People with HIV

Children born to HCV-positive mothers

How is HCV spread?

  • Sharing used needles.
  • Receiving donated blood, blood products or organs. (This is rare in the U.S.)
  • Suffering accidental needle stick injuries in health care settings.
  • Being born from an HCV-infected mother.
  • Sharing toothbrushes or razors.
  • Having unprotected sex with an infected partner.

HCV does not spread through:

  • Sneezing
  • Hugging
  • Kissing
  • Coughing
  • Breastfeeding
  • Sharing food, water, utensils or drinking glasses

What precautions should you take now that you have HCV?

Tell your sexual partners so you can decide how to practice safe sex.

Inform all your healthcare providers so they can adjust your other treatments accordingly.

Cover cuts and sores to keep from spreading blood or other bodily fluids.

Get hepatitis A and B vaccinations.

Check with your doctor before taking any new medications. This includes over-the-counter  medicines like acetaminophen, which may damage your liver if taken in the wrong amount.

Follow your doctor’s directions for taking medications. Tell him or her about any side effects you  may experience.

Talk to your doctor before you or your partner become pregnant.

Join a support group for guidance and support.

Do not:
Share personal items that might have blood on them, such as toothbrushes or razors.
Donate blood or blood products, organs, tissue, or semen.
Drink alcohol or smoke.

Who should receive HCV screenings?

Hepatitis C is usually diagnosed via a blood drawn testing for the presence of HCV antigens and HCV RNA. Since most patients remain asymptomatic (showing no symptoms) for years after being infected, many may not be correctly diagnosed before irreversible liver damage. The American Association for the Study of Liver Disease (AASLD) recommends the following as a precaution to ensure all high risk populations are screened appropriately:

One-time HCV testing for persons born between 1945 and 1965, regardless of country of birth, without prior ascertainment of risk.

One-time HCV testing for all persons with behaviors, exposures, and conditions associated with an increased risk of HCV infection.

Risk behaviors

  • Injection-drug use (current or ever, including those who injected once)
  • Intranasal illicit drug use

Risk exposures

  • Persons on long-term hemodialysis (ever)
  • Persons with injection or infusion exposures in an unregulated setting
  • Healthcare, emergency medical, and public safety workers after needle sticks, sharps, or mucosal exposures to HCV-infected blood
  • Children born to HCV-infected women
  • Prior recipients of transfusions or organ transplants, including persons who:
  • Were notified that they received blood from a donor who later tested positive for HCV infection
  • Received a transfusion of blood or blood components, or underwent an organ transplant before July 1992
  • Received clotting factor concentrates produced before 1987
  • Persons who were ever incarcerated

Other considerations

  • HIV infection
  • Sexually active persons about to start pre-exposure prophylaxis (PreP) for HIV
  • Unexplained chronic liver disease and/or chronic hepatitis including elevated alanine aminotransferase levels
  • Solid organ donors (deceased and living)
  • Annual HCV testing is recommended for persons who inject drugs and for HIV-seropositive men who have unprotected sex with men. Periodic testing should be offered to other persons with ongoing risk factors for exposure to HCV