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Hepatitis C, Acute

By

Sonal Kumar

, MD, MPH, Weill Cornell Medical College

Last full review/revision Jan 2021| Content last modified Jan 2021
Click here for the Professional Version
Topic Resources

Acute hepatitis C is inflammation of the liver that is caused by the hepatitis C virus and that lasts from a few weeks up to 6 months.

  • Hepatitis C is spread through contact with blood or other bodily fluids of infected people, as occurs when people share unsterilized needles to inject illicit drugs.

  • Acute hepatitis C often causes no symptoms

  • Doctors diagnose acute hepatitis C based on blood tests.

  • No vaccine is available.

  • Often, no specific treatment is recommended for acute hepatitis C.

In the United States, over 3,600 cases of acute hepatitis C were reported in 2018. However, because many cases are not recognized or not reported, the actual number of new infections was estimated to be over 50,000 in 2018.

For unknown reasons, about one of five people with alcoholic liver disease has hepatitis C. In these people, alcohol and hepatitis C work together to worsen inflammation and scarring of the liver (cirrhosis).

Transmission of hepatitis C

Hepatitis C is usually spread through contact with blood of an infected person. Hepatitis C is most commonly transmitted among people who share unsterilized needles to inject illicit drugs. The infection can also be transmitted through unsterilized needles used for tattoos and body piercings.

Transmission through blood transfusions or organ transplants is possible but is now rare. Such transmission was common in the United States until 1992, when widespread screening of the blood supply for the hepatitis C virus began.

Transmission through sexual contact is uncommon, as is transmission from an infected pregnant woman to her baby.

Why someone gets hepatitis C sometimes cannot be determined.

Symptoms

At first, acute hepatitis C is usually mild and often causes no symptoms. Most people with acute hepatitis C are unaware that they are infected.

Some people with acute hepatitis C have typical symptoms of viral hepatitis. These symptoms include

  • Loss of appetite

  • A general feeling of illness (malaise)

  • Fever

  • Nausea and vomiting

  • Jaundice (yellowing of the skin and whites of the eyes)

Acute hepatitis C very rarely becomes severe (fulminant).

Hepatitis C becomes chronic in about 75% of people. Chronic infection is usually mild. However, over time, about 20 to 30% of people with chronic hepatitis C develop cirrhosis. Liver cancer may develop but usually only after cirrhosis has developed.

Diagnosis

  • Blood tests

Doctors suspect acute hepatitis C when

  • People have symptoms of acute hepatitis.

  • Blood tests (liver tests) detect inflammation of the liver (hepatitis).

  • People have risk factors for getting hepatitis C.

Testing usually begins with blood tests to determine how well the liver is functioning and whether it is damaged (liver tests). Liver tests involve measuring the levels of liver enzymes and other substances produced by the liver.

If tests detect liver abnormalities, other blood tests are done to check for hepatitis virus infection. These blood tests can identify parts of specific viruses (antigens), specific antibodies produced by the body to fight the virus, and sometimes genetic material (RNA or DNA) of the virus.

Blood tests are done to look for other causes of hepatitis.

The presence of antibodies to hepatitis C suggests that people have been infected with hepatitis C at some time in their life but are not necessarily still infected. If antibodies to hepatitis C are found, the hepatitis C RNA test is done to determine whether the infection is current or occurred in the past. Having antibodies to hepatitis C does not protect people from getting hepatitis C. (In contrast, having antibodies to hepatitis A and hepatitis B does protect against future infection with these viruses.)

Prevention

High-risk behavior, such as sharing needles to inject drugs, should be avoided.

In the United States, all blood donors are tested for hepatitis C to prevent the spread of hepatitis C virus through transfusions. Also, even though the chance of getting hepatitis from transfusions is remote, doctors use transfusions only when there is no alternative. These measures have dramatically decreased the risk of getting hepatitis from a blood transfusion.

No vaccine for hepatitis C is currently available.

Treatment

  • Antiviral drugs

People with acute hepatitis C are treated with the same drugs used to treat chronic hepatitis C as soon as acute hepatitis C is diagnosed. These drugs may decrease the risk of acute hepatitis C becoming chronic.

People with hepatitis C should not drink alcohol because it can damage the liver further. There is no need to avoid certain foods or to limit activity. People should not take drugs that can damage the liver, such as acetaminophen.

Most people can safely return to work after jaundice resolves.

More Information

  • Centers for Disease Control and Prevention: Hepatitis C: This web site provides links to an overview of hepatitis C (including definitions, and statistics) and information about transmission, symptoms, testing, treatment, and hepatitis C and employment, as well as links to information for health care practitioners. Accessed 12/17/20.

NOTE: This is the Consumer Version. DOCTORS: Click here for the Professional Version
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