Public Health

Hepatitis C - Women’s Health Guide

 

Hepatitis C is a disease of the liver caused by hepatitis C virus. Hepatitis C infection can lead to chronic viral hepatitis, including liver damage, cirrhosis (scarring of the liver), and liver cancer.

How is it spread?

Hepatitis C virus is mostly spread by blood from an infected person when:

• Sharing needles or other equipment to inject drugs. This is the most common way people get hepatitis C in the U.S.
• Getting a needle stick with a needle that was used on an infected person
• Sharing items that may have come in contact with another person's blood, such as razors, nail clippers, pierced earrings, toothbrushes
• Being tattooed or pierced with tools that were used on an infected person
• Having sexual contact with a person infected with the hepatitis C virus. The risk of getting hepatitis C from sexual contact is thought to be low.

Hepatitis C is rarely spread from a blood transfusion because:

• Hepatitis C tests are done on all donated blood.
• Blood and blood products that test positive for hepatitis C are safely destroyed. None are used for transfusions.
• There is no risk of getting hepatitis C when donating or giving blood.

Hepatitis C is not spread by kissing,hugging, coughing, or sharing food and eating utensils.

Who is at risk of hepatitis C?

Anyone can get hepatitis C. It is important for people at high risk of infection to be tested and treated for hepatitis C. In the U.S., you are at a higher risk if you:

• Have ever used a needle to inject drugs, even if once and long ago
• Had a blood transfusion or organ transplant before 1992
• Are a health care worker who had blood exposure to mucous membranes or to non-intact skin, or a needlestick injury
• Have ever been on kidney dialysis
• Were born of a mother who had hepatitis C at the time
• Are a Vietnam-era Veteran
• Had contact with hepatitis-C-positive blood to nonintact skin or to mucous membranes
• Received tattoos or body piercings in non-regulated settings
• Have ever snorted drugs or shared drug equipment
• Have liver disease
• Have abnormal liver tests
• Have a history of alcohol abuse
• Have hemophilia and received clotting factor before 1987
• Have had a sexual partner with hepatitis C, now or in the past
• Have had 10 or more lifetime sexual partners
• Have HIV infection

The only way to know if you have Hepatitis C is to be tested. VA offers hepatitis C testing and treatment to enrolled Veterans.

What are signs of hepatitis C?

When you first get hepatitis C, it is called acute hepatitis C. About 15% of people who have acute hepatitis C infection clear the virus from their bodies. The other 85% of people develop a chronic (lifelong) hepatitis C infection. Of these, 50 to 80%, if treated, may be cured.

Acute hepatitis C: Most people with acute hepatitis C do not have any signs. If signs occur, the average time is 6-7 weeks after exposure, but can be less or more. Some people can have mild to severe signs including:

• Yellow skin or eyes (jaundice)
• Tiredness
• Fever
• Nausea
• Vomiting
• Loss of appetite
• Stomach pain
• Light stools
• Dark urine

Chronic hepatitis C: 3-5 million persons in the United States have chronic hepatitis C infection. Most people do not know they are infected. They don't look or feel sick until the virus causes liver damage. This can take 10 years or more to happen. Signs may be the same as acute hepatitis C. There may also be signs of liver damage and cirrhosis such as:

• Weakness
• Weight loss
• Small, red, spider-like blood vessels on the skin
• Confusion or problems thinking
• Loss of interest in sex
• Swollen stomach or ankles
• A longer than normal amount of time for bleeding to stop

How do you know if you have hepatitis C?

The only way to know if you have hepatitis C is by a medical exam. There are several blood tests your health care provider can use to diagnose hepatitis C. These tests can tell you:

• If it is acute or chronic infection
• If you have recovered from infection
• If you could benefit from vaccination for hepatitis A and B

In some cases, your health care provider may suggest a liver biopsy. A liver biopsy is a test for liver damage. A needle is used to remove a tiny piece of liver, which is then sent for tests.

How is it treated?

If you have chronic hepatitis C infection, your health care provider will examine you for liver problems and may prescribe drugs to help control the disease. Hepatitis C drugs can help to:

• Clear the virus from the body
• Slow down or prevent liver damage
• Lower the chance of getting cirrhosis and liver cancer

Before starting treatment it is important to discuss your options with your health care provider. Treatment for hepatitis C may not be for everyone. Some patients might not need treatment. Other patients might not be able to be treated due to other medical problems.

What can happen if hepatitis C is not treated?

For every 100 people infected with hepatitis C:

• About 15 will clear the virus from their bodies.
• About 85 will develop chronic (long-term) infection. Of these 85 people:
• 66 will get only minor liver damage
• 17 will develop cirrhosis and may have symptoms of severe liver disease
• 2 will develop liver cancer

Chronic hepatitis C infection is the leading cause of liver cancer and cirrhosis in the U.S. Cirrhosis is scarring of the liver which causes it to not work properly. Both liver cancer and cirrhosis can be fatal. A liver transplant may be necessary if chronic hepatitis C causes the liver to fail.

If you have hepatitis C

• See your health care provider regularly.
• Tell current and recent sex partners that you have hepatitis C.
• Get vaccinated against hepatitis A and hepatitis B.
• Get plenty of rest.
• Eat healthy foods.
• Drink plenty of fluids
• Avoid drinking any alcohol. Alcohol use speeds up the damage hepatitis C causes in your liver. Drinking alcohol before starting hepatitis C treatment makes treatment less likely to work. There are ways to help you stop drinking alcohol at: What You Can Do.
• Check with your health care provider before taking:
  • Prescription medicines
  • Supplements
  • Over-the-counter drugs
• Avoid spreading hepatitis C to others by:
  • Having safer sex and using condoms during all sexual contact.
  • Not sharing used or unclean needles and sex toys.
  • Not donating blood, blood products, or organs.
  • Cleaning all blood spills – even those that have already dried. Use a mixture of bleach and water (one part household bleach to 10 parts water). Even dried blood is a risk to others.
  • Not sharing personal care items like razors, toothbrushes, nail clippers or earrings.
  • Not sharing glucose-monitoring equipment.
  • Asking your sexual partner(s) to be tested for hepatitis C (and perhaps other infections).

If you have hepatitis C, you can prevent liver damage by not drinking alcohol and by getting vaccinated for hepatitis A and hepatitis B.

How can you avoid hepatitis C?

Right now there is no vaccination to protect you against hepatitis C. However, you can take steps to protect yourself from becoming infected:

• Don't use injectable drugs.
• If you use drugs, get vaccinated against hepatitis A and hepatitis B and enter a treatment program.
• Never share needles, syringes, water, or "works" for intravenous drug use, to inject steroids, or cosmetic substances.
• Handle needles and other sharp objects safely.
• Do not use personal items that may have come into contact with an infected person's blood.
• Do not get tattoos or body piercings from an unlicensed facility or in an informal setting.
• Wear gloves if you have to touch another person's blood. Always clean hands after removing gloves.
• Have safer sex. Each time you have sex use a condom.

For more information, see Safer Sex.

What about pregnancy?

It is possible to get pregnant if you or your partner has hepatitis C. If you are a pregnant woman who already has hepatitis C (or gets hepatitis C during the pregnancy), the chance of passing the virus to your baby is 4 out of 100. The risk becomes greater if the mother has both hepatitis C and HIV. With good prenatal care, babies born to mothers or fathers with hepatitis C are usually quite healthy. The chance of your baby being infected with hepatitis C is the same whether your baby is born by vaginal delivery or C-section. Before breastfeeding, talk to your health care provider.

For more on hepatitis C

• Department of Veterans Affairs (VA):
• Hepatitis C Basics
• Hepatitis C Medications: A Review and Update for Patients
• National Institute of Allergy and Infectious Diseases (NIAID/NIH): Hepatitis
• Centers for Disease Control and Prevention (CDC): Hepatitis C Information for the Public
• National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK/NIH): What I need to know about Hepatitis C
• U.S. Department of Health and Human Services (HHS), Office on Women's Health: Viral Hepatitis Fact Sheet