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Hepatitis C

Sustained virologic response - hepatitis C; SVR - hepatitis C

Hepatitis C is a viral disease that leads to swelling (inflammation) of the liver.

Other types of viral hepatitis include:

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Digestive system
Hepatitis C

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Causes

Hepatitis C infection is caused by the hepatitis C virus (HCV).

You can catch hepatitis C if the blood of someone who has HCV enters your body. Exposure may occur:

People at risk for HCV are those who:

Symptoms

Most people who are recently infected with HCV do not have symptoms. Some people have yellowing of the skin (jaundice). Chronic infection often causes no symptoms. But fatigue, depression and other problems can occur.

Persons who have long-term (chronic) infection often have no symptoms until their liver becomes scarred (cirrhosis). Most people with this condition are ill and have many health problems.

The following symptoms may occur with HCV infection:

Exams and Tests

Blood tests are done to check for HCV:

All adults ages 18 to 79 should get a one-time test for HCV. This screening test checks for antibodies against HCV (anti-HCV). If the antibody test is positive, a PCR test is used to confirm HCV infection.

Further genetic testing is done to check for the type of HCV (genotype). There are six types of the virus (genotypes 1 through 6). Test results can help your doctor choose treatment that is best for you.

The following tests are done to identify and monitor liver damage from HCV:

Treatment

You should talk to your health care provider about your treatment options and when treatment should begin.

Antiviral medicines are used to treat HCV. These drugs help fight HCV. Newer antiviral drugs:

The choice of which medicine depends on the genotype of HCV you have.

A liver transplant may be recommended for people who develop cirrhosis and/or liver cancer. Your provider can tell you more about liver transplant.

If you have HCV:

Support Groups

Joining a support group can help ease the stress of having HCV. Ask your provider about liver disease resources and support groups in your area.

Outlook (Prognosis)

Most people (75% to 85%) who are infected with the virus develop chronic HCV. This condition poses a risk for cirrhosis, liver cancer, or both. The outlook for HCV depends in part on the genotype.

A good response to treatment occurs when the virus can no longer be detected in the blood 12 weeks or more after treatment. This is called "sustained virologic response" (SVR). Up to 90% of those treated for some genotypes have this type of response.

Some people do not respond to initial treatment. They may need to be re-treated with a different class of medicines.

Also, some people can become re-infected or infected with a different genotype strain.

When to Contact a Medical Professional

Call your provider if:

Prevention

Steps that can be taken to help prevent the spread of HCV from one person to another include:

If you or your partner is infected with HCV and you have been in a stable and monogamous (no other partners) relationship, the risk of giving the virus to, or getting the virus from, the other person is low.

HCV cannot be spread by casual contact, such as holding hands, kissing, coughing or sneezing, breastfeeding, sharing eating utensils or drinking glasses.

Currently there is no vaccine for HCV.

Related Information

Hepatitis A
Hepatitis B
Cirrhosis

References

Centers for Disease Control and Prevention website. Hepatitis C questions and answers for the public. www.cdc.gov/hepatitis/hcv/cfaq.htm. Updated April 20, 2020. Accessed March 30, 2020.

Ghany MG, Morgan TR; AASLD-IDSA Hepatitis C Guidance Panel. Hepatitis C Guidance 2019 Update: AASLD-IDSA recommendations for testing, managing, and treating hepatitis C virus infection. Hepatology. 2020;71(2):686-721. PMID: 31816111 pubmed.ncbi.nlm.nih.gov/31816111/.

Jacobson IM, Lim JK, Fried MW. American Gastroenterological Association Institute clinical practice update-expert review: care of patients who have achieved a sustained virologic response after antiviral therapy for chronic hepatitis C infection. Gastroenterology. 2017;152(6):1578-1587. PMID: 28344022 pubmed.ncbi.nlm.nih.gov/28344022/.

Naggie S, Wyles DL. Hepatitis C. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 154.

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Review Date: 1/12/2020  

Reviewed By: Michael M. Phillips, MD, Clinical Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Editorial update 04/28/2020.

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