Hepatitis
Hepatitis C 

Hepatitis (hep-uh-tahy-tis) C is a liver disease caused by the Hepatitis C virus (HCV). HCV infection sometimes results in an acute illness, but most often becomes a chronic condition that can lead to cirrhosis of the liver and liver cancer.

Transmission: Contact with the blood of an infected person, primarily through sharing contaminated needles to inject drugs.

Vaccination: There is no vaccine for Hepatitis C.



Frequently Asked Questions about Hepatitis C

How is Hepatitis C spread?

  • Hepatitis C is usually spread when blood or other body fluids from an infected person enter the body of someone who is not infected.
  • Most people become infected with Hepatitis C through sharing needles, syringes, or other equipment to inject drugs, or sexual contact.
  • Hepatitis C can also be passed from an infected mother to her baby at birth.
  • Before widespread screening of the blood supply began in 1992, Hepatitis C was also commonly spread through blood transfusions and organ transplants. Although uncommon, outbreaks of Hepatitis C have occurred from blood contamination in medical settings.

Can a person get Hepatitis C from a tattoo or piercing?

  • There is little evidence that Hepatitis C is spread by getting tattoos in licensed, commercial facilities. Whenever tattoos or body piercings are given in informal settings or with non-sterile instruments, transmission of Hepatitis C and other infectious diseases are possible.

What are the symptoms of acute Hepatitis C?

  • Acute Hepatitis C is a short-term illness that occurs within the first 6 months after someone is exposed to the Hepatitis C virus. For reasons that are not known, 15%–25% of people “clear” the virus without treatment.
  • Many people with Hepatitis C do not have symptoms and do not know they are infected. Even if a person has no symptoms, the virus can still be detected in the blood and spread to others.
  • If symptoms occur with acute infection, they can appear anytime from 2 weeks to 6 months after exposure and include:

Fever                                     Vomiting                                         Joint pain

Fatigue                                 Abdominal pain                            Yellowing of the skin and whites of eyes

Loss of appetite                   Grey-colored stools

Nausea                                 Dark urine

What are the symptoms of chronic Hepatitis C?

  • Chronic Hepatitis C occurs when the Hepatitis C virus remains in a person’s body. Symptoms can take up to 30 years to develop. Over time, it can lead to serious liver problems, including liver damage, cirrhosis, liver failure, or liver cancer. When symptoms do appear they are similar to acute infection and can be a sign of advanced liver disease. 
  • Approximately 75%–85% of people who become infected with the Hepatitis C virus develop “chronic,” or lifelong, infection.

How common is Hepatitis C?

  • An estimated 3.2 million people in the United States have chronic Hepatitis C. Most are unaware of their infection. Each year, about 17,000 Americans become infected with Hepatitis C.

How serious is Hepatitis C?

  • Acute Hepatitis C is a short-term illness that occurs within the first 6 months after someone is exposed to the Hepatitis C virus. For reasons that are unknown, 15%-25% of people “clear” the virus without treatment. Approximately 75%-85% of people who become infected with the Hepatitis C virus develop “chronic,” or lifelong, infection.
  • Approximately 12,000 people die every year from Hepatitis C-related liver disease.

How is Hepatitis C diagnosed?

  • Doctors can diagnose Hepatitis C using specific blood tests that are not part of blood work routinely performed during regular physical exams. Typically, a person first gets a screening test that looks for “antibodies” to the Hepatitis C virus.
  • Antibodies are proteins released by the body, into the bloodstream, when a person becomes infected. The antibodies remain in the bloodstream, even if the person clears the virus. If the screening test is positive for Hepatitis C antibodies, different blood test are needed to determine whether the infection has been cleared or has become a chronic infection.
  • If a person has a positive antibody test for Hepatitis C, he or she must also have a confirmatory test. This test looks for the presence of the Hepatitis C virus. Unlike the antibody test, when the confirmatory test is positive, it means a person currently has the virus in his or her blood.

How long does it take for blood to test positive after exposure to HCV?

  • After exposure to the virus, it can take a few weeks or a few months until the blood test is positive for Hepatitis C.
  • A few people can have negative test results, but still have the Hepatitis C infection. If a person might have been exposed to the virus right before the tests, it is a good idea to repeat the tests in 6 months to check if the virus is present.

How is Hepatitis C treated?

  • Since acute Hepatitis C rarely causes symptoms, it often goes undiagnosed and therefore untreated. When it is diagnosed, doctors recommend rest, adequate nutrition, fluids, and antiviral medications. People with chronic Hepatitis C should be monitored regularly for signs of liver disease.
  • Treatment success rates are improving and research for new treatment continues.

What should I do if I think I’ve been infected?

  • If you think you have been exposed to the blood or body fluid of an infected individual, notify your primary care physician immediately.

Can I stay in the Army if I am diagnosed with Hepatitis C?

  • Persons diagnosed with Hepatitis C can remain on Active Duty are not deployable to combat theaters. AR 40-501 requires a Medical Evaluation Board (MEB) for chronic Hepatitis C when symptoms persist and there is evidence of liver impairment.

Preventing Hepatitis C

How Can Hepatitis C be prevented?

  • Do not share needles or other equipment to inject cosmetic substances, drugs, or steroids.
  • Do not use personal items that may have come into contact with an infected person’s blood, such as razors, nail clippers, toothbrushes, or glucose monitors.
  • Do not get tattoos or body piercing from an unlicensed facility or in an informal setting.
  • Do not have unprotected sexual encounters.

Is there a vaccine for Hepatitis C?

  • Although there is currently no vaccine to prevent Hepatitis C, research is being conducted to develop one.

Hepatitis C and Pregnancy

What is the risk that a Hepatitis C Virus (HCV)-infected mother will spread HCV to her infant during birth?

  • Approximately 4 of every 100 infants born to HCV-infected mothers become infected with the virus. Transmission occurs at the time of birth, and no treatment is available to prevent it.
  • Most infants infected with HCV at birth have no symptoms and do well during childhood. More research is needed to find out the long-term effects of perinatal HCV infection.

Should pregnant women be routinely tested for antibodies towards HCV?

  • No. Since pregnant women have no greater risk of being infected with HCV than non­pregnant women, and interventions to prevent mother-to-child transmission are lacking, routine testing of pregnant women is not recommended. Pregnant women should be tested for Hepatitis C only if they have risk factors for infection.

Should a woman with HCV infection be advised against breastfeeding?

  • No. There is no evidence that breastfeeding spreads HCV.
  • However, HCV-positive mothers should consider abstaining from breastfeeding if their nipples are cracked or bleeding.

When should children born to HCV-infected mothers be tested to see if they were infected at birth?

  • Children should be tested no sooner than age 18 months because antibodies from the mother might last until this age.
  • If diagnosis is desired before the child turns 18 months, testing for the HCV could be performed at or after the infant’s first well-child visit at age 1–2 months.
  • HCV testing should then be repeated at a subsequent visit, independent of the initial HCV test result.

 

For additional information, visit http://www.cdc.gov/hepatitis/index.htm External Link

 

Sources:

Army Regulation 40-501.Standards of Medical Fitness. 4 Aug 2011 External Link

Centers for Disease Control and Prevention (CDC) (2012). Hepatitis C FAQs for Health Professionals. http://www.cdc.gov/hepatitis/HCV/HCVfaq.htm External Link

Centers for Disease Control and Prevention (CDC) (2010). Hepatitis C: Information About Testing. http://www.cdc.gov/hepatitis/HCV/PDFs/HepCTesting-Diagnosis.pdf External Link

Centers for Disease Control and Prevention (CDC). (2010). General Information Hepatitis C. http://www.cdc.gov/hepatitis/HCV/PDFs/HepCGeneralFactSheet.pdf External Link