Hepatitis C virus (HCV) is a blood born RNA virus that causes hepatitis (liver inflammation) and in its progression is one of the leading causes of cirrhosis/ liver cancer in the world, especially in patients with other risk factor of liver cirrhosis (co-infection, obesity, alcohol etc.). We do not have a preventive vaccine for HCV but it is a curable liver disease.  The natural history of the HCV infection, occurs as follows: Acute hepatitis C within the first 6 months after being exposed to the virus, usually it is asymptomatic. It usually leads to chronic infection, but it can also be a short-term illness. If untreated, chronic hepatitis C can cause progressive liver damage, cirrhosis (scarring of the liver), liver cancer, and even death. Between 75%–85% of people who become infected with hepatitis C virus will develop a chronic infection, while 15%–25% of those infected can clear it from their bodies without treatment and do not develop chronic infection. [1]

Globally, an estimated 71 million people have chronic hepatitis C infection[2] and 3.9 million Individuals are chronically infected with HCV in EU/EEA countries[3].

Untreated HCV infection can cause significant complications, such as: scarring of the liver (cirrhosis), liver cancer and liver failure due to advanced cirrhosis.

Possible symptoms:

The incubation period for hepatitis C is 2 weeks to 6 months. Newly affected usually do not have symptoms or have mild symptoms. However, people affected may have “hepatitis” unspecific symptoms that may occur in hepatitis of different cause, such as: fever, fatigue, decreased appetite, nausea, vomiting, abdominal pain, dark urine, grey-colored faeces, joint pain, jaundice (yellowing of skin and the whites of the eyes).

Transmission:

The HCV is usually transmitted through: injecting drug use through the sharing of injection equipment; the reuse or inadequate sterilization of medical equipment like syringes and needles in healthcare settings as well as the transfusion of unscreened blood and blood products. The virus can be transmitted sexually and can be passed from an HCV infected mother to her baby.

Hepatitis C is not spread through breast milk, food, and water, personal contact such as hugging or by sharing food or drinks with an infected person.

Treatment:

Hepatitis C is a curable disease and nowadays the therapy consists in the administration of direct-acting antivirals (DAA), an oral treatment safe and well tolerated which can cure more than 95% of persons with HCV infection within usually 8-12 weeks.

Although the treatment exists, the gap between those who are diagnosed and those who are directed to the anti-HCV treatment still remains. All adults and children with chronic HCV infection should be assessed for antiviral treatment. In addition, due to the chronic HCV or even cirrhosis could be asymptomatic some people are not aware of their liver disease, for this reason population screening is recommended to achieve HCV elimination in 2030.

Populations at increased risk of HCV infection[4]:
  • people who inject drugs; or used drugs in the past
  • people who use intranasal drugs;
  • recipients of infected blood products or invasive procedures in health-care facilities with inadequate infection control practices;
  • children born to mothers infected with HCV;
  • people with sexual partners who are HCV-infected;
  • people with HIV infection; or HBV infection
  • prisoners or previously incarcerated persons; and
  • people who have had tattoos or piercings

If you are, or a person that you know is, may have features described above and are/is considered to belong to the populations at increased risk of HCV infection, contact your doctor or a liver patient organization in your country. European Liver Patients’ Association is an umbrella organization with the national patient organizations as members. List of our members can be found here

 

[1] Center for Disease Control and Prevention, Hepatitis C Questions and Answers for the Public, https://www.cdc.gov/hepatitis/

[2] World Health Organization, Hepatitis C, www.who.int

[3] European Centre for Disease Prevention and Control, Hepatitis C Annual Epidemiological Report for 2017, https://ecdc.europa.eu/

[4] World Health Organization, Hepatitis C, www.who.int