Hepatitis C

Hepatitis C virus (HCV) is one of the most important causes of chronic liver disease in the United States. Chronic hepatitis C can cause cirrhosis, liver failure, and liver cancer. More than 4 million Americans have chronic hepatitis C.

How Hepatitis C is Spread

HCV is spread primarily by contact with infected blood and blood products. Blood transfusions prior to June 1992 and the use of shared, unsterilized, or poorly sterilized needles, syringes, and injection equipment have been the main routes of the spread of HCV in the United States. Other risk factors for acquiring HCV are injecting drugs, including having used injection drugs only once many years ago; suffering an inadvertent, HCV-contaminated needle-stick in a hospital or healthcare environment; born to an HCV-infected mother; and, rarely, sexual contact with someone with hepatitis C.

Hepatitis C Prevention

To guard against hepatitis C:

  • Do not share drug needles.
  • Wear gloves if you have to touch another person’s blood.
  • Use a condom during sex.
  • Do not borrow another person’s toothbrush, razor, or anything else that could have blood on it.
  • Make sure any tattoos or body piercings you get are done with sterile tools.

Hepatitis C Symptoms

The first symptoms of hepatitis C occur between 6 to 12 weeks of contact with the virus. The most common symptoms include fatigue, nausea, poor appetite, fever, chills, headaches, sore throat, and joint pain. Many patients have no symptoms. Without treatment at the onset of symptoms, the patient will develop chronic hepatitis C, which can lead to cirrhosis of the liver.

Hepatitis C Treatment

Chronic hepatitis C is treated with drugs that slow or stop the HCV from damaging the liver.

Chronic hepatitis C is most often treated with the drug combination peginterferon and ribavirin, which attacks the hepatitis C virus. Peginterferon is taken through weekly shots and ribavirin is taken daily by mouth. Treatment lasts from 24 to 48 weeks.

Two new drugs that are from a new class of medicines known as HCV protease inhibitors have recently been approved by the FDA for the treatment of chronic hepatitis C genotype 1 in adult patients who have never been treated or who have failed previous interferon/ribavirin-based therapy. The two drugs – boceprevir and telaprevir – act directly on the HCV protease, an enzyme essential for viral replication. It is important to emphasize that these two new drugs will increase substantially the response rate for many patients and may result in a shorter treatment for some (24 weeks instead of 48 weeks). Up to 90 percent of patients never treated with interferon/ribavirin may clear the virus with a new drug. Approximately 60 percent of those who relapsed and 30 percent of those who did not respond to interferon/ribavirin previously may still be able to clear the virus with the new, three-drug regimen. Not all patients will be candidates for treatment with these new drugs since interferon and ribavirin are still required.