Hepatitis C is a viral disease that affects the liver. It is often called the “silent killer” because it can remain asymptomatic for years, causing severe liver damage such as cirrhosis or cancer. Recognizing the symptoms of hepatitis C helps detect the disease early and begin treatment.

Acute Symptoms of Hepatitis C

The acute phase of hepatitis C can occur within the first 6 months after infection. Key symptoms include:

• Fatigue — persistent weakness and lack of energy.
• Jaundice — yellowing of the skin and eyes due to elevated bilirubin levels.
• Dark urine and pale stools.
• Abdominal pain, especially in the upper right quadrant.
• Nausea and vomiting, loss of appetite.
• Fever and headache.

Chronic Symptoms of Hepatitis C

For most people, the disease progresses to a chronic stage. Symptoms may include:

• Gradual loss of energy and fatigue.
• Joint and muscle pain.
• Cognitive decline, known as “hepatic brain fog”.
• Skin itching.
• Swelling in the abdominal area (ascites) or legs.
• Easy bruising or bleeding.

Late-Stage Disease

If untreated, hepatitis C can lead to severe complications:

• Liver cirrhosis — irreversible liver tissue damage.
• Liver failure.
• Liver cancer.

When to See a Doctor?

Seek medical attention if you experience:

• Persistent fatigue.
• Jaundice or changes in urine and stool color.
• Abdominal pain, especially near the liver.
• Risk factors such as blood transfusions, tattoos, or contact with infected blood.

How Is Hepatitis C Diagnosed?

Diagnosis includes:

• Blood test for hepatitis C antibodies.
• PCR test to confirm the presence of the virus.
• Ultrasound or liver elastography to assess organ condition.

Prevention

• Use single-use needles and sterile equipment.
• Avoid contact with other people’s blood.
• Get tested for hepatitis C, especially if risk factors are present.

Hepatitis C: Causes, Symptoms, Treatment, and Global Impact

Hepatitis C is a viral infection that primarily affects the liver, causing inflammation and potentially leading to severe complications such as cirrhosis, liver failure, or liver cancer. It is caused by the hepatitis C virus (HCV) and is often referred to as a “silent disease” because many individuals remain asymptomatic for years. Globally, hepatitis C is a significant public health concern, but advancements in antiviral treatments have made it a curable condition for most people.

What Causes Hepatitis C?

Hepatitis C is caused by the hepatitis C virus (HCV), which spreads through blood-to-blood contact. Common routes of transmission include:

• Injection Drug Use: Sharing needles or other drug paraphernalia is the leading cause of HCV transmission.
• Unsafe Medical Practices: Use of unsterilized medical equipment or improper blood transfusions, particularly in low-resource settings.
• Mother-to-Child Transmission: Occurs during childbirth, though the risk is relatively low.
• Sexual Contact: Rare but possible, especially in cases of rough sexual activity or when other sexually transmitted infections are present.
• Needle Stick Injuries: Occupational exposure among healthcare workers.

Hepatitis C is not transmitted through casual contact, such as hugging, kissing, or sharing food and drinks.

Types of Hepatitis C

HCV exists in several genetic variations, called genotypes. The most common genotypes globally are 1, 2, 3, and 4, with genotype 1 being predominant in the United States and Europe. Identifying the genotype is essential for tailoring treatment.

Symptoms of Hepatitis C

Hepatitis C infection occurs in two phases:

• Acute Phase: Occurs within the first six months of exposure. Most people are asymptomatic, but some may experience fatigue, jaundice, nausea, abdominal pain, and dark urine.
• Chronic Phase: If the virus persists in the body for more than six months, it becomes chronic. Chronic hepatitis C often remains asymptomatic for years but may eventually cause:
  • Persistent fatigue
  • Joint pain
  • Loss of appetite
  • Liver damage, including cirrhosis or liver cancer

Complications

If left untreated, chronic hepatitis C can lead to severe complications:

• Cirrhosis: Scarring of the liver that can impair its function.
• Liver Cancer: Chronic HCV is a major risk factor for hepatocellular carcinoma.
• Liver Failure: End-stage liver disease requiring a liver transplant.

Diagnosis

Hepatitis C is diagnosed through blood tests:

• Antibody Test: Detects HCV antibodies, indicating past or current infection.
• HCV RNA Test: Confirms active infection and measures the amount of virus in the blood.
• Genotyping: Determines the specific HCV genotype to guide treatment.
• Liver Function Tests: Assess the extent of liver damage.
• Imaging or Biopsy: May be required to evaluate liver health in advanced cases.

Treatment

Advances in antiviral medications have revolutionized the treatment of hepatitis C. Modern therapies achieve a cure in over 95% of cases:

• Direct-Acting Antivirals (DAAs): These medications target specific steps in the HCV lifecycle. Common regimens include sofosbuvir, ledipasvir, and velpatasvir.
• Treatment Duration: Typically lasts 8–12 weeks, depending on the patient’s condition and genotype.
• Liver Transplant: In cases of end-stage liver disease, a transplant may be necessary, followed by antiviral treatment to prevent reinfection.

Prevention

Hepatitis C prevention strategies focus on reducing exposure to infected blood:

• Safe Injection Practices: Avoiding needle sharing and using sterile medical equipment.
• Screening of Blood Donations: Ensures that transfused blood is free of HCV.
• Safe Sexual Practices: Using condoms, especially in high-risk situations.
• Occupational Safety: Training healthcare workers on avoiding needle stick injuries.
• Education and Awareness: Informing high-risk populations about HCV transmission.

Global Statistics on Hepatitis C

United States

• Approximately 2.4 million people in the U.S. are living with chronic hepatitis C.
• Injection drug use is the leading cause of new infections, with a rise in cases linked to the opioid crisis.
• HCV-related deaths decreased by nearly 50% between 2014 and 2020 due to improved treatments, but it remains a leading cause of liver cancer and liver transplants.

Europe

• An estimated 14 million people in Europe live with chronic hepatitis C.
• Genotype 1 is the most prevalent, accounting for about 50% of cases.
• Rates of infection are higher in Eastern Europe due to inadequate screening and treatment access.
• Recent efforts to improve access to DAAs have significantly reduced the burden of the disease in Western Europe.

Public Health Initiatives

Efforts to combat hepatitis C include:

• WHO Goals: The World Health Organization aims to eliminate hepatitis C as a public health threat by 2030, targeting a 90% reduction in new infections and a 65% reduction in mortality.
• Screening Programs: Expanded testing in high-risk populations, including those born between 1945 and 1965 (“baby boomers”), who are disproportionately affected.
• Harm Reduction Services: Needle exchange programs and opioid substitution therapies help reduce transmission.

Conclusion

Hepatitis C is a curable yet underdiagnosed and undertreated condition that poses a significant global health challenge. Advances in antiviral treatments have transformed the prognosis for those with HCV, making it possible to achieve widespread elimination with coordinated public health efforts. Increased awareness, access to testing, and affordable treatment are essential to combating this silent epidemic and improving outcomes for millions worldwide.