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What is hepatitis C?

Hepatitis C is an infection caused by a virus with the same name. It can cause liver damage and chronic, or long-term, inflammation. It is one of five types of hepatitis caused by viruses: A, B, C, D and E.

Related: Learn more about the different types of hepatitis

How it spreads

Hepatitis C is spread by exposure to infected blood.

¡°In the past, this infection was acquired through unsafe medical and dental procedures,¡± Torres says. ¡°More recently, it has been associated with IV drugs use, infected blood and sharing needles; those are the high-risk populations.¡±

The  writes that ¡°hepatitis C does not spread through casual contact.¡± This means you can¡¯t get it from saliva, food or water. You also can¡¯t get it from actions like kissing, coughing, sneezing, touching, breastfeeding or sharing dining utensils.

Types of hepatitis C

There are two types of hepatitis C.

• Acute hepatitis C is a recently acquired infection.
• Chronic hepatitis C is a long-term infection lasting six or more months.

Untreated hepatitis C may cause permanent liver damage. As a result, the untreated patient may need a liver transplant. 

About 25% of people with hepatitis C can clear the infection on their own, Torres says. 

So, why do hepatitis C infections go away for some people but lead to chronic hepatitis C in others?  

¡°That's the million-dollar question,¡± he says. 

While the answer is unclear for now, researchers are exploring whether biomarkers and immune system strength may be linked to the answer. 

What cancers is hepatitis C linked to?

Hepatitis C increases your risk for:

• Liver cancer
• Non-Hodgkin lymphoma

Hepatitis C infections may also be linked to bile duct cancer, pancreatic cancer and head and neck cancers. The reasons for these links are complex and not fully understood, so more research into this topic is needed.

How are hepatitis C and liver cancer linked?

Hepatitis C is one of the leading causes of liver cancer.

Researchers think that a combination of factors may increase liver cancer risk in people with hepatitis C. These include activation and inactivation of certain genes, long-term inflammation and immune system response.

Over time, hepatitis C infection can cause cirrhosis, or liver scarring. Cirrhosis can lead to hepatocellular carcinoma liver cancer. When someone with hepatitis C has liver cancer, they have cirrhosis in almost 95% of cases, Torres says.

Chronic hepatitis C doesn¡¯t always lead to cancer. When it does, it generally takes 20 to 30 years, Torres says. However, this can change based on the health of an individual. For example, he notes immunosuppressed patients or people with other liver conditions linked to liver cancer ¡ª such as alcohol abuse, HIV or hepatitis B ¡ª may develop liver cancer faster.

The good news is that, in most cases, hepatitis C infection can be cured with oral medications. This treatment can prevent many hepatitis C-associated cancers and reduce your liver cancer risk by 70%, Torres says.

What should cancer patients know about hepatitis C?

If you already have another type of cancer, hepatitis C can cause additional complications or may interfere with cancer treatment.

For example, some cancer patients with hepatitis C might develop cirrhosis more quickly.

In addition, certain cancer treatments, like chemotherapy, may weaken the immune system. For patients with hepatitis C, that could mean the virus flares up and causes active liver disease. This is called hepatitis C reactivation. A hepatitis C specialist can prescribe medications to eliminate this infection and prevent its reactivation.

Is there a cure for hepatitis C?

Yes. When hepatitis C is found and treated early, it can be cured. This reduces your risk for cancer and other complications. That¡¯s why hepatitis C screening and treatment is so important.

¡°I use hepatitis ¡®C¡¯ as ¡®curable,¡¯¡± Torres says. ¡°With the treatment we have right now, we can cure between 90 and 95% of people with hepatitis C.¡±

Who is at increased risk for hepatitis C?

Some groups are at an increased risk for hepatitis C. This includes people who:

• Were born between 1945 and 1965
• Have ever shared needles or injected illegal drugs
• Received a blood transfusion before 1992
• Received an organ transplant before 1992
• Received clotting factor concentrate before 1987
• Are on hemodialysis
• Have an HIV infection
• Have an abnormal liver test
• Were born to mothers with hepatitis C
• Have unprotected sex with a partner who has hepatitis C
• Share personal care items like a toothbrush or razor with someone who has hepatitis C
• Work in health care, emergency medicine or public safety

How is hepatitis C diagnosed?

Today, the recommends all adults be screened for hepatitis C once in their lives. Some people with an increased risk for hepatitis C may need to be screened more than once. Additionally, women should be screened for hepatitis C each time they are pregnant.

Hepatitis C screening is done using a blood test. If blood shows signs of hepatitis C, a second blood test is done to confirm the diagnosis. Additionally, point-of-care testing now allows patients to be screened and get their results in the same appointment without the need for a second blood test.

Hepatitis C screening is covered by most insurances. However, hepatitis C screening isn¡¯t included as part of routine yearly blood work. Your doctor can check if you¡¯ve been screened in the past, Torres notes.

¡°If you have not been screened, tell your provider to screen for hepatitis B and hepatitis C,¡± he says.

Since 2016, MD Anderson has tested all new patients for hepatitis C, becoming the first cancer hospital in the nation to do so. If you are an MD Anderson patient who tests positive for hepatitis C, you will be referred to a hepatitis C specialist. If your diagnosis is confirmed, this specialist will talk to you about risk factors and treatment options, Torres says.

¡°MD Anderson is leading the way in how we approach hepatitis and cancer,¡± he says.

MD Anderson also educates health care providers from around the world on diagnosing and treating cancer patients with viral hepatitis through its Viral Hepatitis ECHO program.

How is hepatitis C treated?

There are several prescription pills that can treat hepatitis C. Treatment has a success rate of about 90 to 95%. These antiviral drugs are more effective and have fewer side effects than medications used in the past.

If you¡¯ve been diagnosed with hepatitis C, it¡¯s best to seek care from a hepatitis C specialist. The goal of hepatitis C treatment is to stop further harm to your liver and reduce your chances of cancer. Typically, your specialist will personalize your treatment based on the type of hepatitis C you have, as well as your other medical conditions and medications.

Tips for preventing hepatitis C

While there¡¯s no vaccine to prevent hepatitis C, there are things you can do to lower your risk. Here¡¯s how.

Do:

• Cover open wounds.
• Avoid contact with menstrual blood.
• If you get body piercings or tattoos, make sure the tools have been sterilized.
• Practice safe sex. Use a condom during sex.

Do not:

• Use illegal drugs.
• Share dirty or used syringes, needles or other drug equipment.
• Share personal items that might have blood on them.
  • For example: toothbrushes, razors, nail clippers, files, scissors
• Donate blood, organs, tissue or semen if you have hepatitis C.

Remember: hepatitis C is curable if diagnosed early. If you¡¯re an adult who hasn¡¯t been screened for hepatitis C, talk to your doctor. Early diagnosis and treatment can save lives.

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