What is HCV?
Hepatitis C (HCV) is a bloodborne virus that causes inflammation and injury to the liver. HCV refers to both the virus and the disease it causes. The word “hepatitis” literally means “liver inflammation” (“hepat” is the Greek word for liver and “itis” means inflammation). Different types of hepatitis are distinguished from one another by their causes. For instance, hepatitis can be caused by alcohol abuse, overuse of certain medications, consumption of certain poisonous substances, or exposure to certain viruses (such as the hepatitis A, B, or C virus).
There are two phases of HCV infection, acute and chronic. “Acute” means short-term; “chronic” means long-term or prolonged. An acute HCV infection occurs in the 6 months following exposure to the virus. An infection that lasts longer than 6 months is a chronic HCV infection, and can last for a long time and in some people for a lifetime, unless it is treated.
Even though the facts about HCV can be scary, there are good reasons to be hopeful if you are diagnosed with HCV.
- HCV infection generally progresses slowly
- You are not alone… approximately 2.7 million people in the US are living with chronic HCV
- Treatment for HCV is available and the chances for a cure are good
- Research is moving ahead quickly, with the promise of new and more effective treatments on the horizon
Is chronic HCV infection a serious health problem?
Chronic HCV infection is a serious health problem that requires treatment to prevent long-term health complications, including irreversible damage to the liver, liver cancer, liver failure, and death. In fact, chronic HCV infection is serious enough that it is the leading reason for liver transplantation in the US. HCV accounts for more than 15,000 deaths from liver disease every year.
How is HCV detected?
There are several blood tests used to detect HCV. Typically, one or a combination of tests is used to determine if a person has HCV. The first test spots the presence of HCV antibodies. The immune system produces antibodies when a foreign substance or organism, such as a virus, invades the body. These antibodies are produced in response to specific organisms, so if you have HCV antibodies, you know that you have been exposed to the virus at some point in time. You will need further testing to determine if you were exposed to HCV and cleared the virus on your own, or if the virus is still in your body.
Learn more about tests used to detect HCV
How does HCV affect the liver?
The liver is one of the largest organs in the body. All the blood in the body passes through the liver, and we require a healthy liver for survival. The liver has a wide range of functions, acting like the body’s processing plant. The liver has a significant role in metabolism of nutrients and drugs, clotting, digestion, immunity, production of hormones, and the removal of toxic substances from the body. The liver stores vitamins, minerals, and glycogen (needed for energy). The liver also has the ability to grow back after it has been injured, a process known as regeneration.
HCV infection causes inflammation that gradually scars the liver tissue. This damage is called fibrosis. The body has the capacity to repair some of this damage. However, if inflammation continues without treatment, the damage to the liver can be irreversible.1
A serious complication that may occur with HCV infection is cirrhosis, in which fibrosis (damaged liver tissue) is replaced by severe scarring. The early symptoms of cirrhosis include fatigue, nausea, stomach pain, decreased appetite, and weight loss. Severe cirrhosis has many complications, including edema (fluid build-up in the ankles and legs), ascites (fluid accumulation in the abdominal cavity), esophageal varicose (enlarged, fragile blood vessels in the esophagus), and hepatic encephalopathy (mental confusion caused by high level of toxins in the blood).1
Having cirrhosis can increase a person’s chances of developing liver cancer (sometimes called hepatocellular carcinoma). Approximately 1 in 50 people with cirrhosis develop this type of cancer. 1
What are the symptoms of HCV?
The symptoms of acute HCV (an infection occurring in the first 6 months following exposure to the virus) are often mild. Many people with acute HCV do not have symptoms, so are unaware that they are infected. When symptoms do occur in the acute phase, they are usually flu-like. People may assume that they have the flu rather than HCV. Acute HCV symptoms include1:
- Fatigue (feeling tired)
- Joint pain
- Muscle soreness
- Loss of appetite
- Abdominal pain
- Dark urine (tea-colored)
- Gray-colored bowel movements
- Jaundice (yellow color in the skin or eyes)
Learn more about the symptoms of HCV.
The goal of HCV treatment is to cure the infection by removing the virus from the body and to prevent the disease from getting worse. Combinations of medications are used to treat HCV, including pegylated interferon alpha (peginterferon), ribavirin, and newer direct-acting antiviral agents (DAAs). The combination of medications and length of treatment differs according to HCV genotype (there are 7 different genotypes or genetic variations of HCV) and other considerations, such as the extent of liver disease and the existence of other health problems.
- Bonis PAL, Chopra S. Patient information: HCV (Beyond the Basics). Di Bisceglie AM, Bloom A, eds. Accessed at: www.uptodate.com. 2014.
- Chopra S. Epidemiology and transmission of HCV infection. Di Bisceglie AM, Bloom A, eds. Accessed at: www.uptodate.com. 2014.
- HCV FAQs for the Public. Centers for Disease Control and Prevention. US Department of Health and Human Services. Available at: http://www.cdc.gov/hepatitis/c/cfaq.htm. Accessed on: 040414.
- Epidemiology of hepatitis C. US Department of Veteran Affairs. Available at: http://www.hepatitis.va.gov/provider/reviews/epidemiology.asp. Accessed on 073014.
- Smith DB, Bukh J, Kuiken C, et al. Expanded classification of hepatitis C virus into 7 genotypes and 67 subtypes: Updated criteria and genotype assignment web resource. Hepatology 2014;59:318-27.