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Learn about the symptoms of this treatable virus, as well as how it’s spread and who’s most at risk

By Marijke Vroomen Durning, RN

Hepatitis C is a liver disease caused by the hepatitis C virus, and it affects around 3 million people in the United States. Hepatitis C (or hep C, also known as HCV, for hepatitis C virus) can be acute or chronic. "Acute" is the term used for the first six months after a person is exposed to and infected with HCV. Unfortunately, more often than not, acute hep C becomes "chronic" hep C over time: approximately 75% of patients with an acute infection will go on to develop chronic or long-term HCV. 

Symptoms of Hep C

Whether hep C is acute or chronic, it’s often a silent disease, meaning people who have it may not feel or look particularly sick. Up to 80% of people with acute hep C don't report any symptoms. And if symptoms do happen, they can be so mild and vague that they’re dismissed or easily mistaken for another illness, like the flu. 

Symptoms can include:

• abdominal pain
• dark-colored urine
• fatigue, or feeling tired all the time 
• itchy skin
• jaundice, or yellowing of the skin and the whites of your eyes
• joint pain
• nausea
• poor or reduced appetite
• sore, aching muscles
• vomiting

Eventually, as the disease advances and the liver becomes more significantly affected, symptoms may be more prominent — but this can take years to happen.

How Is Hep C Spread?

According to the Centers for Disease Control and Prevention (CDC), the hep C virus can live outside the body, at room temperature, for up to 3 weeks. But in order to spread hep C, the blood of someone with the virus has to come into contact with the blood of a person who doesn’t have it. This can happen either through direct exposure to the blood or by using an item that has been in contact with contaminated blood, such as a hypodermic needle or other equipment used to inject drugs, which is the most common way hep C is spread today. 

People once contracted the virus through donated blood (used in transfusions), blood products (such as platelets for people with clotting disorders, like hemophilia) and organs. However, improved screening for hep C in blood products began in 1987; screening was expanded to include donated blood and organs in 1992. Now the risk of getting the virus in these ways is extremely low.

The risk of spreading hep C through sexual contact is also thought to be low, but more research needs to be done. The infection can also potentially spread through personal hygiene products that come into contact with blood (razors, nail clippers and toothbrushes are examples of these kinds of products) though this isn’t common. Pregnant women with hep C have the potential of passing it on to their unborn babies, as well, though the chances are small (around 6 in 100). Talk to your healthcare provider if you have hep C and are worried about transmitting it to the people in your life.

Who Is at Risk for Hep C?

While anyone can become infected with hep C if they’re exposed to the virus, some people are at higher risk than others. It may be surprising to learn that “baby boomers,” Americans born between 1945 and 1965, are five times more likely than others to have hep C.

This is likely because boomers may have been exposed to the virus through contaminated blood, organs or blood products before universal screening for hep C was put in place. Since it’s possible to have the virus for decades with no symptoms, it’s not unheard of to discover you have hep C later in life, long after the infection occurred. That’s why the CDC recommends that all boomers be tested, along with anyone who had a blood transfusion or received a donated organ before 1992, or received a blood product made before 1987.

Others at higher risk include:

• People who share hypodermic needles or inject illegal drugs, like heroin
• Patients who are on hemodialysis or kidney dialysis for an extended period of time
• People who had piercings or tattoos with equipment that wasn’t properly sterilized (this is most common in prison settings; research has shown that hep C isn’t spread in licensed tattoo businesses)
• Healthcare workers and others who have been exposed to infected blood and/or contaminated equipment
• People diagnosed with HIV or AIDS
• Children born to a mother with hep C
• People who have unprotected sex with someone who has hep C, or have shared personal items with someone who has hep C

Hep C is more common than many people think. Knowing what it is, how people get it and who's at risk can help keep it from spreading. Learn how hep C is diagnosed and the next steps after diagnosis. 

Published on March 1, 2016. Updated on April 7, 2017.

Marijke Vroomen Durning, RN, has written articles for numerous healthcare sites and is the author of Just the Right Dose: Your Smart Guide to Prescription Drugs & How to Take Them Safely.