The liver is your largest internal organ. About the size of a football, it's located mainly in the upper right portion of your abdomen — beneath the diaphragm and above your stomach — but a small portion extends into the upper left quadrant.
Hepatitis C is a viral infection that causes liver inflammation, sometimes leading to serious liver damage. The hepatitis C virus (HCV) spreads through contaminated blood.
Until recently, hepatitis C treatment required weekly injections and oral medications that many HCV-infected people couldn't take because of other health problems or unacceptable side effects.
That's changing. Today, chronic HCV is usually curable with oral medications taken every day for two to six months.
Still, about half of people with HCV don't know they're infected, mainly because they have no symptoms, which can take decades to appear. For that reason, the U.S. Preventive Services Task Force recommends that all adults ages 18 to 79 years be screened for hepatitis C, even those without symptoms or known liver disease. The largest group at risk includes everyone born between 1945 and 1965 — a population five times more likely to be infected than those born in other years.
Long-term infection with the hepatitis C virus is known as chronic hepatitis C. Chronic hepatitis C is usually a "silent" infection for many years, until the virus damages the liver enough to cause the signs and symptoms of liver disease.
Signs and symptoms include:
- Bleeding easily
- Bruising easily
- Poor appetite
- Yellow discoloration of the skin and eyes (jaundice)
- Dark-colored urine
- Itchy skin
- Fluid buildup in your abdomen (ascites)
- Swelling in your legs
- Weight loss
- Confusion, drowsiness and slurred speech (hepatic encephalopathy)
- Spiderlike blood vessels on your skin (spider angiomas)
Every chronic hepatitis C infection starts with an acute phase. Acute hepatitis C usually goes undiagnosed because it rarely causes symptoms. When signs and symptoms are present, they may include jaundice, along with fatigue, nausea, fever and muscle aches. Acute symptoms appear one to three months after exposure to the virus and last two weeks to three months.
Acute hepatitis C infection doesn't always become chronic. Some people clear HCV from their bodies after the acute phase, an outcome known as spontaneous viral clearance. In studies of people diagnosed with acute HCV, rates of spontaneous viral clearance have varied from 15% to 25%. Acute hepatitis C also responds well to antiviral therapy.
Hepatitis C infection is caused by the hepatitis C virus (HCV). The infection spreads when blood contaminated with the virus enters the bloodstream of an uninfected person.
Globally, HCV exists in several distinct forms, known as genotypes. Seven distinct HCV genotypes and more than 67 subtypes have been identified. The most common HCV genotype in the United States is type 1.
Although chronic hepatitis C follows a similar course regardless of the genotype of the infecting virus, treatment recommendations vary depending on viral genotype.
Your risk of hepatitis C infection is increased if you:
- Are a health care worker who has been exposed to infected blood, which may happen if an infected needle pierces your skin
- Have ever injected or inhaled illicit drugs
- Have HIV
- Received a piercing or tattoo in an unclean environment using unsterile equipment
- Received a blood transfusion or organ transplant before 1992
- Received clotting factor concentrates before 1987
- Received hemodialysis treatments for a long period of time
- Were born to a woman with a hepatitis C infection
- Were ever in prison
- Were born between 1945 and 1965, the age group with the highest incidence of hepatitis C infection
Normal liver vs. liver cirrhosis
A normal liver (left) shows no signs of scarring. In cirrhosis (right), scar tissue replaces normal liver tissue.
Liver cancer begins in the cells of the liver. The most common form of liver cancer begins in cells called hepatocytes and is called hepatocellular carcinoma.
Hepatitis C infection that continues over many years can cause significant complications, such as:
- Scarring of the liver (cirrhosis). After decades of hepatitis C infection, cirrhosis may occur. Scarring in your liver makes it difficult for your liver to function.
- Liver cancer. A small number of people with hepatitis C infection may develop liver cancer.
- Liver failure. Advanced cirrhosis may cause your liver to stop functioning.
Protect yourself from hepatitis C infection by taking the following precautions:
- Stop using illicit drugs, particularly if you inject them. If you use illicit drugs, seek help.
- Be cautious about body piercing and tattooing. If you choose to undergo piercing or tattooing, look for a reputable shop. Ask questions beforehand about how the equipment is cleaned. Make sure the employees use sterile needles. If employees won't answer your questions, look for another shop.
- Practice safer sex. Don't engage in unprotected sex with multiple partners or with any partner whose health status is uncertain. Sexual transmission between monogamous couples may occur, but the risk is low.