What is it?

Hepatitis C is a liver infection caused by the hepatitis C virus (HCV). Unlike hepatitis B, there is no vaccine. However, hepatitis C is now curable in more than 95% of cases with 8–12 weeks of oral antiviral treatment (direct-acting antivirals / DAAs). Without treatment, chronic hepatitis C can lead to cirrhosis, liver failure, and liver cancer over decades.

How it spreads

Hepatitis C spreads primarily through blood-to-blood contact:

  • Sharing needles, syringes, or drug equipment (most common route)
  • Sexual transmission — less common, but possible during anal sex with bleeding, or when a partner has HIV
  • Sharing personal items like razors or toothbrushes (low risk)
  • From mother to baby during birth
  • Healthcare settings with poor infection control (less common in high-income countries)

HCV is not spread through hugging, kissing, sharing food or water, or casual contact.

Symptoms

Most people with acute hepatitis C have no symptoms. When present:

  • Fatigue
  • Nausea or stomach pain
  • Dark urine, pale stools
  • Jaundice (yellowing of skin and eyes)
  • Fever

75–85% of people develop chronic infection and may have no symptoms for decades while liver damage accumulates. This is why routine testing matters — most people discover HCV through a blood test, not symptoms.

Testing

Testing involves two steps:

1. HCV antibody test (screening) — detects antibodies, window period 8–11 weeks. A positive result means past or current infection.

2. HCV RNA test (confirmatory) — detects active virus, confirms current infection

The CDC recommends hepatitis C testing:

  • At least once for all adults aged 18–79
  • During every pregnancy
  • Regularly for people who inject drugs or have other risk factors

Treatment

Hepatitis C is curable. Direct-acting antivirals (DAAs) achieve cure (SVR — sustained virologic response) in 95%+ of people:

  • Treatment duration: 8–12 weeks of daily oral pills
  • Minimal side effects compared to older interferon-based treatment
  • Works for all genotypes
  • Curing HCV does not provide immunity — re-infection is possible

After cure, regular liver monitoring is still recommended for people with advanced fibrosis. Avoid alcohol during and after treatment.

Prevention

No vaccine exists for hepatitis C. Prevention:

  • Don't share needles, syringes, or drug equipment — this is the most important step
  • Use sterile equipment; harm reduction programs provide clean supplies
  • Use condoms to reduce sexual transmission risk
  • Don't share razors, toothbrushes, or nail clippers
  • Healthcare workers: follow standard precautions

For people who inject drugs, opioid treatment programs and syringe service programs significantly reduce HCV transmission.