Hepatitis C infection is caused by the Hepatitis C virus. It causes inflammation of the liver and if left untreated, Hepatitis C can cause long-lasting damage such as liver cirrhosis.
Hepatitis C is primarily transmitted through direct contact with infected blood. Even though blood is not the only body fluid that can contain the Hepatitis C virus, it is in the blood that the highest concentrations of virus are present. As a consequence only a small trace of blood may have sufficient amounts of the virus present to cause infection. It is rare for Hepatitis C to be transmitted solely through unprotected sex.
In the UK, it has been estimated that around 118,000 people had Hepatitis C in 2019.
There is currently no effective vaccine against Hepatitis C, therefore testing is very important.
The great news is that Hepatitis C is curable, and most people are able to live a full and healthy life once treated.
What are the symptoms of Hepatitis C?
Hepatitis C affects people differently. Many people infected with Hepatitis C do not develop symptoms until it has caused significant damage to the liver. As a result, they may not realise they are infected with Hepatitis C until they get tested.
If you have Hepatitis C for less than six months, this is known as an acute infection. Those who have Hepatitis C for more than six months are known as having chronic Hepatitis C.
Symptoms that can develop in those with Acute Hepatitis C include:
- Body aches and high temperature.
- Feeling tired all the time.
- Loss of appetite and stomach ache.
- Feeling nauseous or vomiting.
Symptoms that can develop in those with Chronic Hepatitis C include:
- Muscle aches and pains.
- Feeling tired all the time.
- Feeling nauseous.
- Brain fog.
- Depression or anxiety.
- Itchy skin.
- Indigestion or bloating.
- Abdominal pain.
- Swelling around the abdominal area.
- Unexplained weight loss.
When do symptoms of Hepatitis C start to appear?
Symptoms usually appear 2 to 12 weeks after exposure. However, not everyone will develop symptoms.
Can I pass Hepatitis C to others if I have no symptoms?
Yes. It is possible to pass Hepatitis C to others even if you have no symptoms.
What causes Hepatitis C?
Hepatitis C is caused by the Hepatitis C virus (HCV). It is transmitted through direct contact with infected blood. You can become infected with Hepatitis C by:
- Sharing needles and syringes used to prepare and inject drugs.
- Having sexual intercourse (especially chem-sex).
- Sharing personal items such as toothbrushes, razors, nail clippers, or any other personal items that could be in contact with infected blood.
- Getting tattooed with unsterile needles.
- Birth (babies born to infected mothers may have an increased risk of getting Hepatitis C).
- Not following safety procedures if you are a doctor, nurse, dentist or healthcare worker. These professions can increase your risk of needlestick injuries.
Although rare, it is possible for Hepatitis C to be passed on during sexual intercourse.
Hepatitis C is not spread by kissing, hugging, water, food, breast milk, holding hands, towels, toilet seats, or sharing cutlery.
What factors can increase the likelihood of getting Hepatitis C?
Your risk of getting Hepatitis C may be increased if you are:
- A HIV-positive man who has sex with other men.
- Born to a Hepatitis C infected mother.
- Born between 1945 and 1965.
- Received a blood transfusion or organ transplant before 1992.
- Received a blood clotting factor for hemophilia before 1987.
- On haemodialysis and there is poor infection control.
Think you might have Hepatitis C?
Can Hepatitis C be cured?
Yes, Hepatitis C can be cured.
The treatment course is usually short and most people are able to clear the virus within 12 weeks. If you have not cleared the virus after finishing your first course of treatment then a new combination or a longer course may be offered.
How do I know if I am eligible for treatment?
Your eligibility for treatment varies depending on:
- Which country you are from.
- What genotype you have been diagnosed with.
- The extent of your liver damage.
- Whether you have had treatment before.
How effective is the treatment for Hepatitis C?
Hepatitis C treatment is very effective. According to the World Health Organisation (WHO), antiviral medication can cure more than 95% of people with a Hepatitis C infection.
What happens if the treatment does not work?
If your Hepatitis C treatment does not clear the virus, a different combination of drugs may be offered. The treatment may also be extended or repeated until the virus has cleared.
Should I tell my partners that I have tested positive for Hepatitis C?
Yes. It is essential that you tell your partners you have tested positive for Hepatitis C. Although Hepatitis C is a blood borne virus, it can still be passed on through sexual contact (although rare). Therefore, it is important that your partners get tested to prevent the possibility of exposing Hepatitis C to others.
Will my partner also need Hepatitis C treatment?
Unless your partner also tests positive, they will not require Hepatitis C treatment. However, there are various precautions that you and your partner will need to take whilst on treatment:
Is there anything else that I should do if I have Hepatitis C?
There are many things you can do at home when you are dealing with Hepatitis C, for example:
- You should maintain a healthy diet.
- You should maintain a healthy level of exercise.
- You should quit smoking and limit your alcohol intake.
- You should not share any personal items such as razors, toothbrushes, body piercings, and other personal hygiene items.
- You should practice safe sex. This includes wearing a condom to prevent any vaginal fluids or semen from entering your partner’s body and notifying your sexual partners of your Hepatitis C status.
- Be mindful that condoms may break and that rough sex can cause small tears inside the vagina where seminal fluids may enter.
- Notify any one who may be in contact with your blood that you have Hepatitis C. This includes those individuals who are nurses, dentists, body piercers, tattooists, and anyone else who may be exposed to your blood.
Can I be treated for Hepatitis C even if I am pregnant?
Hepatitis C transmission from mother to baby is uncommon. According to the Hepatitis C Trust, the risk of transmission is 2-8%. However, if the mother is also infected with HIV at the time of birth, the risk of Hepatitis C transmission may be higher.
If you are pregnant and are infected with Hepatitis C, or you are particularly worried that you may be exposed to the virus, please discuss this with your healthcare provider.
In regards to a caesarean delivery, there is no evidence that supports a higher risk of transmission from giving birth this way.
It is also safe to breastfeed your baby. However, if your nipples are cracked or bleeding, please do not breastfeed until they have healed.
Will I need any follow up tests?
If you have an acute Hepatitis C infection you will need to have a Hepatitis C RNA PCR test 6 months after your initial positive test result to see if your body has cleared the virus.
If you have a chronic Hepatitis C infection, you will need to have multiple blood tests done in order to review the impact and the progression of the infection in your body. After completing your treatment, a HCV RNA PCR test will be done to confirm whether the virus has been cured.
What is the long term prognosis for someone who has Hepatitis C?
Around 95% of patients with Hepatitis C can be effectively treated and cured.
Acute Hepatitis C infections are usually asymptomatic and most do not lead to a life-threatening disease. Around 30% of infected patients clear the virus within 6 months of infection.
The remaining 70% will develop a chronic Hepatitis C infection. Those with chronic Hepatitis C will have a 15% to 30% risk of developing liver cirrhosis over the course of 20 years.
Once treated, am I immune from getting Hepatitis C again?
Successful treatment does not give you any protection against getting Hepatitis C again.
Can I develop natural immunity against Hepatitis C?
Unfortunately not. Having Hepatitis C in the past does not protect you from getting it again.
Is there anything I can do to prevent Hepatitis C from returning?
You may wish to engage in safe sex and avoid other situations that can expose you to Hepatitis C again.
Do I have to tell my partner I have been infected with Hepatitis C?
Yes. It is essential to tell your partner that you have been infected with Hepatitis C so that they can get tested to prevent the infection from passing on to others.
Will my children also have Hepatitis C?
The risk of transmission from a Hepatitis C infected mother to baby during birth is around 2-8%.
You should have your baby tested for Hepatitis C at around 18 months of age as the baby will automatically inherit the mother’s antibodies. It takes 18 months for the mother’s antibodies to leave the baby’s system.
If you are concerned about passing Hepatitis C onto your baby, speak to your clinician regarding possible options for treatment.
Book an appointment
Reviewed by: Mrs. Magda Novacka
Written By: Shannon Abraham
Last reviewed date: 14 February 2023
Next review due: 14 February 2026
Whilst this content is written and reviewed by sexual health specialists, it is for general guidance only. It is not intended to replace the advice of your clinician.
References & Further Reading
- British Liver Trust: Hepatitis C
- CDC: What is Hepatitis C – FAQ
- Terrence Higgins Trust: Hepatitis C
- The Hepatitis C Trust: Symptoms of infection with hepatitis C
- WHO: Hepatitis C
- NHS: Hepatitis C – Diagnosis
- The Hepatitis C Trust: Testing for hepatitis C
- NHS: Essential information for professionals and guidance on testing – Hepatitis C
- The Hepatitis C Trust: Mother to baby
- The Hepatitis C Trust: Genotypes of hepatitis C
- NHS: Hepatitis C – Treatment