Hepatitis C is a viral infection that affects the liver. It causes swelling and inflammation, which deteriorates the liver tissues. There are several causes of hepatitis, and some of them are viruses. In contrast to the other viral hepatitis causes, hepatitis C lingers in the body. When one has chronic inflammation for several years, it damages the liver. Hepatitis C is one of the country’s most prevalent causes of liver transplantation and liver failure.

Usually, people do not know when they have an inflamed liver because they do not experience any symptoms until severe damage has already been done.

Causes
The virus spreads when the body fluids or blood contaminated with the hepatitis C virus enters the bloodstream via contact with an infected person. One can be exposed to the virus from any of the following:

• Getting a piercing or tattoo via an unclean equipment
• Sharing personal care items like nail clippers, razor blades, and toothbrushes
• Getting the virus when in the womb
• Getting tattooed
• Sharing unsanitized tattoo equipment
• Indulging in rough intercourse or having sex with several partners
• Having sex when one has an STD or HIV

However, contrary to popular belief, the things listed below are not responsible for hepatitis C transmission:

• Holding hands
• Coughing
• Casual contact
• Breastfeeding (unless nipples are bleeding and cracked)
• Kissing
• Hugging
• Mosquito bites
• Sneezing
• Sharing drinks or food
• Holding hands
• Sharing eating utensils

Risk factors
Ideally, one must undergo testing for hepatitis C in the following circumstances:

• One has HIV.
• One is 18 or older.
• One received blood from a donor with the disease.
• One is pregnant.
• One underwent an organ transplant or a blood transfusion before July 1992.
• One was born to a mother with hepatitis C.
• One’s liver tests are abnormal.
• One has liver disease.
• One has been on kidney dialysis for a while.
• One was exposed to blood from a person with hepatitis C.
• One received a blood product to cure clotting problems before 1987.

Since July 1992, all organ and blood donations in the country have been testing donors for the hepatitis C virus. Hence, it is rare for someone to receive organ transplants or blood products to get hepatitis C.

Symptoms
Long-term hepatitis C infection is called chronic hepatitis C. It is typically a silent infection for several years until the virus begins damaging the liver to trigger symptoms of liver disease. Some common symptoms are as follows:

• Dark-colored urine
• Bruising or bleeding easily
• Poor appetite
• Fatigue
• Jaundice
• Itchy skin
• Swelling in the legs
• Ascies or fluid buildup in the abdomen
• Spider angiomas
• Drowsiness, confusion, and slurred speech

Chronic hepatitis C begins with an acute infection, which goes undiagnosed as it does not cause any symptoms. However, some people experience muscle aches, fever, nausea, and fatigue. Acute symptoms appear one to three months after virus exposure and last 14 to 90 days.

Acute hepatitis C does not necessarily translate to chronic. Some people eliminate HCV from their bodies during the acute phase, an outcome called spontaneous viral clearance. Antiviral therapy can help combat hepatitis C.

Diagnosis
Often, the diagnosis can come from a routine blood panel that shows abnormal liver enzymes. Some people take tests because of their risk factors, like a history of blood transfusions or exposure to needles. However, doctors recommend the following tests for diagnosis:

• Blood tests
  Those with hepatitis C will have the antibody, but it usually takes months or weeks to develop. So, if one undergoes a test immediately after exposure, the result may be a false negative. But if the result is positive for hepatitis C antibody, one must take the sensitive test to detect minute hepatitis C amounts in the blood. It is called PCR-based diagnosis.
• Liver biopsy
  As part of this procedure, the liver tissue is removed and sent to the lab for testing. Though not invasive, it carries some risk that helps the doctor assess the precise severity and nature of the condition. At times, a biopsy can help determine treatment options. For instance, if the biopsy is normal, one can postpone treatment, but if it shows extensive disease, one must begin treatment immediately.

Treatment options
Direct-acting antivirals can help cure most chronic and acute hepatitis C cases. These are modern treatment options approved in 2013. People can tolerate these treatments but experience side effects like fatigue and headache. Such treatments target specific steps in the HCV lifecycle and disrupt viral cell reproduction.

The duration and choice of treatment depend on the virus genotype. In the country, genotype 1a is the most common.