Hepatitis means inflammation of the liver. Viruses are a frequent cause of hepatitis. One of the common hepatitis viruses is hepatitis C. When the liver is infected with a virus, it becomes inflamed and usually becomes tender and swollen. The infection may destroy patches of liver tissue. If you are infected with hepatitis C, you may develop chronic (ongoing) liver disease. Even mild cases tend to get worse over time, often resulting in cirrhosis of the liver. Hepatitis C also increases the risk of liver cancer.

How does it occur?

Two common causes of hepatitis C are intravenous (IV) drug abuse and blood transfusions. Before 1990 the hepatitis C virus was the most common cause of hepatitis in people who had blood transfusions. However, now blood donors can be screened for the virus. Hepatitis C can be spread by people who do not have an active infection. They are called asymptomatic carriers.

What are the symptoms?

The symptoms of hepatitis C are similar to the symptoms of other forms of viral hepatitis. Symptoms may appear 2 weeks to 6 months after you are infected. The disease usually begins with typical symptoms of infection:

loss of appetite
weight loss
fever
general achiness
fatigue.

Other early symptoms may include:

itching hives
pain in some of the joints
in smokers, a loss of taste for cigarettes.

The following symptoms may follow several days after the early symptoms:

nausea and vomiting
foul breath and bitter taste in the mouth
dark urine
yellowish skin and eyes (jaundice)
pain just below the ribs on the right side, especially when pressure is applied
bowel movements that are whitish or light yellow and may be looser than normal.

Some people develop a chronic form of the disease without any obvious symptoms, even though damage to the liver may be occurring. The symptoms of chronic hepatitis may be persistent fatigue, weakness, and loss of appetite, as well as some of the other symptoms listed above.

How is it diagnosed?

Your medical history and symptoms are the important first step in diagnosis. Especially important is your history of hepatitis risk factors such as blood transfusions or IV drug abuse. When your health care provider examines you, he or she may find that your liver is enlarged and tender. Your provider may use the following lab tests:

blood tests
analysis of a urine specimen
analysis of a stool specimen.

Hepatitis C can now be diagnosed with a blood test. It may be discovered at a routine exam when liver function tests are abnormal. To diagnose chronic hepatitis, the health care provider may order a liver biopsy, a procedure in which a small amount of liver tissue is removed for examination. This is done through the skin after you are given a local anesthetic.

How is it treated?

Your health care provider will recommend getting rest, having a nutritious diet, and avoiding alcohol and certain medications for at least 6 months. Hospitalization isn't usually necessary. In more serious cases (for instance, if you become severely dehydrated), you may need to be hospitalized. Alpha interferon can be used to treat chronic hepatitis C. Adequate nourishment and avoiding overexertion and alcohol are also important in treating chronic hepatitis. To reduce inflammation, your health care provider may prescribe steroids. Regular exams are very important and may continue at regular intervals for months to years.

How long will the effects last?

Symptoms may last from 1 to 6 weeks and are usually followed by complete recovery. Relapse is common, however, and can be triggered by drinking too much alcohol or exerting yourself before you are fully recovered. It may also be caused by another infection. Relapses are usually milder than the initial infection and respond well to rest. After having hepatitis C, a third to half of patients develop chronic hepatitis. As many as 35% develop chronic liver disease, including cirrhosis. Your health care provider may check your blood every few months for signs of chronic liver disease.

How can I take care of myself?

Avoid taking drugs that are metabolized in the liver. Ask your health care provider which drugs these are.
Rest in bed until your fever is gone, your urine returns to its normal color, and your jaundice disappears. Ask your health care provider how much bed rest is necessary and when you should resume normal activity.
As your symptoms improve, you may gradually increase your level of activity. Avoid strenuous activities for several months.
Eat small, balanced meals, even when you feel nauseous. Some foods may not appeal to you, especially in the early stages of the disease. Lightly carbonated soft drinks, juices, and hard candy may help reduce nausea.
Follow your health care provider's instructions for taking medicines to relieve your symptoms.

See your health care provider if any of the following occurs:

Your appetite continues to decrease.
You have worsening drowsiness, confusion, or irritability.
You have vomiting, diarrhea, or abdominal pain. • Your jaundice worsens.
You have a rash or your skin itches.

What can be done to help prevent spreading hepatitis C?

Use good health habits. Take special care to wash your hands thoroughly with soap and warm water after using the bathroom and before eating or preparing food.
Do not let others come in contact with your blood; for example, when you have a bloody nose or a cut.
Avoid sharing needles, razor blades, and toothbrushes with others.
Avoid sexual activity until the disease is no longer contagious.
Avoid donating blood if you have hepatitis or may be a carrier.

At this time there is no immunization for hepatitis C.

Robert B. McWilliams, MD

Return to Infertility and Women's Health Care Articles

Robert B. McWilliams, MD Reproductive Endocrinology and Gynecology

Hepatitis C

Robert B. McWilliams, MD
Reproductive Endocrinology
and Gynecology