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JAMA Patient Page
August 13, 2014

Hepatitis C

JAMA. 2014;312(6):664. doi:10.1001/jama.2013.281899

Hepatitis C virus (HCV) is an infection that affects the liver.

Hepatitis C is contagious and is usually transmitted through blood. People with acute HCV, a short-term illness, usually do not have symptoms. In rare cases, acute HCV may cause fever, nausea and vomiting, and jaundice (yellowing of skin or eyes). Most people with acute HCV infection do not know they are infected, and most eventually develop chronic HCV, a long-term illness. Over time, 20% to 30% develop severe liver disease, such as cirrhosis or cancer, which can be fatal. Currently, most cases of hepatitis are newly diagnosed cases of chronic HCV among baby boomers (people born between 1945 and 1965). As a result, some health organizations have recommended that everyone in this age group be screened for HCV.

The August 13, 2014, issue of JAMA contains a review article about HCV treatment.

Risks for HCV

Hepatitis C can be transmitted in the following ways, among others. Baby boomers may have been exposed many years ago by

  • Injecting drugs

  • Having had a blood transfusion before 1992

  • Being on dialysis

  • Being exposed as a health care worker

  • Having sexual contact with someone who has HCV

  • Getting a tattoo or body piercing with an unclean tool

Fewer people are being infected with HCV than previously, in part because the blood supply for transfusions is safer. Also, fewer people are injecting drugs, and those who do so are less likely to share needles.

Symptoms

If you have chronic HCV infection, you may not have any symptoms. The most common symptom is feeling tired. However, the virus can affect the kidneys, skin, and other organs.

Screening

A blood test is used to screen for HCV. If you are found to have chronic HCV infection, your doctor may perform other tests to determine the degree of liver damage. Tests may include a liver biopsy (using a special needle, taking a small sample of cells from the liver) to help make decisions about treatment.

Baby boomers are 5 times more likely to have HCV infection than people who are younger or older. As a result, 2 government health organizations recommend that everyone in this age group receive a one-time screening for HCV, even if they have no risk factors. Talk to your doctor about your need for screening.

Treatment

Treatment for the most common type of chronic HCV is a combination of the drugs peginterferon; ribavirin; and boceprevir, telaprevir, or sofosbuvir. A number of additional new treatments are currently in development.

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For More Information

To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA’s website at jama.com. Many are available in English and Spanish.

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Article Information
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.

Conflict of Interest Disclosures: The author has completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.

Sources: Centers for Disease Control and Prevention, US Preventive Services Task Force, National Library of Medicine
Rutherford A, Dienstag JL. Viral hepatitis. In: Greenberger NJ, et al. Current Diagnosis and Treatment: Gastroenterology, Hepatology, and Endoscopy. 2nd ed. New York, NY: McGraw-Hill Companies Inc; 2012:chap 39.

Topic: Infectious Diseases

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