Hepatitis C Fact File

Hepatitis C (often called Hep C) is a blood-borne virus impacting the liver. Understanding how it works, how you might find out you have it, how to treat it, and how to protect yourself is really important. If you think you might have been exposed, it’s best to get medical advice quickly.

What is Hepatitis C?

Hepatitis C is caused by the Hepatitis C virus (HCV). It primarily infects liver cells, causing inflammation. This can be short-term (acute) or long-term (chronic). Over years, chronic infection can lead to serious liver damage such as cirrhosis, liver failure, or even liver cancer.

Unlike hepatitis B, there is currently no vaccine to prevent hepatitis C. That absence makes prevention more dependent on behaviour and awareness. On the plus side, treatment has improved significantly in recent years. The medications available today mean that many people who contract hepatitis C can now be cured completely. But even though treatment exists, that doesn’t mean it’s not serious. Left undetected or untreated, hepatitis C can quietly damage the liver for years before anyone realises.

For some people, hepatitis C is a short-lived illness that the body clears on its own. But for most, it becomes chronic. Once it's chronic, it doesn't tend to go away on its own. That doesn’t necessarily mean it will lead to severe illness, but it does mean it needs monitoring and usually treatment.

You might hear different ‘genotypes’ of the virus mentioned. That’s just a way of classifying different strains. While there are several genotypes, the treatment approach is broadly similar thanks to advances in medication.

If you're unsure whether you're at risk, the general rule is this: if you've ever had potential blood-to-blood contact with someone else, especially through injecting equipment or medical procedures in less regulated settings, it’s worth getting tested. Even if it was years ago.

 

How Hepatitis C is Spread (Transmission)

Hepatitis C is a blood-borne virus, meaning it requires infected blood to enter another person’s bloodstream.

Here are common ways the virus is passed on:

• Sharing needles, syringes or other equipment for injecting drugs, performance-enhancing drugs etc
• Receiving blood transfusions, organ transplants, or certain blood products (especially in the UK before safe screening was in place)
• Medical, dental, tattooing, piercing or cosmetic procedures, particularly where infection control is poor
• Sharing personal items that may have even tiny amounts of blood on them - razors, toothbrushes, nail tools etc
• Mother to baby (vertical transmission) - a pregnant person with hepatitis C can pass the virus to their child, though this is relatively uncommon
• Unprotected sex is a less common route. The risk is low but increases if blood is present (for example with sores, STIs, or during menstruation) or among certain groups

The virus is relatively hardy outside the body compared to some others. It can survive in dried blood for several weeks. This is one of the reasons why even sharing something like nail scissors or tweezers with microscopic blood residue can pose a small risk.

The good news is that hepatitis C is not spread through casual contact. You cannot get it by hugging, shaking hands, coughing or sneezing. You won’t catch it from sharing drinks or food with someone. That’s worth knowing because stigma still surrounds this virus in some situations, and much of it is based on misunderstandings about how it spreads.

In the UK today, most new infections are linked to injecting drug use, which is why public health measures like clean needle programmes are crucial. But it's also worth noting that some people living with hepatitis C may have acquired it from medical procedures done decades ago when safety standards weren't what they are today.

Symptoms of Hepatitis C

One of the tricky things about hepatitis C is that many people don’t notice anything for a long time. Symptoms may be few or vague in the early stages.

When symptoms do occur (often in acute infection, or if liver damage has started), they can include:

• Feeling very tired or having reduced energy
• Flu-like symptoms: fever, muscle aches, general unwell feeling
• Loss of appetite, nausea or being sick
• Abdominal pain or discomfort (especially around the liver)
• Dark urine, pale or clay-coloured stools
• Jaundice (yellowing of skin and eyes) in more obvious cases

The early (acute) stage might pass without you even realising. Some people get a bout of flu that never seems to fully make sense. Others feel off for weeks but don’t connect it with something like hepatitis. That’s one of the reasons the virus can persist and go undiagnosed.

In chronic hepatitis C, symptoms may remain mild or entirely absent for many years. When they do start to show, it’s often because the liver has already taken some damage. People might complain of fatigue, mental fog, or unexplained aches. These are easy to brush off as just life. But when paired with risk factors, they warrant further investigation.

Jaundice tends to be more associated with significant liver damage. If someone reaches this point without diagnosis, their hepatitis C has probably gone untreated for a long time. That’s why screening is so important, to catch it before it gets to that stage.

Because the liver is a fairly silent organ (it doesn’t ‘complain’ until something is seriously wrong), hepatitis C has often been called a silent infection. And unfortunately, in many people, that silence lasts until years later, when the damage is more difficult to undo.

Diagnosing Hepatitis C

Early detection can prevent serious complications. Here’s how diagnosis usually works:

1. Risk assessment / medical history
   Health care providers will ask about possible exposure: injecting drug use, blood transfusions in the past, tattoos or piercings in less safe settings, etc.
2. Blood tests

   1. First, a test for antibodies to see if a person has ever been infected.

   2. If antibody test is positive, then a test for viral RNA (to see if the virus is still active) is done.

3. Liver function tests and imaging
   To check for damage to the liver (inflammation, fibrosis, cirrhosis). This can include blood marker tests, ultrasound or other imaging if needed.

4. Assessing severity
   Once diagnosed, doctors may check how far liver damage has progressed, whether there are complications, risk factors (alcohol, other liver disease, co-infections). This helps guide treatment decisions.

The process usually starts with something simple, like a finger prick test or standard blood draw. If you test positive for hepatitis C antibodies, it doesn’t always mean you still have the virus. Some people clear it on their own. That’s why the second test, looking for actual virus (RNA) is so important.

You might also have tests to check liver enzyme levels (ALT, AST), which can show whether your liver is inflamed. But these levels can be normal even when hepatitis C is active, so they’re not enough on their own.

More detailed assessments, like a Fibroscan or liver biopsy, are only needed in some cases. These look at how much scarring (fibrosis) is present and help doctors decide how urgently treatment is needed. But with today’s medicines, many clinicians focus less on staging the liver and more on getting people treated quickly.

Many people discover they have hepatitis C entirely by accident. They might be having blood tests for another reason, or donating blood, or applying for life insurance. That’s why awareness matters, if you know your history involves risk, even from years ago, ask to be tested. It’s a simple step that can change everything.

 

Treatment for Hepatitis C

Good news: treatment for hepatitis C has been transformed in the past decade. It’s no longer the difficult and draining process it once was. Today, most people can be cured with just a short course of oral tablets - no injections, and usually no major side effects.

• Direct-acting antivirals (DAAs)
  These are a class of medicines that work by targeting specific steps in the virus’s life cycle, stopping it from reproducing. The result? In the vast majority of cases, the virus becomes undetectable and stays that way. A full cure.
• Course length and success rates
  A typical treatment course lasts between 8 to 12 weeks. For most people, it’s a once-a-day tablet. Cure rates are above 95%, even for people who have had the virus for years or have some liver damage already.
• Minimal side effects
  Most people experience few, if any, side effects from DAAs. Some report headaches or tiredness, but these are generally manageable. Compared to the older treatments (which involved interferon injections and lots of unpleasant side effects), it’s a massive improvement.
• Post-treatment testing
  After you complete treatment, you’ll have a follow-up blood test, usually after 12 weeks, to confirm the virus is gone. This is called a sustained virologic response (SVR). If the virus is undetectable at that point, it’s considered cured.
• Treatment access
  In the UK, hepatitis C treatment is available through the NHS. Some people are referred through GPs, others through sexual health clinics, addiction services, or liver specialists. Increasingly, community services and pharmacies are offering access points too.

The main challenge now is not the treatment itself but making sure people know they have the virus in the first place. Because symptoms are so silent, many people are living with hepatitis C without realising. That’s why the push to expand testing is so important.

Even if you had hepatitis C in the past and were told it wasn’t treatable or you didn’t qualify, it’s worth asking again. The landscape has changed. What wasn’t possible five or ten years ago is now routine.

Getting treated doesn’t just benefit your health, it also stops the spread of the virus. Once cured, you can’t pass it on. So treatment plays a public health role too.

Preventing Hepatitis C & Reducing Spread

Since there’s currently no vaccine for hepatitis C, prevention focuses entirely on reducing exposure to infected blood. For many people, that means staying informed, being careful, and not making assumptions about who might be at risk.

Here’s what prevention looks like in practical terms:

• Never share needles, syringes or any injecting equipment. Use sterile supplies
• If using drugs, access to harm reduction services (needle exchanges, supervised injecting services etc.) is crucial
• Ensure medical, dental, tattooing, piercing practices use fully sterile, single-use or properly sterilised equipment. Avoid unregulated settings
• Safe sex practices - using barrier methods like condoms especially if there’s risk of blood contact (sores, menstruation, STIs)
• Avoid sharing personal hygiene items that might have blood contamination (razors, toothbrushes etc.)
• Screening and testing of blood/blood products, medical equipment and procedures to ensure safety

Public health campaigns in the UK have begun to focus more on awareness because the more people know, the more likely they are to protect themselves and others. Testing, treatment and education go hand in hand. Prevention isn’t just about saying "don’t do this", it’s about making the safer option easier and more accessible.

 

Living with Hepatitis C

A diagnosis of hepatitis C can be a shock, especially if it comes out of the blue. But it’s important to know that with modern treatments and the right lifestyle, most people go on to live full, healthy lives.

Living with hepatitis C before treatment or while waiting for it means taking care of your liver in any way you can. That often involves small, consistent choices:

• Avoiding alcohol is key. Even moderate drinking can add stress to a liver already under strain from the virus
• Eating well - plenty of fruits, vegetables, lean protein and fibre helps support overall liver health
• Keeping active might not seem related, but physical activity supports your immune system, boosts mood, and can help manage fatigue.

Mental health is a part of the picture too. Chronic illness can bring anxiety, low mood, or isolation. Some people feel shame about how they got the virus, which can be compounded by stigma or misinformation. It’s important to challenge those feelings, they're not helpful or accurate. Hepatitis C is a virus, not a moral judgment.

If you're undergoing treatment, you'll likely have some appointments to attend and tests to check how things are progressing. The good news is that the treatment window is short for most, and the success rate is high.

Even after you're cured, it's worth continuing to look after your liver. The damage done before treatment may not always be reversible, though further damage can certainly be prevented. And just because you’re cured once doesn’t mean you can’t get re-infected. Reinfection is possible, especially if risky behaviours continue.

Support networks can really help, whether that's friends, healthcare providers, or peer groups. You don’t have to manage everything on your own. Many services now treat hepatitis C as a wider wellbeing issue, not just a medical one.

Complications if Untreated

While hepatitis C can often be silent, the long-term consequences of leaving it untreated can be significant. The virus causes persistent inflammation in the liver, and over time this can lead to scarring, also known as fibrosis.

• Fibrosis is the early stage of liver scarring. It may not cause symptoms at first
• Cirrhosis is more severe. The liver becomes hardened and lumpy, struggling to function properly. This can take years to develop, but once present, it’s serious
• Liver failure can happen when too much liver tissue has been damaged
• Liver cancer (specifically hepatocellular carcinoma) becomes a greater risk once cirrhosis develops

The complications don’t stop with the liver. People with advanced liver disease may experience issues like:

• Bleeding problems, due to poor blood clotting
• Fluid build-up in the abdomen (ascites)
• Mental confusion (hepatic encephalopathy), caused by toxins the liver can no longer filter

These complications can have a huge impact on day-to-day life. But what makes this all more frustrating is that it’s preventable. With today’s treatments, most people don’t need to face these outcomes.

Even if you’ve had hepatitis C for years, it’s not too late. Early detection and prompt treatment can stop the virus in its tracks and even allow the liver to repair itself over time.

Hepatitis C and Pregnancy

Hepatitis C doesn’t necessarily interfere with fertility or the ability to have children. But there are a few things worth knowing if you’re pregnant or planning to become pregnant while living with the virus.

• Mother-to-baby transmission is possible but uncommon. Around 5% of babies born to mothers with hepatitis C will contract the virus during birth
• Breastfeeding is generally safe. The virus is not found in breast milk. The only caution is if the nipples are cracked or bleeding, in which case it’s advised to temporarily stop
• Treatment during pregnancy is not currently recommended. Most antiviral medications haven’t been tested for safety in pregnancy. So if you’re planning to conceive, your doctor may suggest waiting until treatment is completed
• Newborn testing is important. Babies born to hepatitis C-positive mothers should be tested after birth to confirm whether they were infected. Most will not be

If you’re thinking about pregnancy or already pregnant and have hepatitis C, it’s worth discussing your options with a specialist. Timing treatment around pregnancy can help protect both your health and your child’s.

Why It Matters

Hepatitis C is a serious infection, but one that is now highly treatable. In many cases, it’s curable. The real challenge is that it often goes unnoticed for years, quietly affecting the liver until symptoms finally surface.

But the tools are there: testing is widely available, treatment is simple and effective, and support exists to help people move forward.

If you’ve ever been at risk even if it was a long time ago, it’s worth checking. A single blood test could offer peace of mind, or a path to treatment and recovery. Either way, you’re in a better position if you know.

With continued public awareness, education, and access to care, hepatitis C can be tackled. And for the individual, taking that first step getting tested is often the most powerful one.

← Previous Post Next Post →