๐ Hepatitis C: Blood Contact Transmission, 95% Cure Rate
Hepatitis C is a "silent disease"—many people are unaware they're infected. However, recent medical advances have introduced highly effective treatments boasting a cure rate of over 95%, transforming Hepatitis C from a feared disease into a highly treatable, manageable condition. Let's delve into Hepatitis C with a detailed yet easy-to-understand professional overview.
What is Hepatitis C?
Hepatitis C is an infectious disease that occurs when the Hepatitis C Virus (HCV) invades the liver. The virus attacks liver cells, causing inflammation that leads to tissue damage and swelling. Simply put, the liver—often called the body's chemical factory—fails to function properly due to the viral infection.
Crucially, the Hepatitis C virus is primarily transmitted through contact with infected blood. This is a key characteristic that distinguishes it from other hepatitis viruses. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), Hepatitis C presents in two forms: acute and chronic.
Acute Hepatitis C is short-term, lasting a few weeks to months, and sometimes the virus clears naturally. Chronic Hepatitis C occurs when the virus remains in the body for six months or longer. The major concern is that over half of acute cases progress to the chronic stage.
1. How Many People are Affected by Hepatitis C?
Globally, Hepatitis C is more common in Eastern Europe, Africa, the Middle East, and parts of Asia, where it's estimated that 2–6% of the population is infected. In countries like the US, where less than 1% of the population is infected, approximately 4,848 new acute cases were reported in 2022.
The actual number of cases is likely much higher, as many people have no symptoms and are therefore unaware of their infection. In the US, Hepatitis C is the most common chronic viral infection spread by blood, with an estimated 2 million people currently living with chronic HCV (NIDDK, 2024).
Even in lower-prevalence countries, such as South Korea, where the antibody positivity rate is around 0.5–1.2%, the focus is shifting to early detection through national health screening programs to expand treatment and improve outcomes.
2. Who is at Higher Risk for Hepatitis C?
Individuals with the highest risk of HCV infection include:
Current or Former Injecting Drug Users: This remains the most common transmission route globally.
Recipients of Blood Transfusions or Organ Transplants before widespread screening (e.g., before 1992 in the US).
Hemophiliacs who received clotting factor concentrates before 1987.
Healthcare Workers: Those exposed to blood or needlesticks on the job.
People with HIV: Lowered immunity increases risk.
Long-Term Hemodialysis Patients.
Children born to mothers with Hepatitis C (vertical transmission during birth).
3. Why Screening is Essential
The biggest challenge with Hepatitis C is that most infected individuals have no symptoms. By the time symptoms appear, liver damage is often advanced. Therefore, screening is paramount.
The US Centers for Disease Control and Prevention (CDC) and NIDDK recommend:
All adults should be screened for Hepatitis C at least once in their lifetime.
Pregnant women should be screened during each pregnancy.
Anyone with ongoing risk factors should be screened periodically.
Testing should be offered to anyone who requests it.
A simple blood test can determine the presence of the virus, the viral load, and the genotype of the virus.
4. What are the Symptoms of Hepatitis C?
Acute Hepatitis C
Symptoms may appear 2–12 weeks after exposure:
Dark urine and light-colored stools
Extreme fatigue
Fever
Joint or abdominal pain
Loss of appetite, nausea, vomiting
Jaundice (yellowing of the skin and eyes)
Chronic Hepatitis C
Many chronic carriers are asymptomatic for decades. Symptoms often appear only after complications like cirrhosis develop. Symptoms of cirrhosis include: extreme fatigue, itchy skin, weight loss, confusion or difficulty thinking, ankle swelling, and abdominal swelling (ascites).
5. How is Hepatitis C Transmitted?
Hepatitis C is transmitted only through contact with the blood of an infected person.
1) Situations Where Infection Can Occur:
| Situation | Explanation / Risk of Infection |
| Sharing needles or drug injection equipment | Direct transmission of infected blood remaining on the syringe/needle. |
| Accidental needlestick injury | Risk for healthcare workers or during caregiving. |
| Tattooing/piercing with unsterilized tools | Blood contact through contaminated equipment, needles, or ink. |
| Sharing an infected person’s personal hygiene items (razors, toothbrushes, nail clippers) | Possible cross-contamination through microscopic cuts and blood. |
| Born to an infected mother (vertical transmission) | Transmission via blood contact during the birthing process. |
| Unprotected sex with an infected partner (low probability) | Risk exists if blood is present in bodily fluids during sexual contact. |
2) Situations Where Infection Does NOT Occur:
| Situation | Explanation / No Risk of Infection |
| Coughing, sneezing, or talking | HCV is not spread by respiratory droplets. |
| Sharing food or water | Transmission does not occur through the digestive tract. |
| Hugging, shaking hands, or holding hands | Not transmitted by skin-to-skin contact alone. |
| Sharing utensils or towels | No risk unless contaminated with blood. |
| Sitting next to an infected person | Not transmitted through the air. |
Hepatitis C is transmitted only through 'blood-to-blood contact.' It is not spread through the respiratory system, digestive system, or casual skin contact. Therefore, everyday life with family or colleagues is safe. Breastfeeding does not transmit the virus, but should be avoided if the mother has cracked or bleeding nipples.
6. Latest Treatments: Over 95% Cure Rate
One of the greatest achievements of modern medicine is the development of Hepatitis C treatments.
According to NIDDK data, the use of Direct-Acting Antivirals (DAAs) can cure over 95% of chronic Hepatitis C patients in just 8 to 12 weeks.
In the past, injectable Interferon alpha was used, but DAAs are now the primary treatment. These oral medications directly attack the virus, preventing its multiplication and eliminating it from the body. They also have relatively few side effects and are generally well-tolerated.
Most governmental and private health insurance plans offer coverage, and pharmaceutical companies or non-profit organizations often run financial assistance programs. Consult your physician for personalized advice.
7. Complications and Prevention
1) Complications
If left untreated, chronic Hepatitis C can progress to severe complications, including cirrhosis, liver failure, and liver cancer.
| Stage | Pathological Change | Key Symptoms & Signs | Complication Risk | Required Management & Tests |
| ① Acute HCV | Virus enters liver cells, causes inflammation (some recover naturally) | Fatigue, loss of appetite, nausea, jaundice (some) | Approx. 70–80% can become chronic | Blood tests (ALT, AST, HCV RNA) for monitoring |
| ② Chronic HCV | Persistent inflammation, repeated liver cell damage | Often asymptomatic, fatigue, mild liver enlargement | Progression to liver fibrosis, cirrhosis possible | Regular blood tests, liver ultrasound, HCV RNA monitoring |
| ③ Fibrosis | Scar tissue replaces damaged liver cells | Few symptoms initially | Risk of progressing to cirrhosis, decreased liver function | FibroScan (Liver Elastography), tracking liver enzyme levels |
| ④ Cirrhosis | Normal liver cells replaced by scar tissue, distorted structure | Abdominal swelling (ascites), jaundice, fatigue, confusion | Greatly increased risk of liver failure, cancer | Regular Ultrasound + AFP test (every 6–12 months), liver function tests |
| ⑤ Liver Failure | Loss of >80% of liver function | Coma, severe jaundice, bleeding, edema | Very high risk of death | Liver transplant consideration, intensive care |
| ⑥ Hepatocellular Carcinoma (HCC) | Cancer cells develop on the cirrhotic liver | Weight loss, abdominal pain, jaundice, ascites | Metastasis, reduced survival rate | Ultrasound, CT/MRI, tumor marker (AFP) tests |
2) Prevention
A Hepatitis C vaccine is not yet available. Therefore, lifestyle habits that block blood exposure are the best preventive measures. The core principle across personal hygiene, medical procedures, and sexual health is "blocking blood contact."
| Prevention Method | Rationale / Principle to Block Infection | Practical Tip |
| 1. Never share drug injection equipment | HCV is transmitted through blood. | Use only sterile, single-use needles and syringes. |
| 2. Wear gloves when handling others' blood | Prevents infection through wounds or micro-abrasions. | Always wear disposable gloves during medical, nursing, or emergency situations. |
| 3. Ensure sterilized tools are used for tattooing/piercing | Equipment can be exposed to blood. | Verify the use of sterile equipment and use licensed facilities. |
| 4. Do not share personal hygiene items (toothbrush, razor, nail clippers) | Possible cross-contamination via micro-cuts. | Use separate items, even among family members. |
| 5. Practice safe sex (use condoms) | Reduces potential for transmission via bodily fluids (especially if blood is present). | Condoms are essential, particularly with multiple partners or in the presence of cuts/sores. |
If you suspect you've been exposed to the Hepatitis C virus, seek medical attention as soon as possible. Early diagnosis and treatment are the surest way to prevent liver damage.
8. Lifestyle and Diet
Patients with Hepatitis C must maintain a healthy diet. Alcohol is strictly forbidden, as it accelerates liver damage and worsens the disease. Maintaining a balanced diet and exercising appropriately supports overall health, which in turn aids liver health.
Always consult your doctor before taking any prescription medication, over-the-counter drugs, or dietary supplements. Some products can cause liver damage or interact with Hepatitis C treatments.
Hepatitis C is no longer an incurable disease. With early detection and appropriate treatment, the vast majority of patients can be cured. Most importantly, focus on regular screening and prevention. If you are in a risk group, don't hesitate to get tested. A healthy liver is the start of a healthy life.
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health, Hepatitis C, 2024
