The “C virus” commonly refers to the Hepatitis C virus (HCV), a virus that primarily targets the liver. This blood-borne pathogen causes inflammation in the liver, potentially leading to serious health issues. HCV is exclusively transmitted through direct contact with infected blood. This article explores how the virus spreads, its effects on the body, how it is detected, and modern treatment approaches.
How Hepatitis C is Transmitted
The Hepatitis C virus is predominantly spread through blood-to-blood contact, most often by sharing needles or drug injection equipment. This includes syringes, cookers, and cottons, which can retain microscopic amounts of infected blood. Before widespread screening of blood products began around 1992, receiving blood transfusions or organ transplants was a common method of transmission. Medical procedures with inadequately sterilized equipment have also contributed to its spread.
Less common routes include occupational exposure among healthcare workers from accidental needlestick injuries. Unregulated tattooing or body piercing with unsterilized tools or contaminated ink also presents a risk. The virus can also transmit from an infected mother to her baby during childbirth, occurring in up to 8% of cases. Sexual transmission is considered uncommon, but the risk increases with activities that involve potential blood exposure, such as rough sex or having multiple partners.
Symptoms and Progression of the Disease
Hepatitis C infection begins with an acute phase, lasting up to six months. Most individuals have no noticeable symptoms during this initial stage, so the infection often goes undiagnosed. When symptoms occur, usually within one to three months after exposure, they might include fatigue, fever, nausea, or abdominal pain. A smaller number of people may also develop jaundice, characterized by yellowing of the skin or eyes, along with dark urine or clay-colored stools.
For most infected individuals, the acute phase progresses to a chronic infection, where the virus persists for years or a lifetime. Chronic Hepatitis C often remains asymptomatic for decades, silently causing damage to the liver. Over time, this inflammation can lead to liver scarring (fibrosis), which can advance to cirrhosis. Cirrhosis severely impairs liver function and can result in severe complications such as liver failure or an increased risk of developing liver cancer.
Diagnosis and Testing
Hepatitis C infection is identified through a two-step blood testing process. The initial step is an antibody test (anti-HCV test), which detects antibodies produced in response to the virus. A positive antibody test indicates exposure to HCV at some point, but it does not confirm a current, active infection. Antibodies can remain in the bloodstream even if the body has naturally cleared the virus, which occurs in about 25% of cases.
If the antibody test is positive, a second blood test determines if the virus is currently active. This is a nucleic acid test (NAT) for HCV RNA, also called a PCR test, which directly detects the virus’s genetic material. A positive NAT for HCV RNA confirms an active Hepatitis C infection, indicating the virus is replicating in the body. Health organizations often recommend screening for certain populations, including individuals born between 1945 and 1965, those with a history of injection drug use, and anyone with abnormal liver enzyme levels.
Modern Treatment Approaches
Hepatitis C treatment has significantly transformed with direct-acting antiviral (DAA) medications. These oral medications target different stages of the viral life cycle, directly interfering with the virus’s ability to replicate. Unlike older therapies that relied on interferon injections, DAAs offer a more tolerable treatment experience with fewer side effects.
Treatment regimens involve taking a combination of these oral medications for 8 to 12 weeks. This short course of therapy has demonstrated high effectiveness, achieving cure rates exceeding 95% in most patients, regardless of their HCV genotype or prior treatment history. Achieving a sustained virological response (SVR), defined as undetectable HCV RNA 12 weeks after completing treatment, signifies a cure and can prevent further liver damage, including the progression to cirrhosis, liver failure, and liver cancer.