Chronic bloodborne infections often progress silently. Among the various pathogens transmitted through blood, Hepatitis C stands out as the most common chronic bloodborne infection in the United States.
Hepatitis C: The Most Common Chronic Bloodborne Infection
Hepatitis C is a viral infection that primarily targets the liver, causing inflammation and potential damage over time. The Hepatitis C virus (HCV) spreads through contact with infected blood. This infection is classified as chronic when the virus persists in the body for more than six months.
An estimated 3.2 million Americans live with chronic Hepatitis C, making it the most prevalent chronic bloodborne infection. The chronic nature of HCV can lead to severe liver problems, including cirrhosis (scarring of the liver) and liver cancer, and is responsible for thousands of deaths annually in the U.S.
How Hepatitis C Spreads and Who is At Risk
Hepatitis C primarily spreads through direct contact with the blood of an infected person. The most common route of transmission involves sharing needles or other drug injection equipment. This method accounts for a substantial proportion of new HCV infections.
Before 1992, blood transfusions and organ transplants were significant sources of HCV transmission because widespread screening was not yet in place. Less common transmission routes include sexual contact, though this is less efficient than blood-to-blood contact, and mother-to-child transmission during birth. Healthcare workers also face a potential, albeit low, risk of exposure through needlestick injuries. Populations at higher risk include current or former injection drug users, individuals who received blood transfusions or organ transplants before July 1992, and people with HIV.
Symptoms and Diagnostic Testing
Hepatitis C is often referred to as a “silent infection” because many infected individuals experience no symptoms in the early stages. This asymptomatic period can last for years or even decades while the virus gradually damages the liver. When symptoms do appear, they are often non-specific and can include fatigue, nausea, abdominal pain, dark urine, and jaundice.
Given the silent nature of the infection, diagnostic testing plays a crucial role in early detection. Screening is recommended for individuals with risk factors, such as those born between 1945 and 1965, or anyone who has ever injected drugs. Initial testing typically involves an antibody test to detect exposure to the virus. If antibodies are present, a follow-up HCV RNA test is performed to confirm an active infection.
Treatment Options and Long-Term Care
Significant advancements have transformed Hepatitis C treatment, offering high cure rates for most patients. Direct-Acting Antivirals (DAAs) represent a major breakthrough in this area. These oral medications specifically target different stages of the viral life cycle, effectively eliminating the virus from the body.
Treatment with DAAs is typically short, often lasting between 8 to 12 weeks, and is associated with minimal side effects compared to older therapies. Cure rates with DAAs often exceed 95%, leading to a sustained virologic response (SVR), which signifies the absence of the virus in the blood 12 weeks after completing treatment. Even after successful treatment, long-term care and monitoring for liver damage remain important, especially for individuals who had significant liver scarring before treatment.
Strategies for Prevention
Preventing Hepatitis C infection primarily involves avoiding direct contact with infected blood. Ensuring sterile practices in healthcare settings, including proper sterilization of medical instruments and safe handling of sharps, also helps prevent transmission. Individuals should also choose licensed and reputable facilities for tattooing or piercing to ensure sterile equipment is used. Although Hepatitis A and B have vaccines, there is currently no vaccine available to prevent Hepatitis C.