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Hepatitis C

Hepatitis C is an infection of the liver caused by the hepatitis C virus. It can cause inflammation and fibrosis of the liver tissue and occasionally significant liver damage. In some cases, those with cirrhosis will go on to develop liver failure or worse complications, including liver cancer or life-threatening esophageal varices and gastric varices.

Many people do not realise they have been infected with the virus as there are no symptoms.Flu-like symptoms can occur but can easily be mistaken for another illness. An estimated 180 million people worldwide are infected with hepatitis C with and estimated 200,000 to 500,000 people infected in England and Wales.

You can become infected with hepatitis C if you come into contact with the blood or, less commonly, body fluids of an infected person. The hepatitis C virus mutates very easily, which makes it hard to create a vaccine, and the virus has different genetic variants.


In most cases, the initial infection doesn't cause any symptoms. When it does, they tend to be vague and non-specific. Possible symptoms of Hepatitis C infection include:

  • Fatigue
  • Weight loss
  • Loss of appetite
  • Joint pains
  • Nausea
  • Flu-like symptoms
  • Anxiety
  • Difficulty concentrating
  • Alcohol intolerance and pain in the liver area

The most common symptom experienced is fatigue, which may be mild but is sometimes extreme. Unlike Hepatitis A and B, Hepatitis C doesn't usually cause people to develop jaundice.

About 20-30% of people clear the virus from their bodies but for about 75% of infected people, it lasts for more than 6 months, known as chronic hepatitis C. In these cases, the immune system has been unable to clear the virus and will remain in the body long term unless medical treatment is given. Most of these people have a mild form of the disease with intermittent symptoms of fatigue or no symptoms at all.

Around 1 in 5 people with chronic Hepatitis C develops cirrhosis of the liver within 20 years.


People with chronic Hepatitis C infection should be seen by a hospital liver specialist who may recommend antiviral drug treatments either as single drug therapy or as combination therapy.

Blood tests are required to identify which strain of Hepatitis C infection is present and how well the liver is functioning, and a liver biopsy to establish whether cirrhosis is occurring.

Treatment is usually a combination of two drugs: Interferon (which is given as an injection) and Ribavirin (given as a capsule or tablet):

Interferon is a protein that is naturally produced by your body in response to a viral infection. It prevents the virus multiplying inside your cells.

Ribavirin is a type of antiviral drug that stops the Hepatitis C virus from spreading inside the body.

Treatment usually lasts for 6 or 12 months. A blood test is done after 4 weeks, and again after 12 weeks, to see how well you are responding. Treatment is usually stopped if you do not show a good response after 12 weeks.

These drugs offer the best chance to clear the virus from the body, and are often used together as dual or combination therapy which has been shown to be effective in 55% of cases. Some genetic variants of the Hepatitis C virus are more likely to respond than others and even if the virus isn’t completely cleared, the treatments can reduce inflammation and scarring of the liver.

However, there are side effects to these drugs that some people find difficult to tolerate.

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This website contains general information about medical conditions and treatments. The information is not advice, and should not be treated as such. Please read our medical disclaimer.