Hepatitis C Explained: Screening, Treatment and Life After Diagnosis

Hepatitis C is an infection caused by the hepatitis C virus (HCV), which primarily affects the liver. Some people clear the virus on their own, but many develop a chronic (long-term) infection. Chronic infection can continue for years, and over time it may affect liver health.

Many people have few or no hepatitis C symptoms, especially early on, so the infection can go unnoticed for a long time. When symptoms do appear, they can include tiredness, mild stomach discomfort, or yellowing of the skin and eyes, but these are not specific to hepatitis C. That is why testing, rather than symptoms alone, is how the infection is identified.

Hepatitis C spreads through blood-to-blood contact. Hepatitis C transmission has historically been linked to blood transfusions or organ transplants before screening began in 1992, and to sharing needles or other drug-injection equipment. It is not spread by casual contact such as hugging or sharing meals. Some groups are screened more often, including people born in certain birth cohorts, people who received blood products before 1992, people who have injected drugs, and people born in regions where hepatitis C is more common. This is a matter of risk and history, not blame.

Hepatitis C is usually found through a blood test that looks for signs of exposure to the virus, followed by additional testing to see whether the virus is currently present. Hepatitis C screening guidelines in the United States have changed over the years, and many public health authorities now encourage broader screening of adults. A licensed clinician can explain what applies to your age and history.

Traditionally, hepatitis C treatment relied on injected and less well-tolerated medicines. Today, hepatitis C direct acting antivirals (DAAs) are the standard approach. These are oral antiviral medications that target the virus itself, and they have made it possible for many people to clear the infection. Which medicine is appropriate, and for how long, is something only a licensed clinician decides after an evaluation.

Clinicians often also look at the overall health of the liver, other health conditions, and current medicines before discussing options. Hepatitis C in older adults is a common topic, since many people who were exposed decades ago are only now being tested. Age alone does not decide whether someone can talk with a doctor about hepatitis C treatment options. Follow-up testing is also a traditional part of care to confirm how the body has responded.

The right doctor, such as a primary care physician, a hepatologist, a gastroenterologist or an infectious disease specialist, may help you understand your test results, what they mean, and which next steps make sense for you. A visit generally starts with a conversation about your health history, medicines, and any possible past exposures, followed by blood tests and sometimes imaging of the liver. A good provider will explain things in plain language and welcome questions.

Questions you might bring to a visit include: Do I currently have the virus, or was it cleared in the past? What do my results say about my liver? Which hepatitis C antiviral medication options might apply to me, and what should I expect from them? How would my other medicines or conditions be taken into account? What follow-up would you recommend afterward?

A doctor can also talk with you about protecting others and your own long-term health, including vaccination for other types of hepatitis such as A and B, and whether screening for household members or partners makes sense. You can look for licensed clinicians through Providers.plus. Whether any approach is right for you is always your clinician's call after an evaluation.