Is Hepatitis C Making a Comeback?

By Temma Ehrenfeld @temmaehrenfeld
May 15, 2023
Is Hepatitis C Making a Comeback?

Sharing needles leads to liver disease and HIV. Cases of hepatitis C have more than doubled, rising among Americans of all ages. Here's what you should know.

Hepatitis C, a bloodborne virus, can kill if it isn’t treated. The number of acute infections has more than doubled in recent years, jumping 15 percent, the Centers for Disease Control and Prevention reports.  

The agency calls hepatitis C a “silent epidemic.” As many as 4.7 million Americans may have a chronic infection, with at least half of them unaware of the problem. About a third of the newly reported chronic cases are among Americans in their 20s and 30s, with another third in their late 50s to 70s.

You might first hear the bad news when you have a routine blood test. The good news is that the current treatment is fast and very effective.


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How do I know if I have hep C?

More than 80 percent of people in the United States with hep C infection inject drugs and probably became infected when sharing needles or other equipment.  

The first symptoms usually occur one to three months after an infection, lasting no longer than three months. They may include:

  • Fever
  • Tiredness
  • Loss of appetite
  • Nausea
  • Vomiting
  • Abdominal pain
  • Joint pain
  • Gray-colored stools
  • Jaundice

Very often the virus never leaves. In about 20 years, about a fifth of people with chronic hep C infections develop serious scarring of the liver, called cirrhosis. A smaller group develops liver cancer. Both conditions tend to creep up without symptoms. Obesity and drinking too much alcohol increase your risk of liver problems.

Hepatitis C risk factors

You have a slight chance of picking up hepatitis C through:

  • Sharing razors or toothbrushes
  • Sex with an infected person
  • Getting a tattoo or piercing in a shop that doesn’t clean equipment properly

The virus is not spread through food or water, insect bites, sharing eating utensils, breastfeeding, hugging, kissing, holding hands, coughing, or sneezing.

To prevent the spread of disease, public health officials have embraced the idea of sites where users can pick up clean needles — rather than share used ones. About three quarters of U.S. needle exchange programs also offer tests for hep C infection and can steer infected people to highly effective treatment.

Treatment of heptatitis C

Treatment with direct-acting antiviral (DAA) tablets clears the infection in about 90 percent of patients within three months. Research suggests that patients with known infection should take them even if their livers aren’t yet damaged. It’s best if the pills are provided at the same site as needle exchanges, research suggests.  

DAA tablets are a big improvement over earlier interferon-based therapy, which cured only half of all patients and was hard to tolerate.

Clearing the virus is essential. Most people who are diagnosed with liver cancer do not survive as long as five years. Your chance of living that long with early-stage cancer, however, is 60 to 70 percent if you have a liver transplant.


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May 15, 2023

Reviewed By:  

Janet O’Dell, RN