What is Hepatitis C?

What is Hepatitis C?

Hepatitis C, also known as hep C, is a viral infection that affects the liver. The infection causes the liver to swell or become inflamed. The disease is curable, but if the hepatitis C virus (HCV) is left untreated it can become a serious lifelong disease. Untreated HCV can lead to scarring of the liver (cirrhosis), liver failure, and liver cancer. If a patient has liver failure or serious liver damage, they may need a liver transplant.

Men and women experience similar symptoms, but biological females with a hepatitis C infection have the risk of passing it to their fetuses during pregnancy. About 2.4 million people in the U.S. have the disease, but because there aren’t many symptoms, most of those infected with HCV don't know.

Types of Hepatitis C


The ability of the Hep C virus to mutate, or change, has created six genetic variations of HCV. These different types, or variations, are called genotypes. Some genotypes are more common in certain areas of the world, but not always. It is important to know the genotype you’ve been diagnosed with since it can impact your treatment plan and medications. Approximately 75% of Americans with HCV have genotype 1 of the virus.

The types (genotypes) of hepatitis C are:

  • Type 1 is the most common, responsible for about 70% of hepatitis C virus infections in the US. This type is treatable with medications known as direct-acting antivirals (DAAs) but also comes with a higher chance of cirrhosis (liver scarring).
  • Type 2 is less common, found in only 13-15% of Americans. This type is highly curable, usually treated with direct-acting antivirals (DAAs).
  • Type 3 is only found in 10-12% of Americans, but accounts for approximately 22 to 30% of all HCV infections worldwide. It is most commonly found in South-East Asia. This type may not respond well to DAAs alone. It is also linked with an increased chance of liver disease, liver cancer, and insulin resistance.
  • Types 4, 5, and 6 are very rare, and not as widely studied or understood as types 1, 2, and 3. Type 4 is most common in Africa. Types 5 and 6 are responsible for less than 5% of cases worldwide. Type 5 is found mainly in South Africa while type 6 is found mostly in Southeast Asia.

Stages of Hepatitis C


The hepatitis C virus may not have the same symptoms or severity for every patient. There are three stages of HCV a patient may go through:

  • Incubation period. This period of time begins when someone is exposed to HCV and lasts until the start of the disease. It can last from 14 to 80 days, but the average time period is 45 days.
  • Acute hepatitis C. An acute hepatitis C infection is a short-term illness that lasts for 6 months after the virus enters your body. After 6 months, some people’s bodies and immune systems will get rid of, or clear, the hep C virus without needing medical intervention.
  • Chronic hepatitis C. About 85% of people infected with HCV remain infected for longer than 6 months. This long-lasting infection is called chronic hepatitis C and requires treatment. After HCV has been present for many years, a patient may develop serious health problems from this chronic infection like liver cancer or cirrhosis.

Signs & Symptoms of Hepatitis C


Many people with hepatitis C do not have any symptoms and may even have normal blood tests. When they are present, the symptoms of hepatitis C are the same for women and men.

Even though symptoms are the same, research shows that women are more likely to become infected, clear an acute infection, have a faster disease progression if chronically infected, and have a lower death rate from chronic HCV than men.

It is currently recommended that all adults be tested for hepatitis C at least once, and those at higher risk be tested on more than one occasion. Along with getting tested for the disease, there are warning signs of HCV you can look out for that show up 2 to 12 weeks after being infected:

  • Fever
  • Fatigue
  • Nausea or vomiting
  • Lack of appetite
  • Mild upper-right abdominal pain or discomfort
  • Diarrhea
  • Joint pain
  • Jaundice
  • Light-colored stools
  • Darker urine

Signs your liver may be failing or that you have cirrhosis (liver scarring):

  • Fatigue
  • Weakness
  • Itchy skin
  • Dark urine
  • Fluid buildup in the legs (edema) or abdomen (ascites)
  • Nausea
  • Reduced appetite
  • Bleeding or bruising easily
  • Hepatic encephalopathy - confusion, drowsiness, and slurred speech
  • Spider angiomas - spidery blood vessels under your skin

Our physicians at NewYork-Presbyterian have exceptional experience in the use of all the currently approved antiviral drugs to treat patients with all genotypes of hepatitis C and degrees of liver disease.

What Causes Hepatitis C?


Hepatitis C is a bloodborne virus that spreads through contact with contaminated blood. It is most commonly transmitted through:

  • Sharing injection drugs and needles
  • Having sex, especially if you have HIV, another STD, or many partners
  • Birth (an HCV-positive mother can pass it to a child)
  • Sharing personal care items that can contact bodily fluids like toothbrushes, razor blades, and nail clippers
  • The use or reuse of unclean medical and tattoo equipment

Hepatitis C is not spread through:

  • Breast milk
  • Food and water
  • Casual contact such as hugging or kissing
  • Sharing food or drinks with an infected person
  • Sneezing or coughing

Risk Factors

Risk Factors

Those who inject drugs are the most at risk for contracting hepatitis C, but there are patients who get HCV without coming into contact with infected blood or using drugs. It is recommended that you get tested for the disease at least once. You may need repeated tests if you:

  • Are pregnant (with each pregnancy)
  • Have been on kidney dialysis
  • Currently inject drugs and share needles or other drug paraphernalia



About 75% to 85% of people who test positive for hepatitis C will develop chronic, or long-term, HCV. If treated early on, symptoms can be managed and even cured. An untreated HCV infection that lasts for many years can cause:

Prevention for Hepatitis C


There is no vaccine against hepatitis C, but there are ways you can reduce your risk of getting the virus. To protect yourself from the disease, you can:

  • Practice safe sex by using a latex condom every time you have sex
  • Avoid sharing personal items like razors or toothbrushes
  • Avoid sharing needles, syringes, or other equipment when injecting drugs
  • Research and ensure you get tattoos or piercings from a reputable and clean shop using clean needles
Get Care

Trust NewYork-Presbyterian for Hepatitis C Care

Your healthcare team includes hepatologists (liver doctors), infectious disease specialists, surgeons, nurses, physician assistants, psychiatrists, and others with experience caring for people with hepatitis C and other liver disorders. We understand the severity of this disease and the need to treat a chronic hepatitis C infection as early as possible, along with follow-up care to ensure you stay healthy and prevent re-infection.

Your team includes internationally renowned leaders in hepatitis C research, too, ensuring you are receiving the most up-to-date therapies available today. We are proud to have helped bring many new hepatitis C drugs into the clinical arena, benefiting patients. Schedule an appointment with us today.