What is Hepatitis C? Symptoms, Transmission, and Treatment

Hepatitis C is a viral infection that settles in liver cells, leading to serious damage and inflammation over time. Because it often progresses silently for many years without showing any symptoms, many people do not even realise they carry the disease. If not diagnosed early, this condition can lead to life-threatening complications like cirrhosis or liver failure. Fortunately, thanks to advancing medical technologies, it can now be permanently treated.

In Brief:

• The Hepatitis C virus (HCV) is a blood-borne microorganism that targets the liver.
• The incubation period of the disease varies between 2 weeks and 6 months.
• Between 75% and 85% of cases tend to become chronic (permanent).
• There is currently no vaccine to prevent the disease.
• With modern medication, it is possible to completely clear the virus from the body.

What is Hepatitis C?

Hepatitis C is a contagious disease caused by the Hepatitis C virus (HCV) that wreaks havoc on the liver. Once the virus enters the body, it attaches to liver cells and begins to multiply. During the first 6 months, the disease is referred to as acute (sudden-onset) hepatitis. However, in the vast majority of patients, the immune system cannot clear the virus on its own, and the infection persists for more than 6 months, turning into chronic hepatitis.

Seen in about 3% of the population worldwide, this infection has an average prevalence of 1% in Türkiye. The fact that the chronicity rate is extremely high, at 75% to 85%, increases the severity of the disease from a public health perspective. Although the likelihood of it becoming chronic is relatively lower in individuals exposed to the virus at a young age, the disease generally follows a silent course. This quiet progression, lasting for years, sets the stage for the liver to gradually lose its function.

Causes and Risk Factors of Hepatitis C

The primary cause of the disease is the Hepatitis C virus, which is transmitted through direct blood contact. Because the virus can survive in the external environment for a certain period, unsterilised instruments pose a significant risk. People who frequently come into contact with blood and blood products are at a higher risk of contracting the infection.

Healthcare workers, intravenous drug users, and haemodialysis patients are at the top of the risk groups. Additionally, individuals who received blood transfusions or organ transplants before 1992, and haemophilia patients who received clotting factors produced before 1987, are also in the high-risk category. Haemophilia patients receiving blood transfusions and children with thalassaemia should be screened regularly, as they have a high probability of encountering the virus. Sharing razors, toothbrushes, or getting manicures and pedicures in unsterilised conditions are also risk factors you might encounter in daily life.

What Are the Symptoms of Hepatitis C?

After the virus enters the body, the incubation period averages between 2 and 26 weeks (about 6 months). During and after this time, the vast majority of patients experience no complaints. The disease can persist for years without causing jaundice and completely without symptoms. However, in some cases, especially as liver damage begins to progress, various signs emerge.

When the disease does show symptoms, the following complaints are generally observed:

• Constant fatigue and unexplained weakness
• Loss of appetite and resulting weight loss
• Nausea and occasional vomiting
• Pain or tenderness in the upper right part of the abdomen, where the liver is located
• Noticeable darkening of urine colour (tea-coloured urine)
• Yellowing of the whites of the eyes and the skin (jaundice)
• Easy bruising and a tendency to bleed

In patients who progress to the chronic stage, these symptoms may be very mild or go entirely unnoticed. This insidious nature makes regular health screenings essential.

How is Hepatitis C Transmitted and What Are the Prevention Methods?

The primary route of transmission is when the blood of an infected person enters the bloodstream of a healthy person. Although a larger amount of blood is needed for transmission compared to Hepatitis B, the risk is always present.

Routes of Transmission

Blood and blood product transfusions, and receiving tissue or organ transplants from an infected donor are the most well-known routes of transmission. Sharing syringes during intravenous drug use causes the virus to spread rapidly. Body modification procedures like tattoos, piercings, or wet cupping (hijama) performed in unsterilised, unregulated environments pose a serious danger. Furthermore, the virus can pass through open wounds or scratches on the skin or mucous membranes. The risk of transmission from mother to baby is between 2% and 8%. While the risk of sexual transmission is low, it does exist, especially in cases with multiple partners. It is reassuring to know that the disease is not hereditary; meaning, it is not passed from parents to children through genes.

Like AIDS, which is one of the first diseases that come to mind when talking about blood-borne illnesses, this infection shares similar transmission dynamics, and the principles of prevention largely overlap.

Prevention Methods

There is currently no approved vaccine or protective serum (immunoglobulin) developed to prevent HCV. Therefore, prevention relies entirely on avoiding risks. Primary prevention measures include meticulous screening of blood and blood products, preferring single-use medical supplies in healthcare institutions, and safe injection practices. Secondary prevention involves regular screening of at-risk individuals, advising carriers of the virus to avoid liver-taxing substances like alcohol, and vaccinating them against Hepatitis A and Hepatitis B.

How is it Diagnosed at the Hospital?

The diagnosis of the disease usually begins during routine blood tests or when abnormalities in liver enzymes (ALT and AST) are noticed. Clinical evaluation starts with the suspicion of sudden-onset jaundice, weakness, or upper right abdominal tenderness. Laboratory tests are essential for a definitive diagnosis.

In the first stage, the blood is checked for Anti-HCV antibodies. A positive result indicates that the person has encountered the virus at some point in their life. However, to understand whether the infection is currently active, a complementary and confirmatory test called HCV-PCR (Hepatitis C virus genetic material test) is performed. If the virus is detected in the PCR test, it is confirmed that the person is actively sick, and additional imaging methods are used to evaluate the current state of the liver for treatment planning.

Hepatitis C Treatment

Interferon-based injection treatments, which were used in the past and had severe side effects, have been replaced by direct-acting antivirals (DAAs). These new-generation pill treatments are revolutionary in the medical world. By directly stopping the virus's replication cycle, these medications ensure the disease is completely cleared (cured) from the body.

New-generation treatments are usually completed in a short period, such as 8 to 12 weeks. The side effects are extremely minimal, and patients tolerate them easily. Following a successful treatment, the virus is eradicated from the blood, liver functions begin to improve, and the risk of developing late-stage complications like cirrhosis or cancer is greatly reduced. Even in advanced stages of the disease (compensated or decompensated cirrhosis), treatment prolongs life expectancy and improves the quality of life.

Complications and Late-Stage Risks

Untreated cases face a destructive process that lasts for decades. The constant inflammation caused by the virus in the liver eventually leads to healthy tissues being replaced by hard scar tissues (fibrosis). Over an average of 20 to 30 years, this condition can turn into cirrhosis. When cirrhosis develops, the liver cannot perform its vital tasks, such as filtering blood and producing clotting factors.

An advancing picture of cirrhosis can result in liver failure. Moreover, in a small number of patients carrying the infection, cellular deterioration can pave the way for liver cancer (hepatocellular carcinoma). For a broader perspective on the long-term effects of viruses on the body and cellular changes, you can also review our article exploring the relationship between viral infections and cancer.

When to See a Doctor?

If you belong to one of the risk groups or have had a medical or cosmetic procedure in an unsterilised environment, you should consult a doctor for screening purposes, even if you have no complaints. Beyond this, certain urgent signals from your body require immediate medical attention.

If you experience the following symptoms, you should apply to a healthcare facility without delay or call the 112 emergency service:

• A sudden, noticeable yellowing of the whites of your eyes and your skin
• Unbearable, severe pain in the upper right part of your abdomen
• Sudden and unexplained swelling in the abdomen (fluid accumulation)
• Vomiting blood or having tar-coloured, black stools
• Mental confusion, excessive sleepiness, or changes in consciousness

The Process at BHT CLINIC

Liver health is directly connected to the body's overall metabolic balance and hormonal functioning. At BHT CLINIC İstanbul Tema Hastanesi, our Infectious Diseases, Gastroenterology, and Endocrinology and Metabolism departments evaluate all processes affecting liver functions with a multidisciplinary approach.

Thanks to the advanced technology laboratory infrastructure in our hospital, confirmatory tests like HCV-PCR are concluded quickly and reliably. Our 24/7 emergency service offers immediate intervention opportunities for sudden liver problems or severe symptoms. You can apply to our hospital and safely have your tests done for a diagnosis and treatment process tailored specifically to you.

Frequently Asked Questions

Is there a Hepatitis C vaccine?

No, there is currently no approved protective vaccine developed against this virus. The only way to protect yourself is to stay away from situations that carry the risk of blood-borne transmission (sharing syringes, unsterilised tattooing procedures, etc.).

Is Hepatitis C fatal?

The disease rarely poses a life-threatening risk in the acute phase. However, when left untreated and allowed to become chronic over years, it can lead to cirrhosis, liver failure, and liver cancer, resulting in fatal outcomes. With early diagnosis and modern treatments, this risk can be eliminated.

Can Hepatitis C be completely cured?

Yes, thanks to the direct-acting antiviral (DAA) medications used today, the disease can be completely cured. With these treatments, which last an average of 8-12 weeks, the virus is permanently cleared from the body with a success rate of over 95%.

Is Hepatitis C hereditary?

No, this infection is not a hereditary (genetic) disease. It is not passed to the child through the mother's or father's genes. There is only a risk (around 2-8%) of transmission from the mother's blood to the baby during pregnancy or childbirth.

Can mothers with Hepatitis C breastfeed?

Yes, it is generally considered safe for mothers carrying the virus to breastfeed their babies, and stopping breastfeeding is not recommended. However, if there are bleeding cracks or sores on the nipple, it is advised to pause breastfeeding until the area heals.

To avoid delaying your treatment process and to learn your current health status, you can book an appointment to consult with our specialist doctors.

This article is for informational purposes only; please be sure to consult your doctor for diagnosis and treatment.