About HCV

What are the case definitions for HCV infections?

The specific viral cause of illness cannot be determined based solely on signs, symptoms, history, or current risk factors. It must be verified by specific serologic testing.

How is HCV transmitted?

HCV is transmitted primarily through parenteral exposures to infectious blood or body fluids that contain blood. Possible exposures include:

  • Injection drug use
  • Received donated blood, blood products, and organs prior to 1994
  • Needle stick injuries in health care settings
  • Birth to an HCV-infected mother

How soon after exposure to HCV do symptoms appear?

Most people with chronic HCV infection are asymptomatic or have non-specific symptoms such as chronic fatigue and depression. In those people who do develop symptoms, the average period from exposure to symptoms onset is 2–12 weeks (range: 2–26 weeks).

What are the signs and symptoms of chronic HCV infection?

Most people with chronic HCV infection are asymptomatic or have non-specific symptoms such as chronic fatigue and depression. Many eventually develop chronic liver disease, which can range from mild to severe, including cirrhosis and liver cancer.

Chronic liver disease in HCV-infected people is usually insidious, progressing slowly without any signs or symptoms for several decades. In fact, HCV infection is often not recognized until asymptomatic people are identified as HCV-positive when screened for blood donation or when elevated alanine aminotransferase (ALT, a liver enzyme) levels are detected during routine examinations.

What are the signs and symptoms of acute HCV infection?

People with newly acquired HCV infection usually are asymptomatic or have mild symptoms that are unlikely to prompt a visit to a healthcare professional. When symptoms do occur, they can include:

  • Fever
  • Fatigue
  • Dark urine
  • Abdominal pain
  • Loss of appetite
  • Nausea
  • Vomiting
  • Joint pain
  • Jaundice
  • Fever
  • Fatigue
  • Dark urine
  • Abdominal pain
  • Loss of appetite
  • Nausea
  • Vomiting
  • Joint pain
  • Jaundice

How likely is HCV infection to become chronic?

HCV infection becomes chronic in approximately 75-85% of cases.

What percentage of those infected with HCV develop symptoms of acute illness?

Approximately 20–30% of those newly infected with HCV experience fatigue, abdominal pain, poor appetite, or jaundice.

Can a patient have normal liver enzyme (e.g. ALT) levels and still have chronic Hepatitis C?

Yes. It is common for patients with chronic Hepatitis C to have liver enzyme levels that go up and down, with periodic returns to normal or near normal levels. Liver enzyme levels can remain normal for over a year despite chronic liver disease.