What is the diagnosis process for hepatitis C? What are the available treatment options? Get the answers to these key questions and more in this detailed article.

Screening for Hepatitis C

The U.S. Preventive Services Task Force recommends that all adults ages 18 to 79 years be screened for hepatitis C, even those without symptoms or known liver disease. Screening is especially important for those at high risk of exposure, including:

• Anyone who has ever injected or inhaled illicit drugs
• Anyone who has abnormal liver function test results with no identified cause
• Babies born to mothers with hepatitis C
• Health care and emergency workers who have been exposed to blood or accidental needle sticks
• People with hemophilia who were treated with clotting factors before 1987
• People who have undergone long-term hemodialysis treatments
• People who received blood transfusions or organ transplants before 1992
• Sexual partners of anyone diagnosed with hepatitis C infection
• People with HIV infection
• Anyone born from 1945 to 1965
• Anyone who has been in prison

Additional Blood Tests

If an initial blood test shows that you have hepatitis C, additional blood tests will:

• Measure the quantity of the hepatitis C virus in your blood (viral load)
• Identify the genotype of the virus

Tests for Liver Damage

Doctors typically use one or more of the following tests to assess liver damage in chronic hepatitis C:

• Magnetic resonance elastography (MRE): A noninvasive alternative to a liver biopsy, MRE combines magnetic resonance imaging technology with patterns formed by sound waves bouncing off the liver to create a visual map showing gradients of stiffness throughout the liver. Stiff liver tissue indicates the presence of scarring of the liver (fibrosis) as a result of chronic hepatitis C.
• Transient elastography: Another noninvasive test, transient elastography is a type of ultrasound that transmits vibrations into the liver and measures the speed of their dispersal through liver tissue to estimate its stiffness.
• Liver biopsy: Typically done using ultrasound guidance, this test involves inserting a thin needle through the abdominal wall to remove a small sample of liver tissue for laboratory testing.
• Blood tests: A series of blood tests can indicate the extent of fibrosis in your liver.

Antiviral Medications

Hepatitis C infection is treated with antiviral medications intended to clear the virus from your body. The goal of treatment is to have no hepatitis C virus detected in your body at least 12 weeks after you complete treatment.

Researchers have recently made significant advances in treatment for hepatitis C using new, “direct-acting” antiviral medications, sometimes in combination with existing ones. As a result, people experience better outcomes, fewer side effects and shorter treatment times — some as short as eight weeks. The choice of medications and length of treatment depend on the hepatitis C genotype, presence of existing liver damage, other medical conditions and prior treatments.

Due to the pace of research, recommendations for medications and treatment regimens are changing rapidly. It is therefore best to discuss your treatment options with a specialist.

Liver Transplantation

If you have developed serious complications from chronic hepatitis C infection, liver transplantation may be an option. During liver transplantation, the surgeon removes your damaged liver and replaces it with a healthy liver. Most transplanted livers come from deceased donors, though a small number come from living donors who donate a portion of their livers.

In most cases, a liver transplant alone doesn’t cure hepatitis C. The infection is likely to return, requiring treatment with antiviral medication to prevent damage to the transplanted liver. Several studies have demonstrated that new, direct-acting antiviral medication regimens are effective at curing post-transplant hepatitis C. At the same time, treatment with direct-acting antivirals can be achieved in appropriately selected patients before liver transplantation.

Vaccinations

Although there is no vaccine for hepatitis C, your doctor will likely recommend that you receive vaccines against the hepatitis A and B viruses. These are separate viruses that also can cause liver damage and complicate the course of chronic hepatitis C.

Clinical Trials

Are you interested in exploring new treatments or interventions for hepatitis C? Check out the latest clinical trials being conducted at Mayo Clinic.

Hepatitis C – Diagnosis and treatment

Diagnosis

Screening for hepatitis C

The U.S. Preventive Services Task Force recommends that all adults ages 18 to 79 years be screened for hepatitis C, even those without symptoms or known liver disease. Screening for HCV is especially important if you’re at high risk of exposure, including:

• Anyone who has ever injected or inhaled illicit drugs
• Anyone who has abnormal liver function test results with no identified cause
• Babies born to mothers with hepatitis C
• Health care and emergency workers who have been exposed to blood or accidental needle sticks
• People with hemophilia who were treated with clotting factors before 1987
• People who have undergone long-term hemodialysis treatments
• People who received blood transfusions or organ transplants before 1992
• Sexual partners of anyone diagnosed with hepatitis C infection
• People with HIV infection
• Anyone born from 1945 to 1965
• Anyone who has been in prison

Other blood tests

If an initial blood test shows that you have hepatitis C, additional blood tests will:

• Measure the quantity of the hepatitis C virus in your blood (viral load)
• Identify the genotype of the virus

Tests for liver damage

Doctors typically use one or more of the following tests to assess liver damage in chronic hepatitis C.

• Magnetic resonance elastography (MRE). A noninvasive alternative to a liver biopsy (see below), MRE combines magnetic resonance imaging technology with patterns formed by sound waves bouncing off the liver to create a visual map showing gradients of stiffness throughout the liver. Stiff liver tissue indicates the presence of scarring of the liver (fibrosis) as a result of chronic hepatitis C.
• Transient elastography. Another noninvasive test, transient elastography is a type of ultrasound that transmits vibrations into the liver and measures the speed of their dispersal through liver tissue to estimate its stiffness.
• Liver biopsy. Typically done using ultrasound guidance, this test involves inserting a thin needle through the abdominal wall to remove a small sample of liver tissue for laboratory testing.
• Blood tests. A series of blood tests can indicate the extent of fibrosis in your liver.

Transient elastography

A member of the care team performs transient elastography — a painless alternative to liver biopsy — to assess liver damage.

Treatment

Antiviral medications

Hepatitis C infection is treated with antiviral medications intended to clear the virus from your body. The goal of treatment is to have no hepatitis C virus detected in your body at least 12 weeks after you complete treatment.

Researchers have recently made significant advances in treatment for hepatitis C using new, “direct-acting” antiviral medications, sometimes in combination with existing ones. As a result, people experience better outcomes, fewer side effects and shorter treatment times — some as short as eight weeks. The choice of medications and length of treatment depend on the hepatitis C genotype, presence of existing liver damage, other medical conditions and prior treatments.

Due to the pace of research, recommendations for medications and treatment regimens are changing rapidly. It is therefore best to discuss your treatment options with a specialist.

Throughout treatment your care team will monitor your response to medications.

Liver transplantation

If you have developed serious complications from chronic hepatitis C infection, liver transplantation may be an option. During liver transplantation, the surgeon removes your damaged liver and replaces it with a healthy liver. Most transplanted livers come from deceased donors, though a small number come from living donors who donate a portion of their livers.

In most cases, a liver transplant alone doesn’t cure hepatitis C. The infection is likely to return, requiring treatment with antiviral medication to prevent damage to the transplanted liver. Several studies have demonstrated that new, direct-acting antiviral medication regimens are effective at curing post-transplant hepatitis C. At the same time, treatment with direct-acting antivirals can be achieved in appropriately selected patients before liver transplantation.

Vaccinations

Although there is no vaccine for hepatitis C, your doctor will likely recommend that you receive vaccines against the hepatitis A and B viruses. These are separate viruses that also can cause liver damage and complicate the course of chronic hepatitis C.

More Information

Show more related information

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Lifestyle and home remedies

If you receive a diagnosis of hepatitis C, your doctor will likely recommend certain lifestyle changes. These measures will help keep you healthy longer and protect the health of others as well:

• Stop drinking alcohol. Alcohol speeds the progression of liver disease.
• Avoid medications that may cause liver damage. Review your medications with your doctor, including over-the-counter medications you take as well as herbal preparations and dietary supplements. Your doctor may recommend avoiding certain medications.
• Help prevent others from coming in contact with your blood. Cover any wounds you have and don’t share razors or toothbrushes. Don’t donate blood, body organs or semen, and advise health care workers that you have the virus. Also tell your partner about your infection before you have sex, and always use condoms during intercourse.

Preparing for your appointment

If you think you may have a risk of hepatitis C, see your family doctor. Once you’ve been diagnosed with a hepatitis C infection, your doctor may refer you to a specialist in liver diseases (hepatologist) or infectious diseases.

What you can do

Because appointments can be brief and because there’s often a lot to discuss, it’s a good idea to be well prepared. To prepare, try to:

• Review your medical record. This is particularly important if you are seeing a liver specialist (hepatologist) for the first time after finding out you have hepatitis C. If you had a liver biopsy to check for damage from chronic infection and a blood test to determine which hepatitis C genotype you have, make sure you know the results so you can share them with your specialty care team.
• Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there’s anything you need to do in advance, such as restrict your diet.
• Write down any symptoms you’re experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
• Make a list of all medications, vitamins or supplements you’re taking.
• Consider taking a family member or friend. Sometimes it can be difficult to remember all the information provided during an appointment. Someone who accompanies you may remember something that you missed or forgot.

To make the most of your time with your doctor, take along a list of questions you want to ask. Put your most important questions at the top of your list, in case time runs out. For a hepatitis C infection, some basic questions to ask your doctor include:

• Should I be tested for other causes of liver disease, such as hepatitis B?
• Has the hepatitis C virus damaged my liver?
• Do I need treatment for a hepatitis C infection?
• What are my treatment options?
• What are the benefits of each treatment option?
• What are the potential risks of each treatment option?
• Is there one treatment you think is best for me?
• I have other medical conditions. How will these affect my hepatitis C treatment?
• Should my family be tested for hepatitis C?
• Is it possible for me to spread the hepatitis C virus to others?
• How can I protect the people around me from hepatitis C?
• Should I see a specialist? Will my insurance cover it?
• Are there brochures or other material that I can take with me? What websites do you recommend?
• What will determine whether I should plan for a follow-up visit?
• Is it safe for me to drink alcohol?
• What medications should I avoid?

Don’t hesitate to ask any other questions that occur to you during your appointment.

What to expect from your doctor

Your doctor is likely to ask you some of the following questions. If you’ve thought about your answers beforehand, this part of the visit may go more quickly than usual, leaving you more time to address your concerns.

• Have you ever had a blood transfusion or an organ transplant? If so, when?
• Have you ever used self-injected drugs not prescribed by your doctor?
• Have you ever been diagnosed with hepatitis or jaundice?
• Does anyone in your family have hepatitis C?
• Is there a history of liver disease in your family?

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Hepatitis C: How common is sexual transmission?

Hepatitis C is transmitted primarily by exposure to blood containing the hepatitis C virus. Current research suggests that if you’re in a long-term, monogamous relationship with a partner who has hepatitis C, your risk of contracting hepatitis C is quite low — unless you also have human immunodeficiency virus (HIV).

For monogamous couples, the Centers for Disease Control and Prevention (CDC) doesn’t recommend routine condom use to prevent hepatitis C transmission. But couples should avoid sharing razors, toothbrushes and nail clippers. Your risk may also be higher if you have intercourse during menstruation or have anal sex, which is more likely to cause bleeding.

Your risk of contracting hepatitis C increases significantly if you have HIV. Also, the risk of transmission is higher if you have multiple short-term sexual relationships with partners who have hepatitis C. Under these circumstances, the CDC recommends routine condom use to reduce your risk of transmission.

If you’re concerned about hepatitis C, talk to your doctor. Hepatitis C can be diagnosed by a simple blood test. Treatment may include medications to help clear the virus from the bloodstream and ultimately cure you of hepatitis C.

With

Stacey A. Rizza, M.D.

• Hepatitis C: What happens in end-stage liver disease?

Nov. 08, 2019

Show references

1. Emerging issues, hepatitis C: Sexually transmitted diseases treatment guidelines, 2015. Centers for Disease Control and Prevention. https://www.cdc.gov/std/tg2015/emerging.htm. Accessed Oct. 18, 2019.
2. Hepatitis C. NHS. https://www.nhs.uk/conditions/hepatitis-c/. Accessed Oct. 18, 2019.
3. Hepatitis C questions and answers for health professionals. Centers for Disease Control and Prevention. https://www.cdc.gov/hepatitis/HCV/HCVfaq.htm. Accessed Oct. 21, 2019.
4. Bennett JE, et al., eds. Hepatitis C. In: Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, Pa.: Elsevier; 2020. https://www.clinicalkey.com. Accessed Oct. 18, 2019.

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Hepatitis C Virus: Signs, Symptoms, and Complications

The signs and symptoms of hepatitis C virus infection (HCV) vary based on the stage of infection.  The most common symptoms include fatigue, jaundice, (yellow coloring of the skin and eyes), fever, and nausea. In advanced stages of the infection, liver failure may cause bleeding problems or encephalopathy (severe confusion). Sometimes liver cancer may develop, often manifesting as a malnourished appearance.

Illustration by Verywell

Stages of Illness

The impact of HCV in the body changes over time after the initial infection. This is largely due to the proliferation of the virus, which can reproduce inside the body, making numerous copies of itself. The progression also has to do with the cumulative effect of the virus on the liver. 

The stages of HCV infection:

• Incubation period: During this stage, you could have been infected with the virus, but you most likely will not have any symptoms. If you do have symptoms, they may include fever, fatigue, or stomach upset.
• Acute Hepatitis: About two to 12 months after the virus invades the body, HCV can cause mild to moderate illness.  Symptoms of acute infection are seen in about 15 to 20 percent of people who have been exposed to the virus. Presentation is often flu-like, with little evidence of liver injury. About one in four people successfully fight off the virus during this stage.
• Chronic Hepatitis: The majority of those infected with HCV go on to have chronic hepatitis. Chronic infection occurs when the hepatitis C virus (HCV) does not spontaneously clear and remains in the body. Some people develop symptoms of chronic infection years after being infected with the virus, without ever having had acute hepatitis symptoms. 
• End Stage Hepatitis: A more complicated form of the disease manifests with liver failure and a number of serious complications, which can include kidney failure and liver cancer. 

Frequent Symptoms

The symptoms of liver failure include generalized flu-like symptoms, as well as more specific signs of liver involvement because the virus targets the liver.  Common symptoms that occur in both the acute and chronic phase of HCV infection generally last longer and are more severe during the chronic stage of the infection.  

The most common symptoms of HCV include symptoms that are not specific to hepatitis and occur with most infections. These symptoms are largely due to the activity of the body’s own immune system as it fights the virus.

The most common symptoms of acute and chronic HCV include:

• Fatigue
• Fever
• Jaundice
• Nausea and vomiting
• Decreased appetite
• Abdominal pain 
• Diarrhea
• Joint pain
• Muscle Pain

Some of the symptoms of acute and chronic stage HCV are similar to the symptoms of any liver disease.

• Bleeding and Bruising: The liver plays a role in producing proteins that aid in blood clotting, which is part of healing from an injury. Bleeding and bruising can be signs of liver dysfunction, resulting from the viral attack on the liver, as well as the body’s inflammatory response to the virus.  
• Dark-colored urine: The build-up of bilirubin, which is produced when the liver is infected or impaired, can cause jaundice, as well as the dark coloring of the urine (choluria), and pale or chalky stools.
• Pale or chalky stools

In acute hepatitis, these symptoms typically resolve on their own, although more severe cases involving jaundice and choluria may take up to a year. In chronic hepatitis, these symptoms are generally more persistent than they are in acute hepatitis. 

Rare Symptoms

A number of less common symptoms of HCV infection can occur during the acute or chronic stages. Many of these symptoms result from liver dysfunction or from the body’s inflammatory response to the virus. 

• Weight Loss: This may occur due to a number of effects of HCV infection. Nausea, vomiting, and fatigue can diminish your appetite, causing you to reduce the amount of food you want to eat. And, as the liver becomes impaired, it may not produce several important proteins and fats that help you digest and absorb the food you eat, leading to diarrhea and basically, malnutrition even when you eat.  
• Abnormal tingling or burning sensations
• An uncomfortable “pins and needles” sensation
• Itchy skin
• Raised, bumpy areas of rash
• Dry eyes accompanied by dry mouth
• Rheumatic diseases: Joint swelling and muscle aches and pains can begin before you know that you have been exposed to HCV and may also occur at any stage of the infection. The joint and muscle pains are due to the fact that the immune system is stimulated continuously to fight the virus.
• Vasculitis (inflammation of the blood vessels) rarely occurs and may cause a range of effects, including pain, blood clots, and even strokes or heart attacks, although this is rare. 
• Cryoglobulinemia: Cryoglobulins are proteins within the blood that get solidified when exposed to cold temperatures, causing problems with circulation. 

Complications

The chronic stage of hepatitis C can persist for decades. During this time, steatosis (chronic build-up of fats) and fibrosis (progressive scarring of tissue) can cause damage to the liver. Both of the conditions often develop silently, with most people experiencing little or no signs of illness.

End-stage liver disease refers to the point where the liver has been severely damaged and is unable to function. Symptoms are usually highly evident at this stage, often affecting multiple organ systems, including the brain, kidney, and upper digestive tract. 

Among people with chronic hepatitis C infection, 10 to 15 percent will advance an irreversible condition called cirrhosis, in which the damage caused by fibrosis is so extensive that the blood flow in and out of the liver is altered.

Cirrhosis is staged by the degree of impairment and classified as either:

• Compensated cirrhosis
• Decompensated cirrhosis

Compensated cirrhosis means that the liver is functioning relatively well and, as such, may cause minimal symptoms. When present, symptoms can include complications involving the skin, muscles, and joints as the constricted blood supply triggers both an increase in localized blood pressure, known as portal hypertension and a build-up of bile and other toxins.  

Among the possible symptoms of compensated cirrhosis:

• Spider veins, mainly on the trunk and face
• Itchy skin
• Redness on the palms of the hands
• Easy bruising or abnormal bleeding
• The build-up of fluid in the ankles and feet
• Poor concentration and memory
• Loss of appetite
• Weight loss
• Shrinking testicles
• Erectile dysfunction or loss of libido
• Alcohol intolerance

The end stage complications of hepatitis C infection include:

• Decompensated cirrhosis
• Hepatocellular carcinoma (HCC)
• End-stage renal disease (ESRD)

Decompensated cirrhosis is a serious condition in which the progressive scarring of the liver has left it severely damaged and unable to function. Symptoms are often profuse and progressive and can present in a number of ways, including:

• Persistent fatigue
• Jaundice
• Tarry or bloody stools
• The build-up of fluid in the abdominal cavity, causing swelling and distention
• A distinct “sweet-musty” to “rotten egg” breath odor
• Extreme bruising or bleeding
• Abnormally decreased urine output
• Personality changes, confusion, or tremors
• Increased sleepiness
• Muscle wasting
• White discoloration or “milk spots” on the nails
• Vomiting of blood
• Esophageal varices (expanded blood vessels of the esophagus that may bleed)

Hepatocellular carcinoma (HCC) is a type of liver cancer that develops almost exclusively in association with cirrhosis in people with hepatitis C.  The symptoms of HCC are similar to those of decompensated cirrhosis and can include:

• Persistent fatigue
• Jaundice
• The build-up of fluid in the abdominal cavity
• Abnormal bruising and bleeding
• Unintentional, extreme weight loss
• Loss of appetite
• Feeling full after eating a small amount
• Delirium, confusion, or coarse “jerking” muscle movements
• Abdominal discomfort, particularly in the upper right quadrant below or just under the ribs

End-stage renal disease (ESRD), which is advanced kidney failure, can both be caused and complicated by hepatitis C infection. The symptoms of ESRD vary and include:

• Persistent fatigue
• Chronic abdominal pain
• Abnormally decreased urine output
• Inability to urinate
• Urine breath odor
• Mottled or uneven, patchy skin discoloration
• Muscle wasting
• Swelling of the legs and feet, or around the eyes
• Nausea or vomiting, particularly in the morning and after meals
• Increased sleepiness
• Repetitive twitchiness of the legs
• Shortness of breath or difficulty breathing
• Mental impairment, confusion

Outcomes of end-stage liver disease are generally poor, with a five-year survival rate of 50 percent in persons with decompensated cirrhosis and 30 percent in those with HCC.

When to See the Doctor

Because the symptoms of HCV may not occur in early stages, and because they are not always terribly alarming, even in the acute and chronic stages, you may need to see a doctor even if you do not have obvious symptoms of the infection.

Signs of Exposure

You should see your doctor if you have been exposed to the virus, either recently or at any time in the past. If you experienced any of the following, you might have been exposed to HCV: 

• If you have had unprotected sex with someone who has or who could have HCV
• If you have shared needles with anyone
• If you have had a cut or a break in your skin from a needle, glass, or any other object that was or could have been contaminated with HCV infected blood

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If you develop symptoms of liver failure or severe infection, you should also see your doctor, as the cause could be HCV or another serious condition that also requires medical attention. Signs and symptoms to look out for include:

• Persistent fevers
• Jaundice
• Change in the color of your urine
• Nausea, vomiting or diarrhea that is excessive or lasting for longer than a week 
• Unexplained fatigue lasting longer than a week
• Swelling of your abdomen

Frequently Asked Questions

How long is the hepatitis C incubation period prior to showing symptoms?

Some people who contract hepatitis C never show symptoms and it is possible to transmit this disease to someone else without showing symptoms. For people who do show symptoms, they typically appear two to 12 weeks after exposure. Symptoms of liver disease or failure can then show up years later.

Can hepatitis C be cured?

Yes, the use of antiviral medication, specifically direct-acting antivirals, has been shown to cure more than 95% of hepatitis C cases.

Hepatitis C Symptoms & Treatment in Children

What Is Hepatitis C?

Hepatitis C is a liver disease caused by the hepatitis C virus, which is carried in the blood of infected people. According to various estimates, there are anywhere from approximately 3 to 10 million people in the United States who are carriers of the virus. One reason for the uncertainty is that the virus wasn’t even diagnosed until the late 1980s. In fact, a majority of hepatitis C virus carriers are still unaware that they have it.

As compared to adults, knowledge of hepatitis C virus infection in children is limited. This is because far fewer children are infected with hepatitis C virus, and children are less likely to have symptoms from their hepatitis C virus infection. Clinical liver disease due to hepatitis C virus is extremely rare in childhood. The exceptions are mainly children with other risk factors (other viruses, chemotherapy, immunosuppression).

The disease is serious for some people, but not for others. Most people who get hepatitis C carry the virus for the rest of their lives. The majority will experience some liver damage, but may not feel sick from the disease. Some people with liver damage due to hepatitis C may develop cirrhosis (scarring) of the liver and liver failure, which may take many years to develop.

Hepatitis C is primarily spread through contact with infected blood. The virus can be passed on by injecting drugs with shared needles; receiving a tattoo, body piercing, or acupuncture with unsterilized equipment; or less commonly through sexual contact. Children are more likely to contract hepatitis C virus through:

• Being born to a mother who is infected with hepatitis C virus
• Receiving hepatitis C virus-infected blood transfusions (before 1992) or blood clotting products (before 1987)
• Receiving an hepatitis C virus-infected organ transplant
• Receiving long-term kidney dialysis treatment (dialysis machine can be tainted with hepatitis C virus-infected blood)
• Sharing personal hygiene items (such as toothbrushes, razors, or nail-clippers) that have hepatitis C virus-infected blood on them

It is important to remember that the hepatitis C virus can not spread through:

• The air
• Unbroken skin
• Casual social contact
• Breast-feeding

Hepatitis C Symptoms in Infants and Children

Although the hepatitis C virus can be detected in blood between one to three weeks after the initial exposure, 80 percent of people with hepatitis C have no symptoms, and thus go undiagnosed. , Most patients begin to develop liver cell injury within approximately 50 days, although they will be asymptomatic (symptom-free). In about 15 percent of people exposed to the virus, their bodies clear it out of their system naturally within six months. The remaining 85 percent of people with hepatitis C will develop some level of chronic hepatitis C. Over time, this can cause serious liver damage, although the rate of progression can vary significantly from individual to individual. Hepatitis C symptoms may include:

• Fatigue
• Loss of appetite
• Jaundice (yellowing of the eyes and skin)
• Darker colored urine
• Abdominal pain
• Aches and pains
• Itching
• Hives
• Joint pain
• Loose, light-colored stools
• Nausea
• Vomiting

Serious complications of hepatitis C infection include:

• The possibility that the infection will become chronic, leading to progressive liver failure
• Increased risk of hepatocellular carcinoma (liver cancer)
• Cirrhosis – Within about 20 years of exposure, about 20 percent of individuals develop cirrhosis, which leads to end-stage liver disease.

Hepatitis C Diagnosis

To diagnosis hepatitis C, your child’s doctor will ask about symptoms, medical history, and perform a physical exam. Your doctor will also want to discuss your child’s risk factors for hepatitis C. Tests that may be conducted include:

• Blood Tests – to look for hepatitis C antibodies or genetic material from the virus (The antibodies are proteins that your body has made to fight the hepatitis C virus.)
• Liver Biopsy – removal of a sample of liver tissue to be examined

Hepatitis C Treatment

Hepatitis C treatment includes medications. The most common are:

• Interferon, given by injection
• Ribavirin, given orally
• A combination of interferon and ribavirin

The course of this type of treatment is usually over a period of months. These medications can cause side effects that resemble the symptoms of hepatitis C itself, only magnified. However, these antiviral treatments can dramatically reduce the presence of the hepatitis C virus in the bloodstream. The limited studies available on the effectiveness of antiviral treatments on children show that they have an overall better response rate to this therapy than adults.

Even with treatment, hepatitis C infection may not clear up within six months. In rare cases, a liver transplant may be needed. However, it is possible that hepatitis C can affect the new liver after transplantation.

Learn about other Liver Disease States.

Signs and Symptoms of Hepatitis C

Even when an acute infection becomes chronic, it can be years before a person receives a diagnosis, thus delaying treatment. In fact, the majority of people with chronic hepatitis C are asymptomatic until the liver becomes severely damaged, often decades after exposure, says Dr. Adalja. (2)

It’s common for people to unknowingly carry HCV until they go through a blood screening or other examination for reasons unrelated to hepatitis C. (1)

However, chronic hepatitis C is a serious issue that can result in long-term health problems, including liver damage, liver cancer, liver failure, and death. (4)

According to the CDC, approximately 10 to 20 percent of people with chronic hepatitis C develop cirrhosis (an irreversible scarring of the liver that prevents the organ from functioning normally) over a period of two to three decades. (1)

People with cirrhosis have a 1 to 5 percent annual risk of developing liver cancer and a 3 to 6 percent risk of hepatic decompensation (the development of serious, life-threatening liver-related problems). There’s a 15 to 20 percent risk of death in the year following the development of decompensation. (1)

Age and gender have been shown to affect how chronic hepatitis C progresses, warns Adalja. It doesn’t advance to cirrhosis and liver cancer as quickly in premenopausal women as it does in men, according to a report published in July 2013 in Southern Medical Journal. (6)

Adalja notes that other factors that may accelerate chronic hepatitis C progression, increasing the risk of liver damage. These include HIV or hepatitis B coinfection, alcohol overuse, and cigarette smoking. (7) The symptoms of chronic hepatitis C vary depending on the type of liver damage.

Cirrhosis can produce a variety of symptoms: (8)

• Itchiness
• Fatigue
• Abdominal bloating from a buildup of fluids
• Swelling (also due to a buildup of fluids) in the feet, ankles, or legs
• Spider angiomas (small red spots of dilated blood vessels)

Hepatitis C Signs and Symptoms

You can live with hepatitis C, a viral infection transmitted through blood, for decades unaware and without symptoms—until you’re met with undeniable proof that something is very wrong. It’s crucial to not to dismiss any early signs and to ask your doctor for testing if you suspect you’ve been exposed to hep C. Some reassuring news: With treatment, hep C is curable.

More Top Articles on Hepatitis C

Hepatitis C Symptoms

Frequently Asked Questions

What’s the most common hep C symptom?

Actually, the most common symptom for hepatitis C is no symptoms at all. The disease can go undetected in the body for years, sometimes decades, which is why it’s important to talk with your doctor about screening if you are in a high-risk group.

How will I know if my hepatitis C is cured?

You doctor will measure something called viral genetic material in your blood. To do this, you will be asked to take a blood test about three months after you’ve finished your course of treatment. If the test does not show any viral genetic material, it means you are cured of hep C.

Are there any less-common signs of hep C ?

Yes. The color of your poop is one indication: Clay-colored stool happens because a damaged liver cannot transfer bilirubin, a substance that gives poop its brown color, from your blood to your stools. That bilirubin instead goes to your urine, which is why people with hep C may have dark pee.

If I have hep C will I need medication?

Not always. In fact, for reasons scientists still don’t completely understand, about 30% of people with the hepatitis C clear the infection through their own immune system without requiring any treatment. This usually happens in the first year of infection.

What Exactly Is Hepatitis C?

Hepatitis C is a viral infection that’s super sly; half of those who have it are unaware they have it. Most people don’t show any symptoms so they can live with it—some for decades—and not feel a thing until major complications crop up.

The virus can cause both acute and chronic illness, ranging in severity from a mild illness that lasts a few weeks, to a serious lifelong condition. It’s estimated that 71 million people around the world have chronic hep C, according to the World Health Organization.

Though it may be silent, hep C can become deadly when it lingers in your system for too long. Too much time inside your body takes a toll and can lead to major issues like cirrhosis (scarring of the liver caused by years of damage), liver disease, and cancer of the liver.

For reasons unknown, not everyone who has hep C needs treatment. In fact, 30% of people with the disease clear the infection through their own immune system, typically within 6 months of infection (called the acute phase), without requiring any treatment. But for the 70% whose condition becomes chronic, treatment is necessary.

While all this may sound scary, hep C isn’t what it used to be—it can be completely cured with a relatively quick course of treatment.

Get the Full Story on Hepatitis C

How Do You Get Hepatitis C?

Hep C is transmitted through infected blood that gets into another person’s bloodstream. It can’t be passed through taking a bite of someone’s burger, kissing, or by holding hands. The disease is largely transmitted in the following ways:

• Shared needles

• Blood transfusions

• Organ transplants that took place before 1992 (when blood wasn’t as thoroughly screened)

• Being born to a mother who has hep C or born between 1945 and 1965 before the virus was identified and the blood supply was properly screened for the disease

Hep C can also be spread through sexual intercourse, but the risk is considered to be low.

What Are the Most Common Signs and Symptoms of Hepatitis C?

It sounds strange, but there really are no symptoms of hep C. In fact, about half of people with hep C don’t even know they’re infected, according to the Mayo Clinic.

Those who do have symptoms may experience minor issues like fatigue and muscle aches, which can be chalked up to any number of reasons, like an intense workout or just life in general. But because these symptoms are so ubiquitous, they’re easy to miss, and you likely wouldn’t associate them with hep C.

What Are Less Common Signs and Symptoms of Hepatitis C?

When hep C becomes a chronic infection, meaning it’s been in the body, untreated for years, it can cause signs of liver disease (a broad term for any number of diseases that prevent this vital organ from functioning properly).

This can lead to cirrhosis, making it difficult for the liver to function properly, liver cancer or even liver failure. The liver performs many crucial functions, including: producing protein; breaking down nutrients from food; storing vitamins, minerals and sugar to prevent nutrient shortages; producing bile and removing bacteria from the blood to prevent infection. This is why the damage wrought by Hep C can be so serious.

Watch out for these signs your liver isn’t working as it should:

• Clay-colored poop: When your liver is damaged, it can’t transfer bilirubin—a substance that gives poop its brown hue—from blood to your stools.

• Dark-colored urine: That bilirubin instead goes to your pee.

• Jaundice skin or eyes: As levels of bilirubin build up, the whites of your eyes and your skin take on a yellow cast.

• Itchy skin: Liver damage can cause irritating bile salt to build up under the skin.

• Stomach pain or swelling: You may experience pain in the upper part of your abdomen.

• Swelling in the legs: When your liver is damaged, you often retain fluid.

• Waning appetite/Weight loss: You may find that food just doesn’t taste the same and you’re eating less.

• Bleeding and bruising easily: A damaged liver doesn’t produce enough clotting proteins.

• Fatigue/Fever: You may develop a fever or feel zonked as your body tries to eliminate the infection.

• Confusion and slurred speech: Advanced liver disease may cause toxins to accumulate in your brain, making clear thinking and communication difficult.

• Spider-like blood vessels on your skin: These veins often surface when you have a surplus of estrogen in your system, common to liver disease.

If you have any of these symptoms, make an appointment with your doctor, pronto, so they can work to determine the cause of the problem, including a possible hep C infection.

Should You Get Tested for Hepatitis C?

Since you can live with hep C for decades without knowing it—it can take 10 to 40 years for hep C to progress from mild disease to cirrhosis, liver failure or liver cancer—the Centers For Disease Control and Prevention recommends a one-time blood screening test for anyone born between 1945 and 1965. This population is more at risk of having received a tainted blood transfusion.

Hepatitis C can only be diagnosed through a simple blood test called an HCV antibody test. True to its name, it looks for antibodies, proteins released into the bloodstream, that show up in someone infected with the hep C virus. If you have a positive HCV antibody test, you’ll then be given a follow-up HCV RNA test to learn whether you have an active infection.

What Are Treatment Options for Hepatitis C?

While no one wants to get diagnosed with a blood infection, hep C is 98% curable when you take the recommended course of treatment. Unlike the weekly interferon injections of the past, which delivered side effects as harsh as chemotherapy, treatment has come a long way in the past few years.

Thanks to a class of meds called direct-acting antivirals (DAAs), most people with hep C can be completely cured of the disease in just a matter of weeks (8 to 12 weeks in many cases). DAAs are taken in daily tablet form and while some patients experience mild side effects, they can usually be managed with OTC meds.

DAAs target and eliminate proteins found in the hep C virus; the two most common medications prescribed are Mavyret (glecaprevir and pibrentasvir) and Epclusa (sofosbuvir and velpatasvir), both of which include a cocktail of different types of antiviral drugs in one pill.

In rare cases (just 2% of patients), DAAs don’t work to clear the virus. When this happens, doctors will most often prescribe a more aggressive antiviral medication such as Vosevi. Because Vosevi is a potent combination of three antiviral drugs (sofosbuvir, velpatasvir, and voxilaprevir), it has a slightly higher burden of side effects, including:

• Headache

• Fatigue

• Diarrhea

• Nausea

If you’re put on DAAs, your doctor might also prescribe a longer course of treatment to clear the infection and will know for sure if the virus is gone by measuring how much viral genetic material (aka viral RNA) is in your blood.

This is determined through a blood test administered three months after you’ve finished your course of treatment. If no RNA is visible, you’re deemed cured, known as a sustained virologic response (SVR). A sustained virologic response is a very good thing for two key reasons: It’s associated with lower rates of liver cancer and cirrhosis. Translation: Getting rid of hep C gives people a better shot at a longer life.

Go Deep Into the Top Hepatitis C Treatments

What Does the Future Look Like After Hepatitis C Treatment?

Because DAAs are so effective and can completely cure the disease, most of those with hep C go on to live normal, healthy lives. But there is a caveat in all this: DAAs are not vaccines and can’t prevent you from getting the infection again (there is no vaccine available yet to prevent hep C).

If you engage in the same behaviors that led to the infection (such as sharing a razor with someone who’s infected or getting a tattoo from an unsterilized needle), you’ll be at risk for contracting the disease again. Be safe.

Meet Our Writer

Jennifer Tzeses

Jennifer Tzeses is a writer and content strategist specializing in health, beauty, psychology and lifestyle. She’s written for The Wall Street Journal, Mind Body Green, CNN, Architectural Digest, Barron’s, Cosmopolitan, Harper’s Bazaar, Psycom, Elle, Marie Claire, and more. Follow her on Instagram @jtzeses.

Hepatitis C (for Teens) – Nemours Kidshealth

What Is Hepatitis C?

Hepatitis C is an infection of the liver caused by the hepatitis C virus (HCV). HCV can lead to liver failure, liver cancer, or chronic liver disease (cirrhosis). HCV infections are a leading reason for liver transplants in the United States.

Some people with HCV have just a short-term illness because their bodies can get rid of the virus. But most infected people (70%–85%) develop a chronic (long-lasting) HCV infection.

How Do People Get Hepatitis C?

HCV spreads by direct contact with an infected person’s blood and other body fluids. This can happen through:

• sharing drug needles and intranasal (snorting) drug devices
• getting a tattoo or body piercing with unsterilized tools
• sexual contact (although this is less common)
• passing of the infection from a pregnant woman to her unborn child

Thanks to blood screening and other health care safety rules adopted in the early 1990s, the spread of HCV from hemodialysis, blood transfusions, or organ transplants is now rare.

It’s also rare, but possible, for someone to get HCV by sharing household items that might contain an infected person’s blood, such as razors, toothbrushes, or scissors.

Who Is at Risk for Hepatitis C?

HCV is more common in adults than in kids. Rates of HCV infection in the United States almost tripled from 2010 to 2015, according to the Centers for Disease Control and Prevention (CDC).

Most of these new infections are in young adults (20 to 29 years old) who inject drugs. Many of them went from abusing prescription drugs to injecting heroin, which often is cheaper and easier to get. Health experts worry that more newborns will be at risk for HCV because so many young women are part of this group.

What Is Chronic Hepatitis C?

Doctors refer to hepatitis C infections as either acute or chronic:

• An acute HCV infection is a short-term illness that clears within 6 months of when a person is exposed to the virus.
• A person who still has HCV after 6 months is said to have a chronic hepatitis C infection. This is a long-term illness, meaning the virus stays in the body and can cause lifelong illness. An estimated 3.2 million people in the U.S. have chronic HCV.

What Are the Signs & Symptoms of HCV Infection?

Most people with HCV have no symptoms. But even without symptoms, they can develop health problems decades later and can still pass the disease to others.

If symptoms do happen, it’s usually when the disease is very advanced. Symptoms can be similar to those of hepatitis A and hepatitis B and include:

• jaundice (when the skin and whites of the eyes look yellow)
• fever
• nausea, vomiting, and lack of appetite
• belly pain (on the upper right side)
• joint pain
• darker than usual urine (pee) or gray-colored stools

What Problems Can Hepatitis C Cause?

Hepatitis C is the most serious type of hepatitis. It’s now one of the most common reasons for liver transplants in adults. Every year, almost 20,000 people in the United States die from HCV.

Fortunately, medicines can now treat people with hepatitis C and cure them in most cases.

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How Is Hepatitis C Diagnosed?

Doctors do a blood test to look for antibodies to hepatitis C. If antibodies are present, it only means that the person has had an HCV infection at some point. To see if the disease is still active, doctors do another test to measure the level of HCV in the blood.

The CDC recommends the diagnostic blood test for:

• all Americans born between 1945–1965 (baby boomers)
• anyone who has ever injected drugs
• patients who received donated blood or organs before 1992
• people who get hemodialysis
• people who have conditions such as HIV or chronic liver disease
• newborns born to mothers with HCV
• people exposed to the blood of someone with HCV

How Is Hepatitis C Treated?

Significant progress has been made in treating and even curing hepatitis C. Older hepatitis C treatments usually required weekly injections, had serious side effects, and often were not effective.

New and better oral medicines now can cure HCV for many people within 3 months. The new medicines were very expensive at first, but their prices have come down, a trend that health experts hope will continue as the incidence of HCV rises and increased screening brings more cases to light.

These medicines successfully cure about 90% of HCV patients. A new oral medicine under development looks promising for the 10% who don’t respond to the standard treatment. This new antiviral combination pill is currently under review by the U.S. Food and Drug Administration (FDA).

What Happens After a Hepatitis C Infection?

As with hepatitis B, anyone who has ever tested positive for hepatitis C cannot be a blood donor.

People who had HCV as a result of drug use should get counseling or further treatment to help them overcome their addiction. Otherwise, they could become reinfected with HCV.

Can Hepatitis C Be Prevented?

Unfortunately, there’s no vaccine to protect against hepatitis C. Prevention means avoiding risky behaviors that can spread HCV, especially injecting drugs.

90,000 Herpes simplex virus

Infection with herpes simplex virus, commonly called herpes, can be caused by either herpes simplex virus type 1 (HSV-1) or herpes simplex virus type 2 (HSV-2). HSV-1 is transmitted primarily through oral contact, causing
infection in or around the mouth (oral herpes). However, HSV-1 can also be transmitted through oral-genital contact and can lead to infection of the genital area (genital herpes).HSV-2 is transmitted almost exclusively through genital
contact during sex and leads to infection of the genital or anal area (genital herpes).

Both oral herpes infections and genital herpes infections are asymptomatic or unrecognized in most cases, but can cause symptoms such as painful blisters or sores at the site of infection, such as
mild to severe.

Herpes simplex virus type 1 (HSV-1)

HSV-1 is a highly contagious infection, widespread and endemic throughout the world.HSV-1 infection occurs in most cases during childhood and the infection persists for life. In the vast majority of cases, infection with HSV-1 develops
oral herpes (an infection in or around the mouth sometimes called orolabial or orofacial herpes), but in some cases, HSV-1 also causes genital herpes (infections in the genital or anal area).

Magnitude of the problem

In 2016, an estimated 3.7 billion people under the age of 50, or 67% of the world’s population, were infected with HSV-1 (oral or genital herpes).The highest prevalence rates are estimated to be
were noted in Africa (88%), and the lowest in the Americas (45%).

Most of the HSV-1 infections were oral infections. Globally, an estimated 122 million to 192 million people aged 15-49 had genital HSV-1 infections in 2016, but the prevalence in the regions is significant.
varied. It is estimated that the largest number of infections with genital HSV-1 occurred in the Region of the Americas, the European Region and the Western Pacific Region, where HSV-1 infection continues into adulthood.

Signs and symptoms

A herpetic infection of the mouth is usually asymptomatic and most people with HSV-1 are unaware that they are infected. Among the symptoms of oral herpes, painful blisters or open lesions can be distinguished,
called sores, inside or around the mouth. Lip lesions are commonly referred to as “fever”. Before lesions appear, infected individuals often experience tingling, itching, or burning in the mouth.After initial infection, vesicles
or sores may recur intermittently. The frequency of their occurrence varies from person to person.

HSV-1 genital herpes may be asymptomatic or with mild symptoms that go unrecognized. In cases where symptoms do appear, genital herpes is characterized by the appearance of one or more vesicles or
ulcers in the genital or anal area. After an initial episode of genital herpes, which can be severe, symptoms may recur.However, genital herpes caused by HSV-1 usually does not recur frequently, in contrast to
from genital herpes caused by herpes simplex virus type 2 (HSV-2; see below).

Transmission

HSV-1 is transmitted primarily through oral contact and causes oral herpes infections through contact with HSV-1 in the affected area, saliva, and surfaces in or around the mouth. However, due to oral-genital contact, HSV-1 can
also come into contact with the genital area and cause genital herpes.

HSV-1 can be transmitted through the surface of the mouth or skin that looks normal and has no symptoms. However, the greatest risk of transmission exists when active lesions are present.

In individuals who already have a herpes infection of the mouth, subsequent infection of the genital area with HSV-1 is unlikely.

In rare cases, HSV-1 infection can be transmitted from a mother with genital HSV-1 infection to her baby during childbirth and lead to neonatal herpes (seebelow).

Potential complications

Severe disease

In individuals with weak immune systems, such as those with advanced HIV infection, HSV-1 can cause more severe symptoms and more frequent relapses … In rare cases, HSV-1 infection can also lead to more
severe complications such as encephalitis (brain infection) or keratitis (eye infection).

Neonatal herpes

The development of neonatal herpes can occur when a newborn comes into contact with HSV in the genital tract during childbirth.Neonatal herpes is rare, with an estimated 10 out of 100,000 births worldwide, but this serious condition can lead to persistent
neurological disability or death. Women who have had genital herpes before pregnancy have a very low risk of passing HSV to their babies. The greatest risk of neonatal herpes occurs when a woman first becomes infected with HSV in the late
pregnancy, in part because the highest levels of HSV concentration in the genital tract are observed in the early stages of infection.

Psychosocial Impact

Recurrent symptoms of oral herpes can be uncomfortable and lead to some social stigma and psychological stress. In genital herpes, these factors can have significant adverse effects on
quality of life and sexual relations. However, over time, most people with some form of herpes will adjust to living with the infection.

Treatment

The most effective drugs for people infected with HSV are antiviral drugs such as acyclovir, famciclovir and valacyclovir.They help to alleviate symptoms and reduce the frequency of their occurrence, but do not lead to complete
healing.

Prophylaxis

HSV-1 is most contagious during the onset of symptoms of oral herpes, but it can also be transmitted when no symptoms are felt or observed. People with active symptoms of oral herpes should
avoid oral contact with other people and sharing objects that have come into contact with saliva.They should also refrain from oral sex to prevent herpes from getting on the sexual partner’s genitals. For people with symptoms
for genital herpes, you should refrain from intercourse while they are showing any symptoms.

Consistent and correct use of condoms can help prevent the spread of genital herpes. However, condoms can only reduce the risk of infection, since symptoms of genital herpes can appear
in places not protected by a condom.

Individuals already infected with HSV-1 may not be re-infected, but they remain at risk of infection with HSV-2 in the genital area (see below).

Pregnant women with symptoms of genital herpes should inform healthcare professionals. Preventing new infections with the genital herpes virus is especially important for women late in pregnancy because
during this period there is the highest risk of developing neonatal herpes.

More research is underway to develop more effective prevention methods for HSV infections, such as vaccines. A number of candidate HSV vaccines are under study.

Herpes simplex virus type 2 (HSV-2)

HSV-2 infection, which causes genital herpes, is widespread throughout the world and is transmitted almost exclusively through sexual contact. HSV-2 is the leading cause of genital herpes, although herpes simplex virus type 1 can also cause it
(HSV-1).HSV-2 infection persists for life and cannot be cured.

Magnitude of the problem

Genital herpes caused by HSV-2 is a global problem, with an estimated 491 million people (13%) globally aged 15-49 in 2016.

There are more women than men among people infected with HSV-2; an estimated 313 million women and 178 million men were living with the infection in 2016. This is because HSV is transmitted sexually more efficiently from man to woman,
than from a woman to a man.

The highest prevalence rates of HSV-2 infection are estimated to be in Africa (44% in women and 25% in men), followed by America (24% in women and 12% in men). The prevalence of infection increases with age.
although adolescents are the largest number of newly infected people.

Signs and symptoms

Genital herpes infection is often asymptomatic or with mild symptoms that go unrecognized.Most infected people are unaware that they are infected. As a rule, about a previously diagnosed genital
herpes is reported by about 10-20% of individuals infected with HSV-2. However, clinical studies that closely track primary infections have shown that up to one third of newly infected people may have symptoms.

When symptoms do occur, genital herpes is characterized by the appearance of one or more blisters or open lesions called ulcers in the genital or anal area.In addition to ulcers in the genital area, symptoms of primary
Genital herpes infections are often feverish, body aches, and swollen lymph nodes.

After an initial episode of HSV-2 herpes infection of the genital area, symptoms often recur, but they are less intense than when they first appeared. The incidence of symptoms tends to decrease over time, but they
can appear over the years. Before sores develop in the genital area, people infected with HSV-2 may experience mild tingling or shooting pain in the legs, thighs, and buttocks.

Transmission

HSV-2 is transmitted mainly through sexual intercourse, through contact with the surfaces of the genitals, skin, affected areas or fluids of a person infected with this virus. HSV-2 can be transmitted through the skin in the genital or anal area,
which looks normal and is often transmitted even in the absence of symptoms.

In rare cases, HSV-2 infection can be passed from mother to child during childbirth and cause neonatal herpes.below).

Potential complications

HSV-2 and HIV

It has been proven that HSV-2 and HIV affect each other. HSV-2 infection increases the risk of HIV infection by about three times. In addition, people with HIV and HSV-2 are more likely to transmit HIV to others. HSV-2 is one of the most
common infections among people living with HIV infection, and occurs in 60-90% of people with HIV infection.

HSV-2 infection in people living with HIV (and other immunocompromised people) is often more severe and with more frequent relapses.In the later stages of HIV infection, HSV-2 can lead to more severe, albeit rare, complications such as
as meningoencephalitis, esophagitis, hepatitis, pneumonitis, retinal necrosis or disseminated infection.

Neonatal herpes

The development of neonatal herpes can occur when a newborn comes into contact with HSV (HSV-2 or HSV-1) in the genital tract during childbirth. Neonatal herpes is rare, with an estimated 10 out of 100,000 births worldwide, but it is a serious condition
can lead to permanent neurological disability or death.Women who have had genital herpes before pregnancy have a very low risk of passing HSV to their babies. The greatest risk of neonatal herpes occurs when a woman first becomes infected
HSV late in pregnancy, in part because the highest levels of HSV in the genital tract are seen in the early stages of infection.

Psychosocial

Relapses of genital herpes symptoms can be painful and the infection can lead to social stigma and psychological stress.These factors can have significant adverse effects on quality of life and sexual relations.
However, over time, most people with herpes will adjust to living with the infection.

Treatment

The most effective drugs for people infected with HSV are antiviral drugs such as acyclovir, famciclovir and valacyclovir. They help to alleviate symptoms and reduce the frequency of their occurrence, but do not lead to complete
healing.

Prophylaxis

Persons with genital HSV infection should abstain from sexual intercourse when symptoms of genital herpes appear. HSV-2 is most contagious during the onset of lesions, but it can also be transmitted when there is no
symptoms are not felt or observed.

Consistent and correct use of condoms can help reduce the risk of spreading genital herpes.However, condoms provide only partial protection, as HSV can be found in areas not protected by a condom.
Male medical circumcision can provide men with lifelong partial protection against HSV-2, as well as HIV and human papillomavirus (HPV).

Individuals with symptoms suggestive of genital HSV infection should be tested for HIV, and those living in areas with high HIV prevalence should be offered more focused
HIV prevention measures such as pre-exposure prophylaxis.

Pregnant women with symptoms of genital herpes should inform healthcare professionals. Preventing new infections with the genital herpes virus is especially important for women late in pregnancy because
during this period there is the highest risk of developing neonatal herpes.

More research is underway to develop more effective methods of preventing HSV infections, such as vaccines or topical bactericides (drugs to protect against sexually transmitted infections).
in a way that can be applied intravaginally or intrarectally).

WHO work on herpes (HSV-1 and HSV-2)

Worldwide, there is a need to raise awareness of HSV infection and its symptoms, improve access to antiviral drugs and intensify prevention efforts HIV infection among people with symptoms of genital infection caused by
HSV.

In addition, there is a need to develop improved treatment and prevention measures, in particular the HSV vaccine. WHO and partners are working to accelerate research to develop new strategies for the prevention and control of genital and neonatal infections,
caused by HSV-1 and HSV-2.These studies include the development of HSV vaccines and topical bactericides. A number of candidate vaccines and bactericides are under study.

Stomatidine

Having settled in the body, the herpes virus is waiting for the right moment. The tactic is simple: catch the time when the immune system is weakened and enter the bloodstream. Immunity lends itself to a serious blow and suffers even more. Against the background of an awakened infection, other diseases may be added. Not only the skin suffers, but also the internal organs, mucous membranes.Herpes is incurable. Nevertheless, humanity lives with it, successfully suppressing the symptoms and the pathogen.

First type

Herpes on the lip and mouth is caused by a type 1 virus. They used to call him a cold, in part, this is so. Colds are the process of activating pathogenic microflora that already lives in the body. It multiplies with a decrease in immunity. Herpes also works.

The child acquires antibodies to the virus from the mother, but by the age of 3 they are reduced to nothing.Since the infection is easy, it does not appear immediately, many do not even notice it. The only way out is to increase the body’s natural defenses (immunity).

Causes of herpes, more precisely, factors that reduce immunity and provoke its manifestation:

• viral diseases and colds
• onset of menstruation in women
• severe stress
• long sun exposure
• lack of sleep
• hypothermia or overheating
• lack of vitamins
• grueling diets

Many factors can be avoided by following a healthy lifestyle.

The virus easily penetrates the environment from patients with rashes. If particles of the pathogen get on the skin or mucous membranes, infection occurs. Any household items can also cause infection: linen, toys, dishes.

Second type

Virus of the second type causes genital infection. It is transmitted sexually. Herpes in the mouth may develop after oral sex. One of the most dangerous forms of the disease is intrauterine infection.This happens if the virus is activated in the mother’s body during pregnancy. For the fetus, the consequences are severe.

With a mild course of the disease, the prognosis is good: the symptoms were eliminated, and the virus subsided for many years. Sometimes complications arise:

• oocyte and sperm damage leading to infertility
• herpetic vision loss
• suffers from the central nervous system and brain
• sciatica
• sore throat and pharyngitis
• pneumonia of herpetic nature
• hepatitis

These dire consequences are a reminder that herpes is a bad joke and that it requires timely treatment when the slightest symptom is detected.

90,000 diagnostics and treatment “- Yandex.Q

The first encounter of a child with HHV-6 usually occurs before the age of 3 years and can manifest itself in the form of roseola (also called sudden exanthema).

Roseola is an acute emerging disease, accompanied by an increase in body temperature to high numbers, which after 3-4 days is replaced by the appearance of a profuse rash.

Diagnostic features

The first thing to say is that the clinical manifestations and the characteristic stages in the development of the disease are sufficient for a diagnosis.

This could end, but given the love of our person to investigate something, which can equally come from both the doctor and the parents of the little patient, I nevertheless decided to write a little about it.

And to a greater extent about what difficulties in diagnostics can be encountered.

1. IgM may be false positive due to the existing potential for cross-reactions with other beta-herpes viruses (CMV, herpes type 7 (HHV-7)
2. IgG appear in the blood several weeks after the onset of the disease.Therefore, if the child was examined at the height of the illness and antibodies of class G were detected, then the virus has nothing to do with the current disease.
3. In the acute period, the most informative is the detection of the virus in the blood by PCR
4. Sometimes it happens that the manifestations of the disease are typical, but the tests are negative. There is also an explanation for this. The fact is that roseola can be caused not only by HHV-6, but also by HHV-7. Then, if there is a goal to find out the cause of the disease, an examination is also required for this virus.

So, laboratory confirmation of the diagnosis is the detection of the virus by PCR, usually in combination with IgM antibodies in the absence of IgG. At the same time, all these ordeals are meaningless if the clinical picture of the disease is typical, because the survey results do not have any influence on further tactics.

Treatment of roseola is symptomatic.

Acute infection

HHV-6 was opened not so long ago – in 1986.This, of course, does not mean that they did not get sick before – they simply did not have the opportunity to identify them. Today, the virus is found in 90% of the adult population in developed countries.

Most often, infection occurs between the ages of 6 months and 2 years, which is associated with the loss of maternal immunity and a high probability of infection due to the prevalence of the virus.

In approximately 1% of cases, intrauterine infection is possible. However, the proven effect on the fetus or the course of pregnancy has not been established.There are suggestions about the possible participation of the virus in the formation of CNS defects and the development of pathology during childbirth and the early postpartum period.

The first encounter with HHV-6 can occur in children in the form of roseola, I already wrote about this. And this is the only situation where we can clinically suspect infection with this virus.

In other cases, the manifestations are nonspecific and can manifest, for example, in the form of acute respiratory viral infections, gastroenteritis, mononucleosis, hepatitis, accompanied by a rash, damage to the central nervous system, or none at all.

There is evidence that primary HHV-6 infection accounts for 10-20% of febrile illnesses in children aged 6-36 months. And, perhaps, this virus is the most common reason for hospitalization of children under 3 years of age due to diseases occurring with fever.

A severe course of acute HHV-6 infection is more common in children with an immunodeficiency state, but in rare cases, children without immune system dysfunctions can develop encephalitis.

So far, none of the antiviral drugs has been included in the recommendations for the treatment of HHV-6 infection. clinical data on their effectiveness are insufficient.

At the same time, the antiviral activity of foscarnet, cidofovir and ganciclovir has been proven in vitro. Their use is permissible in situations where it is about potential life-saving benefits, for example, with severe encephalitis.

In all other cases, only symptomatic treatment.

Chronic forms

Once ingested, HHV-6, like other herpes viruses, never leaves the body.

In most cases, it is in the latency stage, but it is also possible:

• Endogenous reactivation
  – periodic appearance of the virus in blood and other biological fluids. Clinically manifests itself against the background of immunosuppression.
• Reinfection. There are two types of herpesvirus 6 known today, type HHV-6A and HHV-6B. Most often, primary infection is associated with the HHV-6B virus, reinfection with another type is usually asymptomatic, but the virus is found in the blood and IgM is produced in response to it.The manifest course of reinfection is typical for organ donor recipients, HIV-infected and other immunosuppressed patients.

ciHHV-6 is a type 6 herpes virus integrated into chromosomes. A condition in which the genome of a virus is completely integrated into the human genome, i.e. every nuclear cell in the body has a complete set of information about HHV-6. It is found in less than 0.2-1% of the population.

Transmitted by inheritance to offspring or from a stem cell donor and possibly organs to a recipient.It is assumed that the emergence of new cases of ciHHV-6 may be associated with the ability of the virus to infect sperm, but there is no convincing evidence in favor of such a mechanism.

Naturally, such possibilities of the virus are of great concern to scientists’ minds. Attempts are being made to establish a relationship between ciHHV-6 and the development of multiple sclerosis and other demyelinating diseases of the central nervous system, autoimmune thyroiditis, cardiomyopathy, various vasculitis, chronic fatigue syndrome and some oncological diseases.

But so far no definite conclusions. To date, the most convincing data have been obtained on the role of ciHHV-6 in the development of hereditary angina pectoris.

None of the forms of chronic HHV-6 infection can be treated in people without immunosuppression. Even in immunocompromised patients, treatment can only be considered if there is a life-threatening condition.

Considering all of the above, I have a philosophical question. Why examine everyone in a row for herpes type 6?

90,000 ▷ Eurolab Medical Center

General characteristics

Herpes simplex virus type VI is genetically similar to cytomegalovirus (CMV).There are two types of Human herpes virus VI: HHC-6A and HHC-6B.

HHV-6A is most often found in patients with neuroinflammatory diseases (multiple sclerosis, etc.), HHV-6B is the cause of baby roseola. It can manifest itself during organ transplantation, leading to clinical manifestations: encephalitis, bone marrow suppression, pneumonitis.

Transmitted by close contact between people via:

• saliva,
• blood,
• breast milk,
• semen, vaginal secretions.

Indications for Prescribing

• appearance after a short fever of pink maculopapular skin rashes,
• enlargement of lymph nodes: cervical, posterior ear,
• changing diagnostics of infections (rubella, measles, infectious erythema, enterovirus infection, otitis media, meningitis, etc.),
• vesicular herpetiform rash,
• preventive screening studies,
• immunodeficiency states.

Clinical significance

Assistance in express diagnostics of herpes virus type VI infection.

Material for research

Whole blood, peripheral blood plasma, cerebrospinal fluid, saliva, oropharyngeal swabs, biopsy and autopsy material, amniotic fluid, bronchoalveolar lavage, scraped discharge of the mucous membrane of the urogenital tract, urine (first portion).

Rules for the preparation of the patient

Blood

Standard conditions.8-12 hours after the last meal. A break of 6 hours after a meal is allowed (fatty foods should be excluded).

Urogenital scraping

Standard conditions. For three hours before the analysis, they will refrain from urinating. Exclude sexual intercourse within three days. Do not take antibacterial drugs for two weeks.

For women, three days before the study, the following are contraindicated: douching, setting intravaginal suppositories, ointments, tampons.The material does not surrender during menstruation (3 days after its end).

Oropharyngeal scraping

Standard conditions. On an empty stomach or 2-4 hours after eating. Before analysis, rinse your mouth with boiled water.

Saliva

Standard conditions. Do not eat, drink, smoke, or brush your teeth within 30 minutes before taking the material. The day before the analysis, exclude: the use of alcoholic beverages, the ingress of lipstick.

Urine

It is imperative to conduct a toilet of the external genital organs before analysis.The first portion of the morning urine is collected in a sterile dry container.

90,000 Herpes infection: causes, signs and manifestations

Herpes infection (herpes viruses) among all viral diseases occupy one of the leading places.

This is due to the ubiquitous spread of herpes viruses (HS), the variety of clinical manifestations of the disease, as a rule, a chronic course and various routes of transmission of the pathogen.

The family of herpes viruses (Herpesviridae) includes more than 70 representatives, of which herpes simplex viruses of types 1 and 2 (HSV-1, HSV-2), chickenpox and herpes zoster virus (VOG), cytomegalovirus (CMV) have the greatest pathogenicity for humans , Eshptein-Barr virus (EBV), human herpesvirus type 6 (HHV-6), human herpes virus type 7 (HHV-7).

Table: manifestations of various types of herpes infection

“Entrance gate” herpes and cytomegalovirus infection

The main stages in the development of herpes infection are: primary infection of the skin and mucous membranes, “colonization” and acute infection of the nerve nodes (ganglia) with the subsequent establishment of latency, when only viral DNA in the nuclei of neurons indicates the presence of infection.

The gateway for cytomegalovirus infection (CMV) in children and adults may also be the upper respiratory tract; the possibility of alimentary infection is allowed (through plates, not washed hands, etc.)In these cases, the virus is introduced into the mucous membranes of the digestive tract. There were no local changes at the site of the entrance gate of the infection. Cytomegalovirus has a pronounced tropism to the tissues of the salivary glands; in a localized form, it is found only in the tissues of the salivary glands.

L Laboratory diagnostics for herpes and CMV

It has now been established that herpes viral infection in adults and children is essentially an exacerbation of persistent infection against the background of immunosuppression (that is, reduced immunity).

Speech in this case is not only about HIV-infected patients, for example. The reasons for the decrease in immunity may be a previous severe infectious disease, for example, pneumonia, frequent incidence of acute respiratory viral infections, physical and emotional fatigue, vitamin deficiency (including seasonal vitamin D deficiency).

It is during the period of exacerbation of herpes infection that it makes sense to carry out laboratory diagnostics mainly by ELISA, the determination of specific IgG and IgM antibodies in the blood, the latter of which are the main marker of exacerbation of herpes infection.

Who needs laboratory diagnostics for herpes viruses?

As can be concluded from the above, herpes infection should be diagnosed primarily in persons with signs of immunodeficiency: in children with congenital pneumonia or manifestations of neuroinfection, in the presence of pronounced changes in the leukocyte blood count, a sharp decrease in the clinical blood test of neutrophils, thrombocytopenia, during pregnancy planning and early pregnancy in order to avoid the embryotoxic effect of cytomegalovirus infection on the fetus.It makes sense to get tested for herpes infection for those adults and children who suddenly began to often get sick with colds.

Treatment of herpes infection

When a laboratory-confirmed herpes infection is established, complex treatment is prescribed, including antiviral and immunomodulatory drugs. The course of treatment for acute herpes infection, as a rule, takes at least 10-14 days, followed by a control laboratory study.But no less important, in addition to achieving the elimination (destruction) of the herpes virus in the biological environment of the body, it is also important to conduct a thorough diagnosis to identify the factors and causes that contributed to the development of an immunodeficiency state. A study of the state of the gastrointestinal tract can help with this: ultrasound of the abdominal cavity, scatology, examination of feces and blood for the presence of helminths, identification and elimination of possible allergens, as well as the selection of proper nutrition and vitamin therapy.

Herpes – MOSITALMED

Herpes is a highly common chronic infection that infects most of the population.Clinically, the disease is manifested by the formation of confluent blisters on the skin and itching. The causative agent of the disease is the herpes simplex virus, which can affect the central nervous system, eyes, genitals and cause severe complications for the fetus during pregnancy.

In the Mositalmed clinic you can undergo a complete diagnosis of the disease, as well as a course of treatment aimed at relieving herpes symptoms and reducing the frequency of relapses.

Types of herpes virus

The herpes virus belongs to the Herpeveridae family and includes 8 types and three subfamilies:

1. Subfamily Alphaherpesvirinae comprises herpes simplex viruses 1, 2 and varicella-zoster virus;
2. Subfamily Gammaherpesvirinae includes Epstein-Barr virus, HHV-VI, HHV-VII, HHV-VIII;
3. Subfamily Bethaherpesvirinae is type V, Cytomegalovirus

Causes of herpes

Transmission of the virus occurs often at birth, sometimes through contact and everyday life.After the virus enters the body, it enters the cells of the nerve spinal ganglia of the cervical or sacral region, where it remains for life.

Hypothermia, colds, decreased immunity, hypovitaminosis, stress and poor nutrition contribute to the development of symptoms and relapses of the disease.

Herpes Symptoms

Herpes simplex virus 1 causes oral, rarely genital herpes. Such herpes is characterized by the formation of small bubbles in an amount of one to ten pieces, they are located in groups, and inside are filled with serous exudate.Gradually, the bubbles open up, and crusts form in their place, which disappear on the 6th day of the disease. After that, an unobtrusive pigmentation remains, which disappears on its own and without a trace at the end of recovery.

The formation of vesicles is accompanied by severe itching, pain and burning at the site of the pathological process. Systemically, there may be an increase in temperature and an increase in lymph nodes. With oral herpes, vesicles are localized around the mouth and wings of the nose. The genital form of the disease manifests itself with characteristic symptoms on the genital mucosa.

HSV2 leads to the development of genital, vaginal and rarely oral forms of the disease. The type 3 virus provokes shingles, which develops in individuals infected with Herpes Zoster. In this case, a rash is formed along the nerve endings, most often it is the intercostal and trigeminal nerves. The disease is accompanied by severe pain, lacrimation and general weakness.

Epstein-Barr virus is the causative agent of infectious mononucleosis, CNS lymphoma and Burkitt. Cytomegalovirus causes hepatitis, rhinitis, and infectious mononucleosis.Types 6 and 7 are both roseoloviruses and cause childhood roseola, chronic fatigue syndrome.

Herpes Treatment

The main goal of treating herpes in adults is to relieve symptoms of the disease and reduce the frequency of relapses. To eliminate the symptoms of oral and genital herpes, ointments and tablets with a specific antiviral effect are used.

To prevent recurrence of the disease, therapy is carried out aimed at increasing the body’s defenses. For this purpose, immunostimulating drugs, herpes vaccines, vitamin therapy and physiotherapy procedures are used.

At the Mositalmed clinic, our specialist will diagnose the disease and tell you how to treat herpes, according to international standards and the individual characteristics of each patient.

You can get advice and make an appointment by phone: +7 (495) 212-90-98

Genital herpes – causes, signs, symptoms and treatment: herpes diagnosis

Today, one of the most common viral diseases is herpes. This dormant, periodically exacerbating infectious process with characteristic vesicular rashes on the skin and mucous membranes is caused by two types of herpesvirus: HSV-1 and HSV-2.

Types of herpes simplex virus

HSV-1, or simple labial herpes (so-called fever on the lips), is transmitted by airborne droplets or by contact (with particles of infected saliva when coughing and sneezing, when kissing, using other people’s cups, spoons, etc.) … It can be asymptomatic or with rashes on the mucous membrane of the mouth, lips and wings of the nose. After the obvious signs of the disease disappear, the herpes virus does not die, but penetrates the trigeminal nerve node along the sensitive fibers and integrates into the genetic apparatus of nerve cells.With hypothermia, stress and other negative influences leading to a weakening of the body’s immune forces, the pathogen provokes relapses of the disease.

HSV-2, or genital herpes , affects the external genital organs and leads to the development of nonspecific diseases of the urogenital sphere. In this case, infection occurs through unprotected sexual intercourse. Just like herpesvirus type I, the pathogen penetrates the nerve cells located in the lumbar region and until a certain moment is there in a dormant state.In addition, in recent decades, due to the spread of the practice of oral sex, HSV-1 becomes the cause of genital herpes in 10–30% of cases.

How to recognize genital herpes

During an exacerbation, herpes in the intimate area causes the development of symptoms such as malaise, aching joints and muscles, a slight increase in body temperature. The characteristic signs of the disease include itching, tingling in the groin, in the genital area and anus, lumbago in the lower back, swelling and redness of the genitals, an increase in the inguinal nodes.

In 1-2 days after the primary manifestations of herpesvirus infection, rashes appear on the skin and mucous membranes in the form of small painful vesicles filled with a cloudy liquid. In men, as a rule, they are localized on the foreskin and on the coronal sulcus, less often they spread over the entire surface of the penis, and affect the pubis and scrotum. In women, genital herpes manifests itself in the form of a bubble rash on the labia, in the perineum and anus, in especially severe cases, vesicles are localized in the vagina and on the cervix (i.e.n. vaginal and cervical herpes).

Relapses of the disease can be repeated 5–20 times a year and last for 2–3 weeks. During this period, a sick person is the most infectious (1 ml of bubble liquid can contain from 1 to 10 million viral particles).

Treatment of genital herpes

In the presence of symptoms of genital herpes, in order to avoid the development of complications, compulsory treatment with the use of drugs of specific antiviral chemotherapy is required.Their use (especially in the first knocks from the moment the rash appears) prevents the multiplication of the virus and thereby significantly alleviates the patient’s condition.

Drugs with proven efficacy used in the treatment of herpes include drugs based on acyclovir. With frequent exacerbations of the infectious process, in order to reduce the frequency of relapses, it is recommended to use them for several months (after consulting a specialist). Mild local analgesics are used to relieve itching, burning and pain.

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