Department of Health
John J. Dreyzehner, MD, MPH, Commissioner

Hepatitis is an inflammation of the liver that is caused by various viruses and other factors. This inflammation can result in serious liver damage. There are at least six different agents: hepatitis A, B, C, D, E and G viruses. Hepatitis C is considered the most serious and affects the most people.

Most people who are infected with the hepatitis C virus (HCV) do not have symptoms and are leading normal lives. If symptoms are present, they may be very mild and flu-like – nausea, fatigue, loss of appetite, fever, headaches, and abdominal pain. Most people do not have jaundice although jaundice can sometimes occur along with dark urine.

The incubation period varies from 2-26 weeks. Liver enzyme tests may range from being elevated to being normal for weeks to as long as a year. The virus is in the blood and may be causing liver cell damage, and the infected person can transmit the disease to others.

Generally, Americans are unaware of hepatitis and its impact.  If the body does not clear the virus in six months, the infection is said to be chronic.  

• Number of new infections per year has declined from an average of 240,000 in the 1980s to about 30,000 in 2003.
• Most infections are due to illegal injection drug use.
• Transfusion-associated cases occurred prior to blood donor screening; now occurs in less than one per million transfused unit of blood.
• Estimated 3.9 million (1.8%) Americans have been infected with HCV, of whom 2.7 million are chronically infected.
• 80% of affected people can become chronically infected and risk serious long-term clinical disease including cirrhosis and liver cancer.

At greatest risk are people who use intravenous or intranasal drugs. Those who had a blood transfusion prior to 1990, health care professionals and others in occupations with exposure to blood or blood products, or who have unprotected sex with multiple partners are also at risk for hepatitis C. Now, all donated blood is screened for hepatitis C, and the risk of contracting the disease through a blood transfusion is less than one percent. Tattooing and body piercing with contaminated equipment may be a risk.

The most efficient transmission of hepatitis C is through puncture of the skin by contaminated needles. The means of acquisition is unknown in about 10 percent of people infected with hepatitis C.

Many people with chronic hepatitis may eventually develop cirrhosis (scarring of the liver) or liver cancer. Hepatitis is the No. 1 cause of liver transplantation in the U.S. Each year, up to 8,000 Americans die from complications of hepatitis C. The death rate is expected to triple within the next 10 to 20 years, exceeding the death rate associated with AIDS.

There is no vaccine for hepatitis C.  A prudent lifestyle can reduce chances of infection. People in a monogamous sexual relationship with an uninfected partner are not at risk. Those with multiple partners are at risk, but can decrease their likelihood of being infected by using condoms. Contact with other people’s blood should be avoided, as should the sharing of razors, toothbrushes, or pierced earrings. Needles for body piercing and tattooing should be properly sterilized.

The only proven treatment for hepatitis C is alpha interferon. Researchers are currently studying combination therapy with interferon and an antiviral drug called ribavirin that appears to be significantly more effective than interferon alone in inducing sustained remission.

Risk Factors of Hepatitis C Infection
Received blood transfusions before 1990	Used intravenous or intranasal drugs	Worked in an emergency or health care setting with exposure to blood or blood products	Had unprotected sex with multiple partners or a history of sexually transmitted diseases	Obtained tattoos or