Written on June 28, 2023 by Amy Harris, MS, RN, CNM. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.
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Are you among the more than 2 million people in the U.S. with hepatitis C (Hep C) who don’t know they have this viral infection? It seems hard to believe, but because hepatitis C symptoms can take years to develop, you could have hepatitis C and not know it.
The good news is that today’s drug regimens can cure more than 95% of Hep C cases — if the infection is diagnosed and treated early. Less than half (40 %) of the 37 million Americans with hepatitis C have received treatment, despite these significant advances. Regular screening for hepatitis C, practicing safe sex, avoiding intravenous (IV) drug use, watching for symptoms, and learning more about how hepatitis C is treated are all ways to stay safe and healthy.
Hepatitis C is a viral infection that causes liver inflammation, scarring (called cirrhosis), and damage. Hepatitis C transmission occurs most often via contaminated blood — blood from a person with hepatitis C transmits the virus into an uninfected person’s body. Today in the U.S., hepatitis C transmission occurs most commonly through intravenous drug use.  This type of transmission rose to new heights between 2010 and 2018, with more people injecting drugs during the opioid epidemic. Other possible routes for hepatitis C transmission include :
The risk of transmitting hepatitis C through sexual intercourse is low but is more likely if sexual activity involves exposure to blood, as is more common with anal intercourse or vaginal intercourse without a condom during menstruation, for example.
There is not yet a hepatitis C vaccine, but medicines can cure most cases of hepatitis C. If not treated, chronic hepatitis C can cause liver cancer and liver cirrhosis (liver scarring). The CDC recommends that all adults aged 18 to 79 receive screening for hepatitis C at least once in their life.
The hepatitis C virus (HCV) can cause both acute and chronic infections. Every chronic hepatitis C infection starts with an acute infection. Over half of all hepatitis C infections are chronic, meaning the HCV blood test remains positive for over six months.[5,8] Chronic hepatitis C infections may be “silent” for many years because there aren’t any symptoms.
In contrast, most people with acute hepatitis C do have symptoms. Symptoms develop one to three months after being infected with the Hep C virus and can last anywhere from two weeks to three months. The most common symptoms of an acute hepatitis C infection are :
When it comes to testing for hepatitis C, blood tests can’t tell you whether or not you have an acute or chronic hep C infection, just that you have the virus.
If you have symptoms close to when you think you might have been infected, your healthcare provider will want to test for and treat your acute hepatitis C infection. They will most likely use a class of medications called antiretroviral medications. 
Antiretrovirals work by interrupting the hepatitis C virus’s lifecycle. These medications prevent a virus from being able to make copies of itself. This keeps the absolute amount of virus in your body (called the viral load) at low enough levels to protect your liver, keep you healthy, and sometimes eliminate the virus.[3,8]
For adults without cirrhosis, who have never had prior hepatitis C treatment, the recommended treatment is a simplified eight-week regimen of glecaprevir/pibrentasvir or 12 weeks of sofosbuvir/velpatasvir (pills you can take by mouth). These treatment regimens result in more than 95% of the patients treated being cured of hepatitis C.
There are now tests to identify different subtypes of the Hep C virus (like Coronavirus variants). Depending on your subtype, your healthcare provider may recommend different combinations of medications.
Once you test positive for hepatitis C, your healthcare provider will likely want further testing to determine which treatments are best for you. Your care may be managed by a team of specialists such as a liver doctor (hepatologist), a doctor specializing in disease of the stomach and intestines (gastroenterologist), and an infectious disease doctor.[1,8] The goal of treating chronic hepatitis C is to protect your liver against further life-threatening damage.
The success of hepatitis C treatment regimens varies depending on your Hep C genotype (there are seven genotypes and 67 subtypes), whether or not you already have cirrhosis, if you also have HIV, and whether or not you have already been treated with antiretroviral medications previously. Living with hepatitis C is undoubtedly an adjustment. Still, as medicines continue to improve in terms of their ability to cure hepatitis C with fewer side effects, the future looks bright for the millions of Americans living with hepatitis C.
Over many years, chronic hepatitis C may cause severe liver problems and, ultimately, liver failure. When your liver is so damaged that it can no longer perform its vital functions, your healthcare team may recommend a liver transplant. Chronic hepatitis C is the most frequent cause of liver transplantation in the United States.
Early diagnosis and treatment of hepatitis C can prevent chronic liver damage and death. If you have any hepatitis C infection risk factors, consider testing more frequently. Everlywell makes it easy to check for hepatitis C conveniently from the privacy of your home with the at-home Hepatitis C Test.
Not sure whether you are at risk for hepatitis C? Everlywell offers a telehealth option for an online STD consult with a healthcare provider. Expert nurse practitioners will advise you about which STD tests are right for you, whether you might have any symptoms or signs of hepatitis C, and how to best take care of your sexual health.