What is hepatitis C?

Hepatitis C is an inflammation of the liver that is triggered by the hepatitis C virus. It has a worldwide prevalence and is one of the most common infectious diseases. Around 71 million people are affected by this. A differentiation is made between acute and chronic infection. The acute infection can resolve spontaneously in up to 40% of cases. Yet it turns into a chronic form in about 3 out of 4 cases, i.e. the hepatitis C viruses can still be detected in the blood 6 months after infection. Untreated, up to 20% of people with chronic hepatitis C develop cirrhosis after 20 years. Liver cirrhosis increases the risk of developing liver cancer.1

Read more about how cirrhosis can develop and its effects here.

Here you can watch a video that explains hepatitis C

The hepatitis C virus is primarily transmitted through blood-to-blood contact, but it may also be found in other body fluids such as saliva, semen, sweat or even tears. Typical situations with a risk of infection include, for example:1

  • Unprotected sex practices (without a condom) with increased likelihood of injury
  • Using or sharing contaminated paraphernalia for drug use, including sniffing if sniffing tubes or banknotes used for this purpose are shared
  • Sharing personal hygiene items, such as razors or nail scissors
  • Needlestick injuries (medical staff)
  • Childbirth, during which infected mothers can pass on the infection to the child

There are no symptoms of the disease that unambiguously indicate hepatitis C. The disease progresses inconspicuously or mildly in about 75% of those affected. Those suffering from fatigue, lack of energy, non-specific upper abdominal pain, itching and joint pain for a longer period of time should talk to a doctor about it. Raised liver function tests are another possible indication of hepatitis C infection. Hepatitis C can also trigger symptoms outside the liver, such as kidney disease, joint problems, skin disorders and depression. Those affected by hepatitis C also have an increased risk of diabetes mellitus.1

Blood is tested for antibodies against the hepatitis C virus in order to detect a hepatitis C infection. The presence of these antibodies in the blood is not necessarily an indication of an active hepatitis C infection. If you have contracted hepatitis C in the past and have recovered, the antibodies will remain in your body for life. If the result is positive – i.e. antibodies can be detected – then another blood test is carried out to check whether the hepatitis C virus can still be found. It is only then that the diagnosis of hepatitis C is deemed to be confirmed. Caution: Re-infection with the hepatitis C virus is still possible even after successful treatment.1

This examination is particularly useful for: 2

  • People with intravenous/nasal drug use (active and former)
  • People who are already infected with HIV or hepatitis B
  • Sexual and life partners of those infected with hepatitis C
  • Migrants from countries with widespread hepatitis C (e.g. Mediterranean region, Eastern Europe)
  • People with a track history of prison
  • Individuals with raised liver parameters and/or symptoms of hepatitis
  • Recipients of blood, blood products or transplants (before 1992)
  • Patients treated with haemodialysis (blood filtration)
  • Persons with tattoos or piercings
  • Persons who perform sexual activities with an increased risk of injury
  • Children born to mothers infected with hepatitis C
  • Persons with an occupational risk of infection
  • Blood, organ and tissue donors

Everyone with statutory health insurance can be tested for hepatitis C (and B) once free of charge from the age of 35 as part of the health check-up.3

Acute hepatitis C does not usually require treatment, since it often clears up on its own.1 In the case of the chronic form – i.e. when the virus is detected, no signs of acute hepatitis are present and no risk of transmission can be detected in the previous 6 months – several drugs with a direct antiviral effect are approved, which are usually well tolerated and very effective.1,4 A blood test is carried out after the end of the treatment to check whether hepatitis C viruses can still be detected in order to ensure that the treatment was successful.1

Caution: Re-infection with the hepatitis C virus is still possible even after successful treatment.1

There is currently no vaccination against hepatitis C. It is therefore all the more important to avoid a possible infection by taking appropriate measures. Important for avoiding infection:1

  • Practice safer sex
  • Only use sterile utensils when using drugs and do not share them with others
  • Pay attention to hygienic conditions and sterile equipment when tattooing and piercing
  • Do not share personal hygiene products that may be contaminated with blood with other people (e.g. razors or nail scissors)

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  1. RKI guide to hepatitis C. https://www.rki.de/DE/Content/Infekt/EpidBull/Merkblaetter/Ratgeber_HepatitisC.html (Retrieved May 2022).
  2. Sarrazin C et al. Z Gastroenterol 2018; 56: 756–83.
  3. Association of Statutory Health Insurance Physicians – Practice News. https://www.kbv.de/html/1150_50632.php (Retrieved May 2022).
  4. Sarrazin C et al. Z Gastroenterol 2020; 58: 1110–1131.