Most people don't show symptoms, which makes testing extra important. 

By Korin Miller
September 26, 2019

Hepatitis C is an infection that can attack your liver, causing inflammation and damage—and in some untreated cases, it can even be deadly.

Hepatitis C has two phases: an acute phase that happens within the first six months after you’re exposed to the virus, and a chronic phase that can cause serious health issues, including liver damage, cirrhosis, liver cancer, and death, according to the Centers for Disease Control and Prevention (CDC). Worth noting: 85 percent of people who have the acute version of hepatitis C go on to have the chronic version of the disease, per the CDC.

Given how damaging hepatitis C can be, it makes sense that people at risk for contracting the virus would want to get screened for it. But that doesn’t always happen.

It's estimated that 2.7 to 3.9 million people in the U.S. alone have chronic hepatitis C. Because the chronic phase doesn’t typically cause symptoms until complications occur, many of those people don’t even know they have it, let alone that they need to be screened for it, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

RELATED: Why Isn't There a Hepatitis C Vaccine—And When Can You Expect One?

How can you get hepatitis C?

Most people become infected with hepatitis C through blood-to-blood contact with an infected person, William Schaffner, MD, an infectious disease specialist and professor at the Vanderbilt University School of Medicine, tells Health. That can include blood transfusions, organ transplants, and IV drug use.

It’s less common, but the CDC says that you can also get hepatitis C by sharing personal care items that may have come into contact with an infected person’s blood, like razors or toothbrushes. Having sexual contact with someone infected with hepatitis C, being born to a mother with hepatitis C, or getting a tattoo or piercing with an infected needle are also less common causes of hepatitis C, the CDC says.

But even if you contract hepatitis C, you may not know you have it—that's because both the acute and chronic forms of the infection don't typically show symptoms. In some cases, however, the CDC says those infected with the virus might experience a fever, fatigue, dark urine, clay-colored bowel movements, abdominal pain, loss of appetite, nausea, vomiting, joint pain, and jaundice. Still, because symptoms are rare, screening for hepatitis C is essential. 

RELATED: Should All Pregnant Women Get Tested for Hepatitis C?

So, who should be screened for hepatitis C?

Well, ideally everyone should be screened for hepatitis C. The US Preventive Services Task Force (USPSTF) recommends that doctors should ideally screen all of their patients by checking to see if they meet the at-risk criteria. “Hepatitis C should be routinely screened for in all adults at their routine medical visits,” says infectious disease expert Amesh A. Adalja, MD, senior scholar at the Johns Hopkins Center for Health Security.

That criteria, according to the CDC, includes a long list of people:

  • Current or former injection drug users
  • Everyone born from 1945 to 1965
  • Anyone who received clotting factor concentrates made before 1987
  • Recipients of blood transfusions or solid organ transplants before July 1992
  • Long-term hemodialysis patients
  • People with known exposures to the hepatitis C virus, like healthcare workers after needle sticks involving blood from someone infected with hepatitis C
  • People with HIV 
  • Children born to mothers with hepatitis C

The U.S. Preventive Services Task Force (USPSTF) also recommends screening for people in jail, those who snort drugs, and those who have received an unregulated tattoo.

Then, if someone is determined to be at risk, USPSTF recommendations say that blood sample should be taken and tested to see if it contains antibodies (i.e. disease-fighting proteins) that react to the hepatitis C virus. It’s followed by a second test that determines the level of the virus in the blood. When the tests are used together, it can accurately determine whether someone has a hepatitis C infection.

Screening is crucial, Dr. Adalja says. “Hepatitis C is serious and contagious,” he says. “If you get screened now, you can get treatment and can prevent yourself from getting complications like liver cancer or liver cirrhosis.” But, something to note: The screening process is not as widely practiced as many doctors would like. “There are some internists who are with the program and screening for hepatitis C and others who aren’t,” says Dr. Schaffner.

You can, however, order the blood test routinely, so it's best to bring it up to your doctor if you're concerned about your hepatitis C risk, or if you have other questions about the disease. Overall, these screenings and test can only help you take better control of your health.

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