Hepatitis C: symptoms, what it is, treatment and how it spreads

The NHS says most people with hepatitis C do not have any symptoms. If symptoms do occur they may not start for several weeks, months or years after infection. Liver UK says about 8 in 10 people with acute hepatitis C have no symptoms.

If hepatitis C is not treated, the NHS says it may eventually cause other symptoms such as extreme tiredness, itchy skin, anxiety and depression, and memory and concentration problems. Liver UK lists, for chronic hepatitis C, fatigue, itchy skin, feeling sick, joint pains, stomach ache and bloating, mood changes, brain fog and jaundice.

• A high temperature.

• Tiredness.

• Tummy pain.

• Loss of appetite.

• Feeling sick or being sick.

• Yellowing of the skin or whites of the eyes (jaundice), which may be harder to see on black or brown skin.

Hepatitis C is a virus that infects liver cells. Liver UK says there are two stages. Acute hepatitis C, also called recently acquired, lasts about 6 months, and 3 in 10 people will get rid of the virus without any treatment during this stage. Chronic hepatitis C is when you still have the virus more than six months after picking it up; it can last many years before symptoms appear, and it needs treatment to get rid of the virus.

Without treatment the virus can cause inflammation, which can lead to the liver becoming tough and scarred (fibrosis), and over time to serious liver disease such as cirrhosis or liver cancer.

You can get hepatitis C if blood from an infected person gets into your bloodstream. The NHS says the most common ways are sharing equipment to inject drugs, including needles and syringes, and having medical or dental treatment in a country with poor infection control.

Less common ways include a blood transfusion in the UK before 1996 (the NHS) or before 1991 (Liver UK, which says transfusions have been tested since 1991), sharing equipment for snorting drugs, sharing items that could have blood on them such as toothbrushes and razors, tattoos or piercings with unsterilised equipment (unlikely in licensed UK premises), unprotected sex where blood is present, and from a mother to her baby during pregnancy. Liver UK says sexual transmission is possible but not common and that mother-to-baby transmission is now very rare in the UK with good testing and treatment.

The NHS says you cannot get hepatitis C by hugging, kissing or sharing food or drink. Liver UK adds that handshakes and sharing cutlery are not risks, and that once treatment has finished and you are cured you cannot pass it on.

A blood test is used. The NHS says you may be offered a test if you have symptoms or a doctor thinks you could have the infection, and you can also get tested at sexual health clinics or drug addiction services. It can take up to 2 weeks to get results. If the result is negative you may be advised to test again in 6 months, because the test is not always accurate if you were infected recently.

If you are aged 18 or over, the NHS says you can order a free hepatitis C test to do at home by pricking a finger and posting the blood sample. Liver UK explains that the first blood test looks for antibodies, and if it is positive a second test looks for the virus RNA; both positive means active hepatitis C.

The NHS says treatment can cure hepatitis C in most people. You will usually be referred to a specialist and given antiviral tablets to take every day for 8 to 12 weeks. It is important to finish the course for it to work. Most people do not get side effects, though some feel tired, get headaches or feel sick. Blood tests during and after treatment check how well it is working, and if it has not worked your specialist will recommend another medicine.

Liver UK says more than 9 in 10 people with hepatitis C can now get rid of the virus by taking tablets. The NHS says your specialist will also recommend steps to prevent further liver damage, such as keeping to a healthy weight, stopping smoking and avoiding or cutting down on alcohol.

If not treated, the NHS says hepatitis C can cause cirrhosis (damage to the liver) and liver cancer. You are unlikely to get these complications unless you have had hepatitis C for more than 20 years, but you may get them more quickly if you drink alcohol regularly or also have hepatitis B or HIV. Rarely, a liver transplant is needed.

Your specialist will check for signs of complications and advise on treatment.

The NHS says you can get hepatitis C more than once, so it is important to reduce your risk even if you have had it before. It advises using condoms every time you have sex, only getting tattoos or piercings from licensed premises, and not sharing drug injection equipment (needles, syringes, spoons and filters), drug snorting equipment or personal hygiene items such as toothbrushes and razors.

Liver UK adds there is no vaccine against hepatitis C and having it once will not stop you getting it again. If you are pregnant or planning pregnancy and think you might be at risk, ask for a test.

The NHS says to see a GP if you have symptoms of hepatitis C or think you could have been infected, because treatment can cure the infection and help prevent damage to the liver. If you had a blood transfusion in the UK before 1996 and have not been tested, contact your GP surgery.

If you have yellowing of the skin or eyes, see a GP promptly; for urgent concerns NHS 111 can advise.

On the NHS, testing is available through GPs, sexual health clinics, drug services and free home kits, and treatment is led by a specialist team. NHS pages point to The Hepatitis C Trust and Liver UK for information and support.

Private testing is also available, but if a test is positive you will usually be referred to a hepatitis C specialist service for treatment. Whichever route you use, ask who will arrange follow-up blood tests to confirm the virus has gone.