Hepatitis C

Hepatitis C is an infectious disease caused by the hepatitis C virus (HCV), a small, enveloped, single-stranded positive-sense RNA virus classified within the genus Orthohepacivirus of the family Hepaciviridae. The infection is characterized as a type of viral hepatitis that primarily affects hepatic tissue. As a bloodborne pathogen, HCV represents one of five identified hepatitis viruses, alongside hepatitis A, B, D, and E.

Acute hepatitis C infection is typically asymptomatic, with only approximately 20% of infected individuals developing noticeable symptoms. When symptoms do appear, they may include fever, fatigue, nausea, vomiting, abdominal pain, decreased appetite, dark urine, clay-colored stools, and jaundice. Following acute infection, approximately 70% of individuals develop chronic HCV infection, defined as detectable viral persistence for at least six months. Chronic infection often remains asymptomatic for decades but may progress to cirrhosis in 15-30% of cases within 20 years, with potential complications including liver failure, liver cancer, and portal hypertension. Extrahepatic manifestations have been documented, including mixed cryoglobulinemia, autoimmune disorders, and metabolic conditions such as diabetes.

Hepatitis C virus infection occurs across all World Health Organization regions, though the burden is unevenly distributed. The Eastern Mediterranean Region bears the highest burden with approximately 12 million people chronically infected, followed by the South-East Asia Region and European Region each with approximately 9 million cases. The Western Pacific Region accounts for approximately 7 million chronic infections, the African Region for approximately 8 million, and the Region of the Americas for approximately 5 million. Among the estimated 39 million people living with HIV globally, approximately 2.3 million have serological evidence of past or present HCV infection, representing a significant comorbidity concern.

Hepatitis C is predominantly transmitted through direct blood-to-blood contact with an infected individual. Common transmission routes include unsafe injection practices and medical procedures, receipt of unscreened blood transfusions, and sharing of needles and syringes among people who inject drugs. Less common transmission pathways include mother-to-child transmission during childbirth and sexual practices that result in blood exposure, particularly among individuals with multiple sexual partners and men who have sex with men. The virus is not transmitted through breast milk, food, water, or casual contact such as hugging, kissing, or sharing food or beverages.

Populations at elevated risk for hepatitis C infection include people who inject drugs, who face transmission risk through sharing of injection equipment. Men who have sex with men, particularly those with HIV coinfection or multiple sexual partners, demonstrate increased infection risk through sexual transmission pathways. Individuals living with HIV are disproportionately affected, with chronic liver disease representing a major cause of morbidity and mortality in this population. Those with repeated exposure to healthcare procedures, including hemodialysis patients and recipients of unscreened blood products prior to universal screening implementation, also face elevated risk.

There is currently no effective vaccine available for hepatitis C prevention, making exposure avoidance the primary prevention strategy. Public health measures focus on preventing blood contact, including implementation of safe injection practices in healthcare settings, screening of blood products prior to transfusion, and harm reduction programs for people who inject drugs. Infection control measures in healthcare facilities and education regarding risks associated with needle sharing constitute key prevention pillars. Individuals at elevated risk should receive targeted education and periodic screening to facilitate early detection and treatment.

Hepatitis C surveillance presents particular challenges due to the largely asymptomatic nature of both acute and early chronic infection. Most new infections remain undiagnosed at the time of acquisition because symptomatic acute infection is uncommon. Chronic infections frequently go undetected for decades until secondary complications from liver damage manifest clinically. Diagnosis requires a two-step process: initial screening for HCV antibodies followed by confirmatory testing for viral RNA or core antigen to confirm active infection. In confirmed chronic cases, assessment of liver damage through biopsy or non-invasive testing guides treatment decisions and disease staging.

1. 1 WHO Fact Sheet. Hepatitis C.
2. 2 Wikidata. hepatitis C.
3. 3 Wikipedia. Hepatitis C - Wikipedia.

ICD-10

B17.1

ICD-11

1E50.2

Total cases

3.7M

Total deaths

10K

Peak month

2018-03

Coverage

3 reporting countries · 2000-01-01 → 2026-05-09