Hepatitis is a term that means inflammation of the liver, an organ of great importance for the human body that, among other functions, processes nutrients, filters the blood, and fights infections.

Hepatitis C is a liver disease caused by infection with the hepatitis C virus (HCV), which causes inflammation and scarring of the liver tissue, impairs its proper functioning.

After infection with the hepatitis C virus, an incubation period occurs, which lasts about six months and is known as acute hepatitis C. About 20% of people who get HCV can get rid of it naturally and without treatment during this period.

The remaining 80% will develop chronic hepatitis C, which will cause continued replication of the virus in the liver, although liver involvement generally progresses slowly. 

The physical consequences of this chronic infection can vary from person to person: some will never develop significant liver damage; others will suffer slight scarring of the tissue of this organ, and between 20% and 30% will develop cirrhosis after 15 or 20 years. A smaller percentage, however, will end up developing liver cancer, which may necessitate a transplant.

However, hepatitis C, today, can be cured in a high percentage of cases through treatment.

Types of hepatitis viruses

The hepatitis C virus is designated with this letter of the alphabet to differentiate it from the other types of hepatitis viruses that exist. Specifically, the hepatitis A, B, C, D, and E viruses are known.

All of them attack the liver, but they come into contact with the human body differently. Hepatitis A and E viruses are transmitted by mouth, hepatitis C through the blood, and hepatitis D through blood and fluids.

The evolution is also different in each typology since some only cause acute hepatitis (A and E), and others become chronic (B, C, and D).

Finally, a person can have several types of hepatitis viruses in succession since being infected with one of them does not prevent infection with another type.

Hepatitis C genotypes

Just as there are different types of hepatitis viruses, within hepatitis C itself, there are several types, known as genotypes. These genotypes are numbered from 1 to 6 and, in turn, are further subdivided into subtypes, designated with lower case letters.

The most frequent genotypes in the West are 1, 2, and 3. 4 and 5 are found almost entirely in Africa and 6 in South Asia. Genotypes influence the effectiveness of treatment.

How is hepatitis C transmitted?

Transmission routes

The hepatitis C virus travels through the human body through the blood. Therefore, transmission occurs when the blood of a person with the virus comes into contact with another person. Furthermore, this virus can survive for several days in dried blood, for example, from personal hygiene materials.

Some behaviors or habits increase the possibility of transmission. They are specifically:

• Having sex where there is blood contact, especially if protection is not used.
• Use materials that are not properly sterilized when performing tattoos or piercings, as well as dental interventions.
• Share personal hygiene material, such as razors, toothbrushes, or tweezers, as they may have blood traces.
• Likewise, share syringes or other non-sterile materials for drug use.

Hepatitis C can also be transmitted from mother to child during pregnancy or during childbirth.

A person’s ability to continue transmitting the virus will last as long as the virus remains in their blood.

Finally, the transmission does not occur by touching, kissing, hugging, or sharing cutlery or dishes, for example.

Who can it affect?

However, there are several groups at increased risk of contracting or having contracted the infection. These groups are:

• Health personnel, such as nurses, because of accidental punctures that they may suffer.
• For people who received a blood transfusion, blood products, or organ transplant before the early 1990s, the blood supply is thoroughly tested after that date.

Primary prevention

Currently, a vaccine capable of preventing infection has not yet been found, this is due to the hepatitis C virus’s ability to continually change.

Therefore, the measures to be taken consist of reducing the risk of exposure, for example, among people who inject drugs, those who have unprotected sex, or among health personnel.

The recommended series of interventions to reduce the risk of transmission, such as:

• Hand hygiene: including preparing the hands for surgery, washing the hands, and wearing gloves.
• Sterilization of material that poses a risk of transmission of HCV.
• Safe handling and disposal of sharp objects and debris.
• Analysis of donated blood.
• Training of health personnel.
• Promote the correct and systematic use of condoms.