Hepatitis C is a virus that can infect and damage the liver. You can become infected with hepatitis C if you come into contact with the blood of an infected person.

In most cases, hepatitis C causes no noticeable symptoms until the liver has been significantly damaged.

When symptoms do occur, they are often vague and can be easily mistaken for another condition. Symptoms include:

• flu-like symptoms, such as muscle aches and loss of appetite
• feeling tired all the time
• depression

Because of this, many people remain unaware that they are infected by hepatitis C.

Read more about the symptoms of hepatitis C.

How do you get hepatitis C?

The hepatitis C virus is particularly concentrated in the blood of an infected person, so it's usually transmitted through blood-to-blood contact. Some examples of ways blood can be transferred include:

• sharing razors or toothbrushes
• sharing unsterilised needles - for example, while injecting drugs

It's estimated that up to 49% of people who inject drugs in England are thought to have hepatitis C. It's not only regular drug users who are at risk. People who have only injected drugs once in their life have been known to develop hepatitis C.

Hepatitis C can be transmitted through sex, although this is very rare. The risk may be higher among men who have sex with men. Wearing a condom with a new partner is advised.

Hepatitis C is more common in certain parts of the world, including North Africa, the Middle East and Central and East Asia, and this is thought to result from the use of shared needles for vaccination or medical treatment.

Read more about the causes and risk factors of hepatitis C.

Getting tested

Because hepatitis C often causes no obvious symptoms, testing is usually recommended if you are in a high-risk group, such as being a current or former injecting drug user.

Your GP, sexual health clinic, GUM (genitourinary medicine) clinic or drug treatment service all offer testing for hepatitis C. It can be done using a blood test.

The sooner treatment begins after exposure to the hepatitis C virus, the more likely it is to succeed.

Read more about who should be tested for hepatitis C.

Treating hepatitis C

Hepatitis C can be treated with antiviral medicines designed to stop the virus from multiplying inside the body and prevent liver damage.

Two widely used antiviral medications are interferon and ribavirin.

There are six different strains of hepatitis C, known as genotypes, and some genotypes respond better to treatment than others.

The most common genotypes of hepatitis C in England are genotypes 1 and 3.

With treatment, around half of people with genotype 1 will be cured, and around eight out of 10 people with genotype 3 will be cured.

Two new medications, released in 2011, called boceprevir and telaprevir, have been found to be effective in some people who do not respond to conventional antiviral treatments.

Read more about treating hepatitis C.

Who is affected?

There were 10,873 reported new cases of hepatitis C in England during 2012, but the true figure is probably much higher.

It is estimated that around 215,000 people in the UK have chronic hepatitis C.

Hepatitis C is more common in men than women as men are more likely to inject drugs.

Prevention

Unlike other forms of hepatitis, there is no vaccine for hepatitis C.

Two ways to reduce your risk of catching hepatitis C are:

• Never share any drug-injecting equipment with other people (not just needles, but also syringes, spoons and filters).
• Don't share razors, toothbrushes or towels that might be contaminated with blood.

The risk of sexual transmission is low. However, the risk is increased if there is blood present, such as menstrual blood or during anal sex. For this reason, condoms are not usually recommended for long-term heterosexual couples.

However, the best way to avoid transmitting hepatitis C is to use a condom or female condom, especially with a new partner.

Read more about preventing hepatitis C.

Stages of infection

The first six months of a hepatitis C infection are known as acute hepatitis C. Around one in four people will fight off the infection and will be free of the virus.

In the remaining three out of four people, the virus will stay in their body for many years. This is known as chronic hepatitis C.

Depending on other risk factors, such as alcohol use, between 10% and 40% of people with untreated chronic hepatitis C will go on to develop scarring of the liver (cirrhosis), often more than twenty years after first catching the virus.

Around one in five people with cirrhosis will then develop liver failure, and one in 20 will develop liver cancer, both of which can be fatal.

Read more about the complications of hepatitis C.