HEPATITIS C GUIDE 2025: BLOOD TESTS, ANTIBODY, ANTIVIRALS & COMPLICATIONS

Hepatitis C is a viral infection of the liver caused by the hepatitis C virus (HCV). Commonly transmitted through blood-to-blood contact, it can cause serious long-term liver damage if left untreated. In this blog, we’ll explore everything you should know about hepatitis C from early signs and how it spreads, to advanced testing, modern antiviral drug treatments, lifestyle and diet tips, and emerging complications.

What Is Hepatitis C?

Hepatitis C refers to inflammation of the liver resulting from infection with HCV, a single-stranded RNA virus discovered in 1989. The virus primarily affects liver cells, causing damage through both direct viral effects and immune system responses.

“Know more about the basics of Hepatitis, you can also explore detailed information on Hepatitis A and Hepatitis B.”

How Does Hepatitis C Spread?

Hepatitis C is a blood-borne disease:

• Sharing needles or syringes (high risk)
• Unsafe medical practices or dental work
• Needlestick injuries among healthcare workers
• Tattooing or body piercing without sterile equipment
• Rarely passed via sex or from mother to baby at birth
• Not spread by hugging, sharing utensils, breastfeeding, or casual contact

Early Symptoms & Extrahepatic Manifestations

Many individuals with acute HCV have no symptoms. When symptoms occur, they may include:

Hepatic manifestation:

• Jaundice, dark urine, pale stools, fever
• Fatigue, low appetite, nausea, abdominal discomfort
• Fever and joint pain

Extrahepatic manifestations of hepatitis C are health conditions that occur outside the liver due to chronic HCV infection. These complications result from immune system activity triggered by the virus and may affect multiple organs. Common extrahepatic manifestations include:

• Mixed cryoglobulinemia – inflammation of blood vessels causing fatigue, joint pain, skin rashes, and kidney damage
• Lichen planus – itchy, purplish skin lesions or white patches in the mouth
• Non-Hodgkin lymphoma – a type of blood cancer linked to long-term HCV infection
• Type 2 diabetes and insulin resistance – due to HCV’s impact on glucose metabolism
• Thyroid disorders, such as hypothyroidism or hyperthyroidism
• Sjögren’s syndrome – dry eyes and mouth from an immune system attack on the glands
• Glomerulonephritis – kidney inflammation leading to protein in urine or renal failure
• Peripheral neuropathy – nerve damage causing numbness or tingling in hands and feet

These manifestations can occur even if liver disease is mild, and often improve or resolve after successful hepatitis C treatment.

How Long Does Hepatitis C Last?

• Acute HCV may be resolved in ~30% of cases within six months.
• In ~70% of cases, infection becomes chronic, often without symptoms, increasing risks of cirrhosis and liver cancer over decades.

Diagnosing Hepatitis C: What Tests Should You Get?

Here’s what your doctor may request:

Test	Purpose
Anti-HCV antibody (ELISA)	Shows past or current exposure to HCV
HCV RNA (PCR)	Confirms active infection and monitors viral load
Liver enzymes (ALT, AST)	Detects liver inflammation due to HCV
Genotype test	Identifies HCV genotype to guide treatment
Imaging (ultrasound/FibroScan)	Evaluates liver scarring (fibrosis) and cirrhosis
Extrahepatic assessment	Checks for related conditions like kidney injury or rashes

Hepatitis C Treatment

HCV is now curable in >95% of cases:

Direct-Acting Antivirals (DAAs): The Modern Cure for Hepatitis C

The introduction of Direct-Acting Antivirals (DAAs) has revolutionized hepatitis C treatment, turning a once-chronic, life-threatening condition into a highly curable disease for most patients. Unlike older interferon-based therapies, DAAs are taken orally, work quickly, and are associated with fewer side effects.

DAAs target specific steps in the hepatitis C virus (HCV) replication cycle. By blocking these steps, they stop the virus from multiplying, reduce liver inflammation, and ultimately lead to a sustained virologic response (SVR), which is considered a cure.

• Sofosbuvir/Velpatasvir (brand: Epclusa):
  A pill that treats all HCV genotypes over 12 weeks.
• Glecaprevir/Pibrentasvir (brand: Mavyret):
  A highly effective combination approved for 8-week treatment courses in most patients, even those with prior treatment failure or coexisting conditions.

A recent 2025 clinical study confirmed that glecaprevir/pibrentasvir (Mavyret) achieved a 96% cure rate for acute hepatitis C within just 8 weeks of treatment.

Side Effects of DAAs:

Most patients tolerate DAAs very well. Reported side effects are generally mild and may include:

• Headache
• Fatigue
• Nausea
• Sleep disturbances

These are significantly fewer than with older treatments, making adherence easier and outcomes better.

Successful treatment leads to sustained virologic response (SVR) with no detectable HCV RNA months after therapy. This SVR reduces liver-related mortality by over 75%. Additionally, regular follow-up ensures liver recovery and helps address any complications.

Complications of Hepatitis C

Untreated chronic HCV can cause:

Cirrhosis and Liver failure:

Cirrhosis is a condition where healthy liver tissue is gradually replaced by irreversible scar tissue (fibrosis), impairing the liver’s ability to function. This happens when chronic HCV inflammation continues unchecked over years or decades.

Cirrhosis symptoms may include:

1. Fatigue and weakness
2. Easy bruising or bleeding
3. Swelling in the legs or abdomen (ascites)
4. Spider veins on the skin
5. Yellowing of the skin or eyes (jaundice)

Liver cancer (Hepatocellular carcinoma)

Chronic hepatitis C significantly increases the risk of developing hepatocellular carcinoma (HCC), the most common type of primary liver cancer. The risk is highest in patients with cirrhosis but can also occur in non-cirrhotic cases.

HCC often develops silently and may not cause symptoms until it is advanced. Regular surveillance with imaging (e.g., ultrasound every 6 months) and alpha-fetoprotein (AFP) blood testing is recommended for at-risk individuals

Hepatic encephalopathy:

As liver function deteriorates, the body can no longer filter toxins effectively, particularly ammonia. These toxins accumulate and reach the brain, causing hepatic encephalopathy, a serious complication marked by:

1. Confusion or forgetfulness
2. Difficulty concentrating
3. Drowsiness or even coma in severe cases

This is often reversible with treatment, but recurrence is common in end-stage liver disease.

Liver Failure

Liver failure (also known as end-stage liver disease or decompensated cirrhosis) occurs when the liver can no longer perform essential tasks such as:

1. Processing nutrients
2. Producing clotting factors
3. Detoxifying blood
4. Regulating hormones

Signs include severe jaundice, bleeding, ascites, infections, and encephalopathy. At this point, the only long-term solution may be a liver transplant.

Extrahepatic issues

like cryoglobulinemia, kidney disease, lichen planus, rash, and arthralgia.

Prevention & Precautions

1. Ensure Blood Safety

In modern healthcare systems, all blood donations are rigorously screened for the hepatitis C virus (HCV). Still, individuals undergoing blood transfusions or organ transplants, especially in countries with limited resources, should be aware of the risks. At Reem Hospital, we adhere to strict HCV screening protocols to ensure safe transfusions.

2. Practice Safe Needle Use

Sharing needles, syringes, or any drug injection equipment is one of the most common ways hepatitis C spreads. To prevent transmission:

• Never share personal items that may be contaminated with blood (razors, nail clippers, glucose meters).
• Always use new, sterile needles and syringes for medical injections or intravenous therapies.
• People who inject drugs should be encouraged to seek harm reduction services and treatment.

3. Choose Safe Tattooing and Piercing Facilities

Tattooing and body piercing can carry a significant hepatitis C risk if equipment is not properly sterilized. To reduce this risk:

• Only visit licensed and hygienic studios.
• Ensure that single-use needles and inks are opened in front of you.
• Check that artists follow strict disinfection procedures.

4. Protect Yourself in Healthcare Settings

Healthcare workers are at risk of accidental needlestick injuries, which account for up to 3% transmission risk if exposed to HCV-positive blood. Hospitals minimize this with:

• Universal precautions: gloves, masks, and sterilization of tools
• Safe disposal of sharps
• Post-exposure protocols to monitor and, if needed, treat potential infections

Patients also benefit from these standards, as they reduce the risk of cross-contamination during procedures like injections, surgery, or dental care.

Hepatitis C Diet & Wellness

Support your liver with:

• Fresh fruits and vegetables
• Whole grains and lean proteins
• Limiting alcohol, saturated fats, and processed foods
• Staying hydrated and active

Hepatitis C Screening Recommendations

• One-time screening for all adults at least once

Did You Know?

• 75% of infected individuals are unaware—the silent epidemic.
• HCV infection can increase cancer risk beyond the liver, such as lymphoma.

Conclusion

Hepatitis C is a serious but treatable liver disease. Early detection through hepatitis C blood tests and interventions with DAAs offers>95% cure rates. Lifestyle measures, safe practices, and follow-ups are critical. Reem Hospital provides comprehensive care—testing, treatment, monitoring, and patient support—to help you live hepatitis-free.