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Hepatitis C

What is hepatitis C?
Hepatitis C is a liver disease caused by the hepatitis C virus (HCV), which is found in the blood of persons who have this disease. In 2002, over 4,000 cases of HCV infection were reported in Wisconsin. An estimated 3.9 million Americans are infected with HCV.

How is the virus spread?

HCV is spread primarily by contact with blood from an infected person. Blood products, organs, tissues, semen and vaginal secretions from an infected person are sources for potential HCV infection transmission. HCV is most often spread through sharing needles. Much less often, it can also be transmitted from an infected mother to her baby during birth, through sexual contact or through needlesticks or sharps exposures on the job. HCV is not spread by casual contact such as hugging, sneezing, coughing or sharing food.

Who should get tested for hepatitis C?
Injection drug users, including those who injected once or a few times many years ago
Anyone treated for clotting problems with a blood product made before 1987
Persons who were notified that they received blood from a donor who later tested positive for hepatitis C
Anyone who received a blood transfusion or solid organ transplant before July 1992
Long-term hemodialysis patients
People who have signs or symptoms of liver disease (e.g., abnormal liver enzyme tests)
Healthcare workers after exposures (e.g., needle sticks or splashes to the eye) to HCV- positive blood on the job
Children born to HCV-positive women
Sexual partners of HCV infected persons, although the risk of transmission is low

What are the signs and symptoms of HCV infection?
Most HCV infections are not symptomatic. Some individuals experience loss of appetite, fatigue, nausea and vomiting, abdominal pain and jaundice (yellowing of the eyes and skin). Of persons infected with HCV, 15% may develop cirrhosis over a period of 20 to 30 years, and 5% may die from the consequences of long term infection (liver cancer or cirrhosis).

How soon do signs or symptoms occur?
Persons with acute illness usually develop symptoms 6-7 weeks after exposure.

When and for how long is a person able to transmit HCV?
Most people carry the virus in their blood and may remain contagious for years. A chronic carrier state may develop in as many as 75-85% of infected persons.

Are there treatments for hepatitis C?
The FDA has approved three drugs to treat HCV infection. Patients are advised to consult their medical providers about treatment options.

What tests are available for diagnosing hepatitis C?
There are several blood tests that can be done to diagnose HCV infection. Tests that detect anti-HCV (antibody to HCV) include the EIA (enzyme immunoassay) and the RIBA (recombinant immunoblot assay). The EIA is usually done first. If it is positive, it should be confirmed by another test, either a RIBA or a qualitative reverse transcriptase polymerase chain reaction test (RT-PCR). The RIBA is a supplemental test used to confirm a positive EIA test. Both the EIA and the RIBA detect anti-HCV in serum or plasma. Anti-HCV does not tell whether the infection is new (acute), chronic (long-term) or is no longer present.

The presence or absence of virus (HCV RNA) in the blood is detected with the RT-PCR. A single positive PCR test indicates current HCV infection. A single negative PCR test does not prove that a person is not infected. Virus may be present in the blood and not found by PCR. When hepatitis C is suspected and the PCR is negative, the PCR should be repeated 6 months later. A person whose PCR tests are negative over time is likely to have resolved his HCV infection.

How long after exposure to HCV does it take to test positive for HCV antibodies?
Anti-HCV can be found in 70% of people when symptoms begin (6-7 weeks after exposure) and in about 90% of people within 3 months after symptoms begin. However, many people with HCV have no symptoms.

How long after exposure to HCV does it take to test positive with PCR?
With the PCR test, it is possible to find HCV within 1-2 weeks after being infected with the virus.

How can the spread of HCV be prevented?
Persons who are infected with HCV should take the following precautions to prevent transmitting hepatitis C:
Do not donate blood, body organs, semen (sperm), or other tissue
Do not share toothbrushes, razors or other sharp personal care items
Cover cuts and open sores
Do not share needles with others and use only clean needles
Practice safe sex (use latex condoms)- the proper use of latex condoms may reduce transmission

Wisconsin Division of Public Health - Bureau of Communicable Diseases
CDC - Division of Viral Hepatitis

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