Quick summary
- Hepatitis C is a virus that can damage your liver.
- It is passed on by blood to blood contact
- Many people won’t have symptoms for months or years after they pick up hepatitis C.
- Hepatitis C can be diagnosed and checked using blood tests.
- There is no vaccine against hepatitis C.
- Treatment is taking tablets for 8-12 weeks. Most people have no side effects.
- If not treated, hepatitis C can continue to damage your liver. This can be very dangerous.
What is hepatitis C?
Hepatitis C is a virus that can cause liver damage. If it gets into your blood, it will infect liver cells and make copies of itself (replicate).
There are two stages of hepatitis C.
Acute hepatitis C:
This might also be called “recently acquired hepatitis C”.
This stage lasts about 6 months.
- 3 in 10 people will get rid of the virus without any treatment during this stage.
- 8 in 10 will have no symptoms.
Chronic hepatitis C:
If you still have the virus more than six months after picking it up, this is called chronic hepatitis C. Chronic means long-lasting.
This stage can last many years before you get symptoms. If you have chronic hepatitis C, you will need treatment to get rid of the virus.
Without treatment, the virus can cause inflammation. This can lead to your liver becoming tough and scarred. This is known as “fibrosis”.
Over time, the damage can build up. This can lead to serious liver disease such as cirrhosis or liver cancer .
Often people do not realise that they have hepatitis C until they get symptoms of liver disease.
What causes hepatitis C?
Hepatitis C is a blood-borne virus (BBV). This means it is passed on when blood from someone with the virus gets into someone else’s blood.
In the UK, the most common way for this to happen is when people share needles or syringes for injecting drugs. Other drug equipment like spoons and straws can also be a risk.
Never share needles, syringes, or other drug equipment with someone else. Find a needle exchange near you.
In the past, some people got the virus through blood transfusions and other blood products. Since 1991 all blood transfusions in the UK have been tested and are safe. You can find out more about the infected blood inquiry here.
If you have had a transfusion overseas, or in the UK before 1991, you should ask your doctor for a hepatitis C test.
It is possible to pick up hepatitis C through sex, but this is not common. The risk is higher for people who have multiple partners, or have HIV, particularly men who have sex with men.
Condoms stop the spread of the virus. You can find out more about sexual transmission of hepatitis C, and the things that can increase your risk on the Terrence Higgins trust website.
Razors, piercing needles, and other things that might have blood on them can also pass on hepatitis C.
Never share a toothbrush or razor. In the UK it should be safe to get a professional tattoo or piercing. Always ensure that the needles used are properly sterilised. Especially if you are overseas in an area where hepatitis C is more common.
It is possible for a mother with hepatitis C to pass the virus to her baby during pregnancy or birth. With good testing and treatment this is now very rare in the UK.
If you think you might be at risk of hepatitis C, and you are pregnant, or thinking of becoming pregnant, ask for a hepatitis C test.
You can get Hepatitis C more than once.
There is no vaccine against hepatitis C. Having hepatitis C and then getting better will not stop you from getting it again. If you currently have one type of hepatitis C you can pick up another type at the same time.
It can take years to find out that you have hepatitis C. So it may be hard to know how and when you picked it up. About 1 in 10 people with hepatitis C have no recognised risk factor.
Things that DO NOT cause hepatitis C
There is no need to treat someone with hepatitis C as if they are dangerous or infectious. The virus can only be passed on by blood-to-blood contact.
Dentist refused to treat me and announced it in a public waiting area.
– Comment from our stigma survey
You cannot get hepatitis C through everyday things like hugging, handshakes, or sharing cutlery. Or anything else that doesn’t involve blood passing from one person to another.
Once someone has finished treatment, and been cured, they cannot pass it on to anybody else.
Our online screener can help you find out if you might be at risk of hepatitis C or other liver conditions.
If you think you might have been exposed to the virus it is important to get tested.
What are the symptoms of hepatitis C?
Symptoms of acute hepatitis C
About 8 in 10 people with acute hepatitis C will have no symptoms. For people who do get symptoms, the most common are:
- Feeling very tired (fatigue)
- Loss of appetite
- Feeling or being sick
- Fever (high temperature over 38oC)
- Stomach ache
- Muscle or joint aches and pains
- Jaundice (a yellow colour to your eyes or skin)
Symptoms of chronic hepatitis C
You can have chronic hepatitis C for many years before having any symptoms. During this time the virus is damaging your liver. Many people only find out that they have hepatitis C once they start to get symptoms of liver disease. These symptoms include:
- Feeling very tired (fatigue)
- Itchy skin
- Feeling sick
- Joint pains
- Stomach ache and bloating
- Mood changes
- Brain fog and memory problems
- Jaundice (a yellow colour to your eyes or skin)
If it is not treated, liver damage from hepatitis C can eventually lead to cirrhosis and a type of liver cancer called HCC.You can find out more about the symptoms of cirrhosis of the liver here. And about HCC here.
Tests for hepatitis C
Where can I get a hepatitis C test?
Free home testing
If you live in England and you are at risk of hepatitis C, you can now order a free, confidential home test.
The test kit will contain everything you need. To do the test you prick your finger and collect a small amount of blood. You then post the sample to the lab to be tested.
If your test is positive you will be contacted by an NHS healthcare professional. They will talk with you about your results. And help you to get treatment.
Click here to order your free NHS home test
You can also have a test by asking your GP, or local sexual health clinic. Some drug treatment services can also arrange testing.
If you are a health care worker or a researcher and you may have been exposed to hepatitis C at work, contact your occupational health team to get tested. You will then have a series of tests over several weeks.
If you have symptoms of hepatitis C, always get tested.
It is also worth getting tested if any of these things apply to you, even if you have no symptoms:
- You have ever injected drugs
- You had a blood transfusion in the UK before 1991 or received other blood products before 1986
- You were born or grew up somewhere where chronic hepatitis C is common
- Your mother had hepatitis C when you were born
- You are an HIV positive man who has sex with men
- You have a close family member, friend or sexual partner who has hepatitis C
- You have had a home-made tattoo or a tattoo done overseas
- If you go into prison, you should be tested each time
Tests for hepatitis C
If the doctor thinks you might have hepatitis C you will have a blood test to look for antibodies against the virus.
If this test finds antibodies (a positive result), you will have another blood test to look for a part of the virus called the RNA. This test might be done using the same sample as the antibody test.
If both tests are positive, that means you have active hepatitis C virus in your body.
If you are immunosuppressed, for example if you have HIV, or take immunosuppressant medicines, an antibody test might not work. Your first test for hepatitis C should be an RNA test.
If you have had hepatitis C before, your first test should be an RNA test.
If one or both of the tests are negative, you might be asked to come back in a few months for another test. You can find out more about why you might need repeat tests below.
In some cases you can have a rapid test, where you get your results in a few hours.
More about antibody tests
When a virus enters your body, your immune system makes antibodies to help fight it off. The antibody test looks for these antibodies in your blood sample.
The antibody test might be done using a blood sample taken with a syringe or with a small sample of blood taken by pricking your finger.
A positive antibody test means that there are antibodies in your blood, and you should have an RNA test.
Antibodies can stay in your blood for many years after you have had a virus, even if the virus has gone. So, an RNA test is needed to see if the virus is still in your blood.
More about RNA tests
An RNA test might also be called a PCR test.
The Hepatitis C virus contains RNA. RNA is the genetic instructions that the virus uses to make more viruses.
Hepatitis C RNA will only be in your blood if you have the virus now.
A positive RNA test means you have have active hepatitis C.
Antigen tests
You might have a blood test to look for hepatitis c core antigen. This is a protein made by the virus. The antigen will only be in your blood if you currently have hepatitis C virus.
Repeating tests
Viral load
Your RNA test can also be used to find out your “viral load”. This is a number that tells you how much virus is in a sample of your blood.
Doctors will find out your viral load before you start treatment and will check it again after you finish your medicine to make sure the treatment has worked.
Your viral load might be checked more often during treatment to check that it is going down.
Genotype
Hepatitis C viruses aren’t all exactly the same. The different types of virus are called “genotypes”.
A genotype test will tell you which type of hepatitis C you have.
There are 6 main genotypes around the world. In the UK the most common are type 1 and type 3. It is possible to have two or more types of hepatitis C at the same time.
Knowing the genotype of your hepatitis C can help doctors to choose the best treatment.
Other tests
If your doctor thinks you might have hepatitis C, you might have tests to check on your liver and your general health. These will be blood tests and the blood can usually be taken at the same time as the hepatitis C test sample.
You can find out more about liver blood tests here.
If your tests show that you have hepatitis C you might have some more tests to find out if your liver has been damaged. You can find out more about the tests you might have by clicking on the links below. Most people won't have all of these tests.
Transient elastography eg FibroScan
Treatment for hepatitis C
The treatment for hepatitis C has changed and improved a lot in recent years.
If you are diagnosed with hepatitis C you should be referred quickly to a specialist service. This could be in a hospital hepatology, gastroenterology or infectious disease clinic. In some places, sexual health clinics or GPs can treat hepatitis C.
You will probably have most of your appointments with a specialist nurse. A consultant doctor will oversee cases, especially if they might be more complicated.
If you have recently picked up acute hepatitis C, doctors might decide to wait and see if your body will get rid of the virus by itself. But if you are unwell, or have chronic hepatitis C, you will be asked to start treatment.
The medicines now used to treat hepatitis C are called “direct acting antivirals” or DAAs. They are tablets. You will be asked to take them every day, for 8 to 12 weeks.
There are many different DAAs and exactly which one you are given will depend on:
- How much damage there is to your liver
- Any other health problems you have
- If you have had hepatitis C treatment before
- In some cases, the type (genotype) of your hepatitis C
More than 9 in 10 people with hepatitis C will get rid of the virus with treatment. It is important to take your medicine every day.
For most people, the first course of treatment will get rid of the virus. If this doesn’t work, you might be asked to take a mixture of different DAA drugs.
You can find out more about the different medicines used in the UK here:
Side effects
Treatment for hepatitis C is now very safe. Most people have no side effects. For those few who do, the most common side effects are headache and tiredness.
Cirrhosis and hepatitis C
If hepatitis C is not found and treating it can lead to long term liver damage called cirrhosis. Cirrhosis is very serious but there are ways to treat or mange it. We have a lot more information in our cirrhosis section.
Clearing the virus
When you have been successfully treated, you might be told that you have “cleared the virus”. Or have a “sustained virological response” (SVR). This means that an RNA test cannot find any virus in your blood.
This is great news! It means there is no more virus causing harm to your liver. And you cannot pass hepatitis C on to anyone else.
But it is possible to get hepatitis C again.
So always take care to prevent a new infection.
Recovering from hepatitis C
I no longer have to worry about the ticking time bomb of hepatitis C.
Your liver has an amazing ability to repair itself. But if hepatitis C has caused damage, it might take a while for you to feel better. Even if your tests show the virus has gone.
After successful treatment, it will be much easier for your liver to work properly. And you will have a much lower risk of developing severe liver disease or liver cancer.
In some cases, your liver can even repair damage. But if you have already developed cirrhosis you can find out more information here.
Your doctors might suggest you have regular checks for liver cancer. You can find out more about this here.
There is also a rare condition called Cryoglobulin-associated vasculitis, also known as cryoglobulinemia. This can happen to some people who have had hepatitis C. You can find out more about this and it’s symptoms on the NHS vasculitis page by clicking here.
You can help your liver to recover by staying healthy or by making a few changes to how you live your everyday life:
Alcohol
Alcohol can damage your liver. If you are recovering from hepatitis C you should only drink a very small amount of alcohol. And aim to have 2 to 3 consecutive alcohol-free days every week. If the damage to your liver is more severe, your doctor may recommend that you do not drink alcohol at all. You can read more about alcohol and liver disease here.
Stopping drinking can be a very difficult change to make, especially if those around you continue to drink alcohol. We have links to organisations that can help here. You can find some help with coping with the stigma of not drinking here.
Weight and diet
If you have developed cirrhosis you may need to eat a special diet.You can find out more about it here.
If you do not have cirrhosis, then you do not need to eat or to avoid any specific foods. Instead, aim to eat a healthy balanced diet and keep to a healthy weight.
Being overweight can cause fat to build up in your liver. This damages the liver and will make it harder for it to repair itself. We have more information about keeping to a healthy weight here.
Smoking
One of your liver’s jobs is removing toxins from your body. If you smoke, this greatly increases the amount of toxins in your body and makes it harder for your liver to work.
Stopping smoking will help your liver to recover and has lots of other health benefits.
Complementary and alternative medicines
There are no supplements or alternative medicines that have been shown to help with hepatitis C. But some people may find complementary treatments helpful for relaxing or coping with symptoms.
If you have a liver condition you should always talk to your doctor or pharmacist before taking a new medicine or supplement. Even if it is something natural or complementary, or it has been recommended by a complementary therapist or practitioner.
You can read more about liver disease and complementary and alternative treatments here.
Avoiding getting hepatitis C again
Unfortunately, even if you have had hepatitis C and got better, you can still get it again. So, try to avoid things that increase your risk.
The British liver trust is here to support everyone who is living with a liver condition.
We have lots of information, an online forum, support groups and a helpline run by specialist liver nurses.
Find supportThanks
We would like to thank everyone who gave their time, knowledge and experience to help with creating this information. In particular Lindsay Chalmers, British liver trust specialist liver nurse. Adrienne Schoenwetter, lived experience expert. Dr Kathryn Jack, lead Nurse for Research and Innovation, Nottingham university hospitals. And the blood-borne virus team at Western General Hospital, Edinburgh. Also Professor Stephen Ryder and Dr Dáire T O’Shea for expert clinical review.
This page was published: February 2023
Review date: February 2026