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Hepatitis C

Hepatitis C is a blood-borne viral infection caused by the Hepatitis C virus (HCV). What was once a lifelong chronic illness is now curable in more than 95% of cases with a short course of tablets. A disease that caused cirrhosis and liver cancer in millions is now fully curable. The challenge today is finding people who have it – because most don’t know they do.

How Hepatitis C Spreads

  • Sharing needles or drug equipment – the leading cause in many countries
  • Blood transfusions before 1992, before routine screening was available
  • Unsterilized medical or dental instruments
  • Tattooing or piercing with non-sterile equipment
  • Mother to baby during childbirth (less common than Hepatitis B)

It does not spread through sharing food, water, hugging, or casual contact.

Why Most People Don’t Know They Have It

Hepatitis C is often called a ‘silent’ infection. Acute infection may cause mild flu-like symptoms or nothing at all. Only about 25% of people clear it on their own. The remaining 75% develop chronic infection. The virus quietly damages the liver over 20–30 years, often without noticeable symptoms – until significant liver disease has developed.

Symptoms

Most patients are asymptomatic for years. When symptoms appear: persistent fatigue, nausea and loss of appetite, joint pain and muscle aches, jaundice in more advanced cases, right-sided abdominal pain, and cognitive issues such as brain fog.

Diagnosis

  • Anti-HCV antibody test – screens for past or current infection
  • HCV RNA (PCR) test – confirms active infection and measures viral load
  • HCV genotyping – determines genotype; affects treatment selection in some regimens
  • LFTs, ultrasound, FibroScan – assess liver damage

Treatment: Direct-Acting Antivirals (DAAs)

Since around 2014, Direct-Acting Antivirals have transformed Hepatitis C treatment.

  • Sofosbuvir-based combinations and Glecaprevir/Pibrentasvir are the main regimens used
  • Treatment duration: 8–12 weeks of once-daily tablets
  • Cure rate: 95–99%
  • Side effects: minimal – most people complete treatment without significant issues

Treatment is recommended for nearly all patients with chronic Hepatitis C, regardless of disease stage.

The treatment eliminates the virus from your body - it doesn't come back on its own. However, reinfection is possible if you're exposed to HCV again through the same routes (shared needles, unsterile instruments). A sustained virologic response (SVR), confirmed by a negative HCV RNA test 12 weeks after completing treatment, means the virus is gone.

If you had significant fibrosis (F3) or cirrhosis at the time of treatment, yes - 6-monthly ultrasound and AFP surveillance for liver cancer should continue indefinitely. Curing HCV stops further damage, but a liver with established scarring still carries a residual risk of cancer. Patients with mild or no fibrosis generally don't need ongoing surveillance.

Significantly more so than in the past. Generic versions of sofosbuvir-based combinations are manufactured in India and available at a fraction of the original cost. Government health schemes also cover HCV treatment for eligible patients. A specialist can advise on the most appropriate and cost-effective regimen.

Yes. The absence of symptoms does not mean the liver is unharmed. Hepatitis C silently causes fibrosis over years. Treatment stops this process and eliminates the future risk of cirrhosis and cancer. Given that treatment is short, highly effective, and well-tolerated, there is no strong reason to delay. Think you may have been exposed to Hepatitis C? A simple blood test is the first step - and if confirmed, a cure is now within reach.

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