Hepatitis C is a liver disease caused by the hepatitis C virus (HCV). HCV infection can either cause an acute or a chronic infection which may be lifelong. The disease burden of hepatitis C is high, with up to 170 million people estimated to have had contact with the virus and 130 million people chronically infected worldwide.
Hepatitis C illness ranges from mild to severe: most people with acute hepatitis C infection do not have any symptoms. Those who do can experience fatigue and jaundice (a yellowing of the skin and eye-balls).
If the infection lasts for longer than six months it is called “chronic hepatitis C infection” and treatment may be needed. Some people who develop chronic hepatitis C may never have any symptoms while others only develop symptoms after many years, like fatigue, nausea and abdominal discomfort. Around 30% of people with chronic hepatitis C will go on to develop liver damage (called cirrhosis) and a proportion of these progress to liver cancer.
Transmission and prevention
Humans are the only reservoir of hepatitis C virus which is passed on through infected blood. The infection is mainly acquired by contact through broken skin with infectious blood. In Europe, the main route of HCV transmission is via injecting drug use as a result of sharing contaminated needles. Hepatitis C can also be passed on by tattooing, body piercing and acupuncture, if done in unsterile conditions with contaminated equipment. Pregnant women with hepatitis C may rarely pass the infection on to their babies.
In the past before screening tests were developed, blood transfusions could have been a source of infection with hepatitis C. Nowadays, all blood donors are screened for the virus and all blood products are tested to stop this from happening.
Vaccination against hepatitis C is not yet available. Current treatment options include antivirals and agents that stop the virus from replicating. The most effective preventive measures to reduce the risk of exposure to HCV include harm reduction programmes amongst people who inject drugs, the most affected population across Europe and strict hygienic measures in healthcare settings.
Epidemiology and burden in EU
In 2012, 30 607 cases of hepatitis C were reported in 27 EU countries (no data from Belgium, France, Liechtenstein and Spain). Of those, 509 (1.7%) were reported as acute, 3 905 (12.8%) as chronic and in 23 712 (77.5%) the type of infection was reported as unknown. The overall notification rate was 7.8 cases per 100 000 population. The number of cases reported by countries ranged from 24 cases in Malta to 13 474 in the United Kingdom. However, due to the differences in surveillance systems across Europe, these figures are known to be an underestimate of the true situation.