Hepatitis C is a form of hepatitis (liver inflammation) caused by a virus, the Hepatitis C virus (HCV). Before the virus was discovered, in 1989, the syndrome was initially referred to as a "non-A-non-B hepatitis".

Hepatitis C infects an estimated 170 million persons worldwide and 4 million persons in the United States. There are around 35,000 to 185,000 new cases of infections a year in the United States. Co-infection with HIV is common and rates among HIV positive populations are higher.

Currently, serological tests are available to check for Hepatitis C. In addition, PCR can be used for more sensitivity and to elucidate a genotypes for the infection. There are eleven groups, divided by locations. Genotype 1a is the most common in North America, and 1b in Europe. The infection of Hepatitis C is spread by blood exchange and, less commonly, sexual contact. Before serological tests became available, it was often caused by the use of medical products derived from blood and by blood transfusion.

Though hepatitis A, hepatitis B, and hepatitis C have similar names (because they all cause liver disease) the viruses themselves are quite different. Unlike hepatitis A and hepatitis B, there is no vaccine for hepatitis C.

In most cases, carriers with chronic acute hepatitis C infection have no symptoms. However, over time this blood borne virus can cause long term damage to the liver, including cirrhosis and hepatocellular carcinoma (liver cancer). Severe liver damage may not develop for 10-40 years after infection. Certain medical phenomena has been associated with the presence of hepatitis C; some are thyroiditis, cryoglobulinemia and some types of glomerulonephritis. It is important to remember that every hepatitis C carrier is different, and no two cases are the same. Some carriers begin to develop symptoms after only a few years. These can be flu-like, but just don't go away. They include any combination of body aches, headaches, night sweats, loss of appetite, diarrhea, fatigue, nausea and mild abdominal pain. There can also be upper right quadrant pain. As stated before, not all hepatitis C carriers will present the same symptoms. Each person is different, with a different set of experiences.

Most people are not aware that they carry the hepatitis virus until something causes them to require a physical exam, and then something routine is done, such as blood work. There are also cases where carriers have found out through blood donation or plasma donation that their blood carried a positive response to a HCV (Hepatitis C Virus) test.

There are several risk factors that qualify one for a higher risk of exposure to HCV virus. They include:

Blood contact is a prime mode of transmission. Moreover, it is spread vertically (from mother to child). Risk of transmission to a neonate from a mother with Hepatitis C is 5%. Risk is related to the mothers viral load at the time of delivery with a higher viral load confering an increased risk for transmission. Hepatitis C is not considered a sexually transmitted disease (STD). The CDC reports that only 1.5% of partners of hepatitis C carriers test positive for the disease. In most developed countries, it is usually seen primarily in intravenous drug users.

The hepatitis C virus is a single-stranded, enveloped, positive sense RNA virus in the flaviviridae family. When circulating in the bloodstream, it binds to receptors on liver tissue, most prominently the receptor for low density lipoprotein (LDL).

Treatment is mainly based on interferon alpha (IFN?), combined with other drugs; though this action does not guarantee results. Currently, the preferred treatment is pegylated interferon together with ribavirin. Studies have shown sustained cure rates of 75% or better in people with genotypes 2 or 3 HCV/Hepatitis C Virus (which is easier to treat) and about 50% in those with genotype 1.

Individuals with Hepatitis C should be vacinnated for Hepatitis A and Hepatitis B if they have not yet been exposed to these viruses.

It is well known that alcohol makes HCV (Hepatitis C Virus) associated liver disease progress faster, and makes interferon treatment less effective.

Approximately 40% of U.S. patients infected with HIV are also infected with the hepatitis C virus (HCV), mainly because both viruses share the same routes of transmission. HCV (Hepatitis C Virus) is one of most important causes of chronic liver disease in the U.S. It has been demonstrated in clinical studies that HIV infection causes a more rapid progression of chronic hepatitis C to cirrhosis and liver failure in HIV-infected persons.

Several "alternative therapies" purport to reduce the liver's duties, rather than treat the virus itself, thereby slowing the course of the disease or keeping the quality of life of the person. As an example, extract of silybum marianum and licorice are sold for their HCV (Hepatitis C Virus) related effects; the first is said to provide some generic help to hepatic functions, and the second to have a mild antiviral effect and to raise blood pressure.

There are new drugs under development like the protease inhibitor BILN 2061 that look promising but are all in early phase of developement Morpholino antisense oligos have shown promise against HCV (Hepatitis C Virus) in animal models, All of these are not approved remedies and have not yet demonstrated their efficacy in clinical trials.

Immunoglobulins against the Hepatis C virus exist and newer types are under development. Thus far, their roles have been unclear as they have not been shown to help in clearing chronic infection or in the prevention of infection with acute exposures (ie. needlesticks). They do have a limited role in transplant patients.