Hepatitis C

Your Path

  • Hepatitis C

Risk Factors

  • Sexual (rare)
  • Baby boomers
  • HIV
  • Spread via needles (e.g. shared during IVDU)
  • Unscreened blood transfusion
  • Cocaine inhaling tools
  • Needle sticks in health care workers
  • Vertical: Mother to baby (in-utero)
  • Unclean tattooing needles


  • Most w/acute hep C are asymptomatic - if symptomatic: RUQ pain, fever, malaise, jaundice
  • 10-20% resolve spontaneously
  • Chronic hep C can lead to cirrhosis (20-30% of those infected), over ~20-30y
  • With cirrhosis, 5% annual risk decompensation: ascites, confusion, edema, bleeding
  • With cirrhosis, 1-5% annual risk of HCC (abdominal pain, weight loss, sometimes portal hypertension)

Physical Exam Findings

  • Most have no findings in acute phase
  • With cirrhosis and decompensation: ascites, jaundice, edema, encephalopathy, spiders, melena or hematemesis
  • With HCC, engaged and firm liver