- Sexual (rare)
- Baby boomers
- 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)
- 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
- Hepatitis C Anti-body
- Active infection + hepatitis C viral load