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Hepatitis C - Wikipedia

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id="toc-Signs_and_symptoms-sublist" class="vector-toc-list"> <li id="toc-Acute_infection" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Acute_infection"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.1</span> <span>Acute infection</span> </div> </a> <ul id="toc-Acute_infection-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Chronic_infection" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Chronic_infection"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.2</span> <span>Chronic infection</span> </div> </a> <ul id="toc-Chronic_infection-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Extrahepatic_complications" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Extrahepatic_complications"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.3</span> <span>Extrahepatic complications</span> </div> </a> <ul id="toc-Extrahepatic_complications-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Occult_infection" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Occult_infection"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.4</span> <span>Occult infection</span> </div> </a> <ul id="toc-Occult_infection-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Virology" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Virology"> <div class="vector-toc-text"> <span class="vector-toc-numb">2</span> <span>Virology</span> </div> </a> <ul id="toc-Virology-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Transmission" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Transmission"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>Transmission</span> </div> </a> <button aria-controls="toc-Transmission-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Transmission subsection</span> </button> <ul id="toc-Transmission-sublist" class="vector-toc-list"> <li id="toc-Body_modification" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Body_modification"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.1</span> <span>Body modification</span> </div> </a> <ul id="toc-Body_modification-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Drug_use" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Drug_use"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.2</span> <span>Drug use</span> </div> </a> <ul id="toc-Drug_use-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Fomites" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Fomites"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.3</span> <span>Fomites</span> </div> </a> <ul id="toc-Fomites-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Healthcare_exposure" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Healthcare_exposure"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.4</span> <span>Healthcare exposure</span> </div> </a> <ul id="toc-Healthcare_exposure-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Mother-to-child_transmission" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Mother-to-child_transmission"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.5</span> <span>Mother-to-child transmission</span> </div> </a> <ul id="toc-Mother-to-child_transmission-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Sexual_intercourse" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Sexual_intercourse"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.6</span> <span>Sexual intercourse</span> </div> </a> <ul id="toc-Sexual_intercourse-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Diagnosis" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Diagnosis"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>Diagnosis</span> </div> </a> <button aria-controls="toc-Diagnosis-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Diagnosis subsection</span> </button> <ul id="toc-Diagnosis-sublist" class="vector-toc-list"> <li id="toc-Serology" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Serology"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.1</span> <span>Serology</span> </div> </a> <ul id="toc-Serology-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Biopsy" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Biopsy"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.2</span> <span>Biopsy</span> </div> </a> <ul id="toc-Biopsy-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Screening" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Screening"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.3</span> <span>Screening</span> </div> </a> <ul id="toc-Screening-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Prevention" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Prevention"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>Prevention</span> </div> </a> <ul id="toc-Prevention-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Treatment" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Treatment"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>Treatment</span> </div> </a> <button aria-controls="toc-Treatment-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Treatment subsection</span> </button> <ul id="toc-Treatment-sublist" class="vector-toc-list"> <li id="toc-Medications" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Medications"> <div class="vector-toc-text"> <span class="vector-toc-numb">6.1</span> <span>Medications</span> </div> </a> <ul id="toc-Medications-sublist" class="vector-toc-list"> <li id="toc-No_prior_treatment" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#No_prior_treatment"> <div class="vector-toc-text"> <span class="vector-toc-numb">6.1.1</span> <span>No prior treatment</span> </div> </a> <ul id="toc-No_prior_treatment-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Surgery" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Surgery"> <div class="vector-toc-text"> <span class="vector-toc-numb">6.2</span> <span>Surgery</span> </div> </a> <ul id="toc-Surgery-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Alternative_medicine" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Alternative_medicine"> <div class="vector-toc-text"> <span class="vector-toc-numb">6.3</span> <span>Alternative medicine</span> </div> </a> <ul id="toc-Alternative_medicine-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Prognosis" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Prognosis"> <div class="vector-toc-text"> <span class="vector-toc-numb">7</span> <span>Prognosis</span> </div> </a> <button aria-controls="toc-Prognosis-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Prognosis subsection</span> </button> <ul id="toc-Prognosis-sublist" class="vector-toc-list"> <li id="toc-Spontaneous_resolution" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Spontaneous_resolution"> <div class="vector-toc-text"> <span class="vector-toc-numb">7.1</span> <span>Spontaneous resolution</span> </div> </a> <ul id="toc-Spontaneous_resolution-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Epidemiology" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Epidemiology"> <div class="vector-toc-text"> <span class="vector-toc-numb">8</span> <span>Epidemiology</span> </div> </a> <ul id="toc-Epidemiology-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-History" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#History"> <div class="vector-toc-text"> <span class="vector-toc-numb">9</span> <span>History</span> </div> </a> <ul id="toc-History-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Society_and_culture" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Society_and_culture"> <div class="vector-toc-text"> <span class="vector-toc-numb">10</span> <span>Society and culture</span> </div> </a> <ul id="toc-Society_and_culture-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Special_populations" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Special_populations"> <div class="vector-toc-text"> <span class="vector-toc-numb">11</span> <span>Special populations</span> </div> </a> <button aria-controls="toc-Special_populations-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Special populations subsection</span> </button> <ul id="toc-Special_populations-sublist" class="vector-toc-list"> <li id="toc-Children_and_pregnancy" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Children_and_pregnancy"> <div class="vector-toc-text"> <span class="vector-toc-numb">11.1</span> <span>Children and pregnancy</span> </div> </a> <ul id="toc-Children_and_pregnancy-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Immunosuppressed" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Immunosuppressed"> <div class="vector-toc-text"> <span class="vector-toc-numb">11.2</span> <span>Immunosuppressed</span> </div> </a> <ul id="toc-Immunosuppressed-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Research" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Research"> <div class="vector-toc-text"> <span class="vector-toc-numb">12</span> <span>Research</span> </div> </a> <button aria-controls="toc-Research-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Research subsection</span> </button> <ul id="toc-Research-sublist" class="vector-toc-list"> <li id="toc-Animal_models" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Animal_models"> <div class="vector-toc-text"> <span class="vector-toc-numb">12.1</span> <span>Animal models</span> </div> </a> <ul id="toc-Animal_models-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-See_also" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#See_also"> <div class="vector-toc-text"> <span class="vector-toc-numb">13</span> <span>See also</span> </div> </a> <ul id="toc-See_also-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">14</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> <span class="vector-toc-numb">15</span> <span>External links</span> </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" ><span class="vector-icon mw-ui-icon-listBullet mw-ui-icon-wikimedia-listBullet"></span> <span class="vector-dropdown-label-text">Toggle the table of contents</span> </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading"><span class="mw-page-title-main">Hepatitis C</span></h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" 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Available in 75 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-75" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">75 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D8%A7%D9%84%D8%AA%D9%87%D8%A7%D8%A8_%D8%A7%D9%84%D9%83%D8%A8%D8%AF_C" title="التهاب الكبد C – Arabic" lang="ar" hreflang="ar" data-title="التهاب الكبد C" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-as mw-list-item"><a href="https://as.wikipedia.org/wiki/%E0%A6%B9%E0%A7%87%E0%A6%AA%E0%A6%BE%E0%A6%9F%E0%A6%BE%E0%A6%87%E0%A6%9F%E0%A6%BF%E0%A6%9B_%E0%A6%9A%E0%A6%BF" title="হেপাটাইটিছ চি – Assamese" lang="as" hreflang="as" data-title="হেপাটাইটিছ চি" data-language-autonym="অসমীয়া" data-language-local-name="Assamese" class="interlanguage-link-target"><span>অসমীয়া</span></a></li><li class="interlanguage-link interwiki-az mw-list-item"><a href="https://az.wikipedia.org/wiki/Hepatit_C" title="Hepatit C – Azerbaijani" lang="az" hreflang="az" data-title="Hepatit C" data-language-autonym="Azərbaycanca" data-language-local-name="Azerbaijani" class="interlanguage-link-target"><span>Azərbaycanca</span></a></li><li class="interlanguage-link interwiki-azb mw-list-item"><a href="https://azb.wikipedia.org/wiki/%D9%87%D9%BE%D8%A7%D8%AA%DB%8C%D8%AA_%D8%B3%DB%8C" title="هپاتیت سی – South Azerbaijani" lang="azb" hreflang="azb" data-title="هپاتیت سی" data-language-autonym="تۆرکجه" data-language-local-name="South Azerbaijani" class="interlanguage-link-target"><span>تۆرکجه</span></a></li><li class="interlanguage-link interwiki-bn mw-list-item"><a href="https://bn.wikipedia.org/wiki/%E0%A6%B9%E0%A7%87%E0%A6%AA%E0%A6%BE%E0%A6%9F%E0%A6%BE%E0%A6%87%E0%A6%9F%E0%A6%BF%E0%A6%B8_%E0%A6%B8%E0%A6%BF" title="হেপাটাইটিস সি – Bangla" lang="bn" hreflang="bn" data-title="হেপাটাইটিস সি" data-language-autonym="বাংলা" data-language-local-name="Bangla" class="interlanguage-link-target"><span>বাংলা</span></a></li><li class="interlanguage-link interwiki-be mw-list-item"><a href="https://be.wikipedia.org/wiki/%D0%93%D0%B5%D0%BF%D0%B0%D1%82%D1%8B%D1%82_C" title="Гепатыт C – Belarusian" lang="be" hreflang="be" data-title="Гепатыт C" data-language-autonym="Беларуская" data-language-local-name="Belarusian" class="interlanguage-link-target"><span>Беларуская</span></a></li><li class="interlanguage-link interwiki-be-x-old mw-list-item"><a href="https://be-tarask.wikipedia.org/wiki/%D0%93%D0%B5%D0%BF%D0%B0%D1%82%D1%8B%D1%82_%D0%A1" title="Гепатыт С – Belarusian (Taraškievica orthography)" lang="be-tarask" hreflang="be-tarask" data-title="Гепатыт С" data-language-autonym="Беларуская (тарашкевіца)" data-language-local-name="Belarusian (Taraškievica orthography)" class="interlanguage-link-target"><span>Беларуская (тарашкевіца)</span></a></li><li class="interlanguage-link interwiki-bg mw-list-item"><a href="https://bg.wikipedia.org/wiki/%D0%A5%D0%B5%D0%BF%D0%B0%D1%82%D0%B8%D1%82_C" title="Хепатит C – Bulgarian" lang="bg" hreflang="bg" data-title="Хепатит C" data-language-autonym="Български" data-language-local-name="Bulgarian" class="interlanguage-link-target"><span>Български</span></a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Hepatitis_C" title="Hepatitis C – Catalan" lang="ca" hreflang="ca" data-title="Hepatitis C" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target"><span>Català</span></a></li><li class="interlanguage-link interwiki-cs mw-list-item"><a href="https://cs.wikipedia.org/wiki/Hepatitida_C" title="Hepatitida C – Czech" lang="cs" hreflang="cs" data-title="Hepatitida C" data-language-autonym="Čeština" data-language-local-name="Czech" class="interlanguage-link-target"><span>Čeština</span></a></li><li class="interlanguage-link interwiki-da mw-list-item"><a href="https://da.wikipedia.org/wiki/Hepatitis_C" title="Hepatitis C – Danish" lang="da" hreflang="da" data-title="Hepatitis C" data-language-autonym="Dansk" data-language-local-name="Danish" class="interlanguage-link-target"><span>Dansk</span></a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Hepatitis_C" title="Hepatitis C – German" lang="de" hreflang="de" data-title="Hepatitis C" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-dv mw-list-item"><a href="https://dv.wikipedia.org/wiki/%DE%80%DE%AC%DE%95%DE%A6%DE%93%DE%A6%DE%87%DE%A8%DE%93%DE%A8%DE%90%DE%B0_%DE%90%DE%A9" title="ހެޕަޓައިޓިސް ސީ – Divehi" lang="dv" hreflang="dv" data-title="ހެޕަޓައިޓިސް ސީ" data-language-autonym="ދިވެހިބަސް" data-language-local-name="Divehi" class="interlanguage-link-target"><span>ދިވެހިބަސް</span></a></li><li class="interlanguage-link interwiki-et mw-list-item"><a href="https://et.wikipedia.org/wiki/C-hepatiit" title="C-hepatiit – Estonian" lang="et" hreflang="et" data-title="C-hepatiit" data-language-autonym="Eesti" data-language-local-name="Estonian" class="interlanguage-link-target"><span>Eesti</span></a></li><li class="interlanguage-link interwiki-el mw-list-item"><a href="https://el.wikipedia.org/wiki/%CE%97%CF%80%CE%B1%CF%84%CE%AF%CF%84%CE%B9%CE%B4%CE%B1_C" title="Ηπατίτιδα C – Greek" lang="el" hreflang="el" data-title="Ηπατίτιδα C" data-language-autonym="Ελληνικά" data-language-local-name="Greek" class="interlanguage-link-target"><span>Ελληνικά</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Hepatitis_C" title="Hepatitis C – Spanish" lang="es" hreflang="es" data-title="Hepatitis C" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-eu mw-list-item"><a href="https://eu.wikipedia.org/wiki/C_hepatitis" title="C hepatitis – Basque" lang="eu" hreflang="eu" data-title="C hepatitis" data-language-autonym="Euskara" data-language-local-name="Basque" class="interlanguage-link-target"><span>Euskara</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D9%87%D9%BE%D8%A7%D8%AA%DB%8C%D8%AA_%D8%B3%DB%8C" title="هپاتیت سی – Persian" lang="fa" hreflang="fa" data-title="هپاتیت سی" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/H%C3%A9patite_C" title="Hépatite C – French" lang="fr" hreflang="fr" data-title="Hépatite C" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-fur mw-list-item"><a href="https://fur.wikipedia.org/wiki/Epatite_c" title="Epatite c – Friulian" lang="fur" hreflang="fur" data-title="Epatite c" data-language-autonym="Furlan" data-language-local-name="Friulian" class="interlanguage-link-target"><span>Furlan</span></a></li><li class="interlanguage-link interwiki-ga mw-list-item"><a href="https://ga.wikipedia.org/wiki/Heipit%C3%ADteas_C" title="Heipitíteas C – Irish" lang="ga" hreflang="ga" data-title="Heipitíteas C" data-language-autonym="Gaeilge" data-language-local-name="Irish" class="interlanguage-link-target"><span>Gaeilge</span></a></li><li class="interlanguage-link interwiki-gl mw-list-item"><a href="https://gl.wikipedia.org/wiki/Hepatite_C" title="Hepatite C – Galician" lang="gl" hreflang="gl" data-title="Hepatite C" data-language-autonym="Galego" data-language-local-name="Galician" class="interlanguage-link-target"><span>Galego</span></a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/C%ED%98%95_%EA%B0%84%EC%97%BC" title="C형 간염 – Korean" lang="ko" hreflang="ko" data-title="C형 간염" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target"><span>한국어</span></a></li><li class="interlanguage-link interwiki-ha mw-list-item"><a href="https://ha.wikipedia.org/wiki/Hepatitis_C" title="Hepatitis C – Hausa" lang="ha" hreflang="ha" data-title="Hepatitis C" data-language-autonym="Hausa" data-language-local-name="Hausa" class="interlanguage-link-target"><span>Hausa</span></a></li><li class="interlanguage-link interwiki-hy mw-list-item"><a href="https://hy.wikipedia.org/wiki/%D5%80%D5%A5%D5%BA%D5%A1%D5%BF%D5%AB%D5%BF_C" title="Հեպատիտ C – Armenian" lang="hy" hreflang="hy" data-title="Հեպատիտ C" data-language-autonym="Հայերեն" data-language-local-name="Armenian" class="interlanguage-link-target"><span>Հայերեն</span></a></li><li class="interlanguage-link interwiki-hi mw-list-item"><a href="https://hi.wikipedia.org/wiki/%E0%A4%B9%E0%A5%87%E0%A4%AA%E0%A5%87%E0%A4%9F%E0%A4%BE%E0%A4%87%E0%A4%9F%E0%A4%BF%E0%A4%B8_%E0%A4%B8%E0%A5%80" title="हेपेटाइटिस सी – Hindi" lang="hi" hreflang="hi" data-title="हेपेटाइटिस सी" data-language-autonym="हिन्दी" data-language-local-name="Hindi" class="interlanguage-link-target"><span>हिन्दी</span></a></li><li class="interlanguage-link interwiki-hr mw-list-item"><a href="https://hr.wikipedia.org/wiki/Hepatitis_C" title="Hepatitis C – Croatian" lang="hr" hreflang="hr" data-title="Hepatitis C" data-language-autonym="Hrvatski" data-language-local-name="Croatian" class="interlanguage-link-target"><span>Hrvatski</span></a></li><li class="interlanguage-link interwiki-id mw-list-item"><a href="https://id.wikipedia.org/wiki/Hepatitis_C" title="Hepatitis C – Indonesian" lang="id" hreflang="id" data-title="Hepatitis C" data-language-autonym="Bahasa Indonesia" data-language-local-name="Indonesian" class="interlanguage-link-target"><span>Bahasa Indonesia</span></a></li><li class="interlanguage-link interwiki-it badge-Q17437798 badge-goodarticle mw-list-item" title="good article badge"><a href="https://it.wikipedia.org/wiki/Epatite_C" title="Epatite C – Italian" lang="it" hreflang="it" data-title="Epatite C" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%94%D7%A4%D7%98%D7%99%D7%98%D7%99%D7%A1_C" title="הפטיטיס C – Hebrew" lang="he" hreflang="he" data-title="הפטיטיס C" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target"><span>עברית</span></a></li><li class="interlanguage-link interwiki-ka mw-list-item"><a href="https://ka.wikipedia.org/wiki/C_%E1%83%B0%E1%83%94%E1%83%9E%E1%83%90%E1%83%A2%E1%83%98%E1%83%A2%E1%83%98" title="C ჰეპატიტი – Georgian" lang="ka" hreflang="ka" data-title="C ჰეპატიტი" data-language-autonym="ქართული" data-language-local-name="Georgian" class="interlanguage-link-target"><span>ქართული</span></a></li><li class="interlanguage-link interwiki-sw mw-list-item"><a href="https://sw.wikipedia.org/wiki/Homanyongo_C" title="Homanyongo C – Swahili" lang="sw" hreflang="sw" data-title="Homanyongo C" data-language-autonym="Kiswahili" data-language-local-name="Swahili" class="interlanguage-link-target"><span>Kiswahili</span></a></li><li class="interlanguage-link interwiki-ky mw-list-item"><a href="https://ky.wikipedia.org/wiki/%D0%93%D0%B5%D0%BF%D0%B0%D1%82%D0%B8%D1%82_%D0%A1" title="Гепатит С – Kyrgyz" lang="ky" hreflang="ky" data-title="Гепатит С" data-language-autonym="Кыргызча" data-language-local-name="Kyrgyz" class="interlanguage-link-target"><span>Кыргызча</span></a></li><li class="interlanguage-link interwiki-la mw-list-item"><a href="https://la.wikipedia.org/wiki/Hepatitis_C" title="Hepatitis C – Latin" lang="la" hreflang="la" data-title="Hepatitis C" data-language-autonym="Latina" data-language-local-name="Latin" class="interlanguage-link-target"><span>Latina</span></a></li><li class="interlanguage-link interwiki-lv mw-list-item"><a href="https://lv.wikipedia.org/wiki/C_hepat%C4%ABts" title="C hepatīts – Latvian" lang="lv" hreflang="lv" data-title="C hepatīts" data-language-autonym="Latviešu" data-language-local-name="Latvian" class="interlanguage-link-target"><span>Latviešu</span></a></li><li class="interlanguage-link interwiki-lt mw-list-item"><a href="https://lt.wikipedia.org/wiki/Hepatitas_C" title="Hepatitas C – Lithuanian" lang="lt" hreflang="lt" data-title="Hepatitas C" data-language-autonym="Lietuvių" data-language-local-name="Lithuanian" class="interlanguage-link-target"><span>Lietuvių</span></a></li><li class="interlanguage-link interwiki-hu mw-list-item"><a href="https://hu.wikipedia.org/wiki/Hepatitis_C" title="Hepatitis C – Hungarian" lang="hu" hreflang="hu" data-title="Hepatitis C" data-language-autonym="Magyar" data-language-local-name="Hungarian" class="interlanguage-link-target"><span>Magyar</span></a></li><li class="interlanguage-link interwiki-mk mw-list-item"><a href="https://mk.wikipedia.org/wiki/%D0%A5%D0%B5%D0%BF%D0%B0%D1%82%D0%B8%D1%82_%D0%A6" title="Хепатит Ц – Macedonian" lang="mk" hreflang="mk" data-title="Хепатит Ц" data-language-autonym="Македонски" data-language-local-name="Macedonian" class="interlanguage-link-target"><span>Македонски</span></a></li><li class="interlanguage-link interwiki-ml mw-list-item"><a href="https://ml.wikipedia.org/wiki/%E0%B4%B9%E0%B5%86%E0%B4%AA%E0%B5%8D%E0%B4%AA%E0%B4%B1%E0%B5%8D%E0%B4%B1%E0%B5%88%E0%B4%B1%E0%B5%8D%E0%B4%B1%E0%B4%BF%E0%B4%B8%E0%B5%8D-%E0%B4%B8%E0%B4%BF" title="ഹെപ്പറ്റൈറ്റിസ്-സി – Malayalam" lang="ml" hreflang="ml" data-title="ഹെപ്പറ്റൈറ്റിസ്-സി" data-language-autonym="മലയാളം" data-language-local-name="Malayalam" class="interlanguage-link-target"><span>മലയാളം</span></a></li><li class="interlanguage-link interwiki-ms mw-list-item"><a href="https://ms.wikipedia.org/wiki/Hepatitis_C" title="Hepatitis C – Malay" lang="ms" hreflang="ms" data-title="Hepatitis C" data-language-autonym="Bahasa Melayu" data-language-local-name="Malay" class="interlanguage-link-target"><span>Bahasa Melayu</span></a></li><li class="interlanguage-link interwiki-mn mw-list-item"><a href="https://mn.wikipedia.org/wiki/%D0%93%D0%B5%D0%BF%D0%B0%D1%82%D0%B8%D1%82_%D0%A1" title="Гепатит С – Mongolian" lang="mn" hreflang="mn" data-title="Гепатит С" data-language-autonym="Монгол" data-language-local-name="Mongolian" class="interlanguage-link-target"><span>Монгол</span></a></li><li class="interlanguage-link interwiki-my mw-list-item"><a href="https://my.wikipedia.org/wiki/%E1%80%A1%E1%80%9E%E1%80%8A%E1%80%BA%E1%80%B8%E1%80%9B%E1%80%B1%E1%80%AC%E1%80%84%E1%80%BA_%E1%80%A1%E1%80%9E%E1%80%AC%E1%80%B8%E1%80%9D%E1%80%AB_%E1%80%9B%E1%80%B1%E1%80%AC%E1%80%82%E1%80%AB_%E1%80%85%E1%80%AE%E1%80%95%E1%80%AD%E1%80%AF%E1%80%B8" title="အသည်းရောင် အသားဝါ ရောဂါ စီပိုး – Burmese" lang="my" hreflang="my" data-title="အသည်းရောင် အသားဝါ ရောဂါ စီပိုး" data-language-autonym="မြန်မာဘာသာ" data-language-local-name="Burmese" class="interlanguage-link-target"><span>မြန်မာဘာသာ</span></a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Hepatitis_C" title="Hepatitis C – Dutch" lang="nl" hreflang="nl" data-title="Hepatitis C" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target"><span>Nederlands</span></a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/C%E5%9E%8B%E8%82%9D%E7%82%8E" title="C型肝炎 – Japanese" lang="ja" hreflang="ja" data-title="C型肝炎" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target"><span>日本語</span></a></li><li class="interlanguage-link interwiki-nn mw-list-item"><a href="https://nn.wikipedia.org/wiki/Hepatitt_C" title="Hepatitt C – Norwegian Nynorsk" lang="nn" hreflang="nn" data-title="Hepatitt C" data-language-autonym="Norsk nynorsk" data-language-local-name="Norwegian Nynorsk" class="interlanguage-link-target"><span>Norsk nynorsk</span></a></li><li class="interlanguage-link interwiki-or mw-list-item"><a href="https://or.wikipedia.org/wiki/%E0%AC%B9%E0%AD%87%E0%AC%AA%E0%AC%BE%E0%AC%9F%E0%AC%BE%E0%AC%87%E0%AC%9F%E0%AC%BF%E0%AC%B8_%E0%AC%B8%E0%AC%BF" title="ହେପାଟାଇଟିସ ସି – Odia" lang="or" hreflang="or" data-title="ହେପାଟାଇଟିସ ସି" data-language-autonym="ଓଡ଼ିଆ" data-language-local-name="Odia" class="interlanguage-link-target"><span>ଓଡ଼ିଆ</span></a></li><li class="interlanguage-link interwiki-uz mw-list-item"><a href="https://uz.wikipedia.org/wiki/Gepatit_C" title="Gepatit C – Uzbek" lang="uz" hreflang="uz" data-title="Gepatit C" data-language-autonym="Oʻzbekcha / ўзбекча" data-language-local-name="Uzbek" class="interlanguage-link-target"><span>Oʻzbekcha / ўзбекча</span></a></li><li class="interlanguage-link interwiki-pa mw-list-item"><a href="https://pa.wikipedia.org/wiki/%E0%A8%B9%E0%A9%87%E0%A8%AA%E0%A8%BE%E0%A8%9F%E0%A8%BE%E0%A8%88%E0%A8%9F%E0%A8%BF%E0%A8%B8_%E0%A8%B8%E0%A9%80" title="ਹੇਪਾਟਾਈਟਿਸ ਸੀ – Punjabi" lang="pa" hreflang="pa" data-title="ਹੇਪਾਟਾਈਟਿਸ ਸੀ" data-language-autonym="ਪੰਜਾਬੀ" data-language-local-name="Punjabi" class="interlanguage-link-target"><span>ਪੰਜਾਬੀ</span></a></li><li class="interlanguage-link interwiki-pnb mw-list-item"><a href="https://pnb.wikipedia.org/wiki/%DB%81%DB%8C%D9%BE%D8%A7%D9%B9%D8%A7%D8%A6%D9%B9%D8%B3_%D8%B3%DB%8C" title="ہیپاٹائٹس سی – Western Punjabi" lang="pnb" hreflang="pnb" data-title="ہیپاٹائٹس سی" data-language-autonym="پنجابی" data-language-local-name="Western Punjabi" class="interlanguage-link-target"><span>پنجابی</span></a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Wirusowe_zapalenie_w%C4%85troby_typu_C" title="Wirusowe zapalenie wątroby typu C – Polish" lang="pl" hreflang="pl" data-title="Wirusowe zapalenie wątroby typu C" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target"><span>Polski</span></a></li><li class="interlanguage-link interwiki-pt badge-Q17437798 badge-goodarticle mw-list-item" title="good article badge"><a href="https://pt.wikipedia.org/wiki/Hepatite_C" title="Hepatite C – Portuguese" lang="pt" hreflang="pt" data-title="Hepatite C" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-ro badge-Q17437796 badge-featuredarticle mw-list-item" title="featured article badge"><a href="https://ro.wikipedia.org/wiki/Hepatit%C4%83_C" title="Hepatită C – Romanian" lang="ro" hreflang="ro" data-title="Hepatită C" data-language-autonym="Română" data-language-local-name="Romanian" class="interlanguage-link-target"><span>Română</span></a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%93%D0%B5%D0%BF%D0%B0%D1%82%D0%B8%D1%82_C" title="Гепатит C – Russian" lang="ru" hreflang="ru" data-title="Гепатит C" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target"><span>Русский</span></a></li><li class="interlanguage-link interwiki-sco mw-list-item"><a href="https://sco.wikipedia.org/wiki/Hepatitis_C" title="Hepatitis C – Scots" lang="sco" hreflang="sco" data-title="Hepatitis C" data-language-autonym="Scots" data-language-local-name="Scots" class="interlanguage-link-target"><span>Scots</span></a></li><li class="interlanguage-link interwiki-sq mw-list-item"><a href="https://sq.wikipedia.org/wiki/Hepatiti_C" title="Hepatiti C – Albanian" lang="sq" hreflang="sq" data-title="Hepatiti C" data-language-autonym="Shqip" data-language-local-name="Albanian" class="interlanguage-link-target"><span>Shqip</span></a></li><li class="interlanguage-link interwiki-simple mw-list-item"><a href="https://simple.wikipedia.org/wiki/Hepatitis_C" title="Hepatitis C – Simple English" lang="en-simple" hreflang="en-simple" data-title="Hepatitis C" data-language-autonym="Simple English" data-language-local-name="Simple English" class="interlanguage-link-target"><span>Simple English</span></a></li><li class="interlanguage-link interwiki-sk mw-list-item"><a href="https://sk.wikipedia.org/wiki/Hepatit%C3%ADda_typu_C" title="Hepatitída typu C – Slovak" lang="sk" hreflang="sk" data-title="Hepatitída typu C" data-language-autonym="Slovenčina" data-language-local-name="Slovak" class="interlanguage-link-target"><span>Slovenčina</span></a></li><li class="interlanguage-link interwiki-sl badge-Q17437796 badge-featuredarticle mw-list-item" title="featured article badge"><a href="https://sl.wikipedia.org/wiki/Hepatitis_C" title="Hepatitis C – Slovenian" lang="sl" hreflang="sl" data-title="Hepatitis C" data-language-autonym="Slovenščina" data-language-local-name="Slovenian" class="interlanguage-link-target"><span>Slovenščina</span></a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/%D0%A5%D0%B5%D0%BF%D0%B0%D1%82%D0%B8%D1%82%D0%B8%D1%81_%D0%A6" title="Хепатитис Ц – Serbian" lang="sr" hreflang="sr" data-title="Хепатитис Ц" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target"><span>Српски / srpski</span></a></li><li class="interlanguage-link interwiki-sh mw-list-item"><a href="https://sh.wikipedia.org/wiki/Hepatitis_C" title="Hepatitis C – Serbo-Croatian" lang="sh" hreflang="sh" data-title="Hepatitis C" data-language-autonym="Srpskohrvatski / српскохрватски" data-language-local-name="Serbo-Croatian" class="interlanguage-link-target"><span>Srpskohrvatski / српскохрватски</span></a></li><li class="interlanguage-link interwiki-fi mw-list-item"><a href="https://fi.wikipedia.org/wiki/Hepatiitti_C" title="Hepatiitti C – Finnish" lang="fi" hreflang="fi" data-title="Hepatiitti C" data-language-autonym="Suomi" data-language-local-name="Finnish" class="interlanguage-link-target"><span>Suomi</span></a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/Hepatit_C" title="Hepatit C – Swedish" lang="sv" hreflang="sv" data-title="Hepatit C" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target"><span>Svenska</span></a></li><li class="interlanguage-link interwiki-tl mw-list-item"><a href="https://tl.wikipedia.org/wiki/Hepataytis_C" title="Hepataytis C – Tagalog" lang="tl" hreflang="tl" data-title="Hepataytis C" data-language-autonym="Tagalog" data-language-local-name="Tagalog" class="interlanguage-link-target"><span>Tagalog</span></a></li><li class="interlanguage-link interwiki-te mw-list-item"><a href="https://te.wikipedia.org/wiki/%E0%B0%B9%E0%B1%86%E0%B0%AA%E0%B0%9F%E0%B1%88%E0%B0%9F%E0%B0%BF%E0%B0%B8%E0%B1%8D_C" title="హెపటైటిస్ C – Telugu" lang="te" hreflang="te" data-title="హెపటైటిస్ C" data-language-autonym="తెలుగు" data-language-local-name="Telugu" class="interlanguage-link-target"><span>తెలుగు</span></a></li><li class="interlanguage-link interwiki-th mw-list-item"><a href="https://th.wikipedia.org/wiki/%E0%B8%95%E0%B8%B1%E0%B8%9A%E0%B8%AD%E0%B8%B1%E0%B8%81%E0%B9%80%E0%B8%AA%E0%B8%9A%E0%B8%8B%E0%B8%B5" title="ตับอักเสบซี – Thai" lang="th" hreflang="th" data-title="ตับอักเสบซี" data-language-autonym="ไทย" data-language-local-name="Thai" class="interlanguage-link-target"><span>ไทย</span></a></li><li class="interlanguage-link interwiki-tg mw-list-item"><a href="https://tg.wikipedia.org/wiki/%D2%B2%D0%B5%D0%BF%D0%B0%D1%82%D0%B8%D1%82%D0%B8_C" title="Ҳепатити C – Tajik" lang="tg" hreflang="tg" data-title="Ҳепатити C" data-language-autonym="Тоҷикӣ" data-language-local-name="Tajik" class="interlanguage-link-target"><span>Тоҷикӣ</span></a></li><li class="interlanguage-link interwiki-tr mw-list-item"><a href="https://tr.wikipedia.org/wiki/Hepatit_C" title="Hepatit C – Turkish" lang="tr" hreflang="tr" data-title="Hepatit C" data-language-autonym="Türkçe" data-language-local-name="Turkish" class="interlanguage-link-target"><span>Türkçe</span></a></li><li class="interlanguage-link interwiki-uk mw-list-item"><a href="https://uk.wikipedia.org/wiki/%D0%93%D0%B5%D0%BF%D0%B0%D1%82%D0%B8%D1%82_C" title="Гепатит C – Ukrainian" lang="uk" hreflang="uk" data-title="Гепатит C" data-language-autonym="Українська" data-language-local-name="Ukrainian" class="interlanguage-link-target"><span>Українська</span></a></li><li class="interlanguage-link interwiki-ur mw-list-item"><a href="https://ur.wikipedia.org/wiki/%DB%81%DB%8C%D9%BE%D8%A7%D9%B9%D8%A7%D8%A6%D9%B9%D8%B3_%D8%B3%DB%8C" title="ہیپاٹائٹس سی – Urdu" lang="ur" hreflang="ur" data-title="ہیپاٹائٹس سی" data-language-autonym="اردو" data-language-local-name="Urdu" class="interlanguage-link-target"><span>اردو</span></a></li><li class="interlanguage-link interwiki-ug mw-list-item"><a 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.navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox ib-medical-condition"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Hepatitis C</th></tr><tr style="background-color: #f8f9fa;"><td colspan="2" class="infobox-full-data"><span class="mw-default-size" typeof="mw:File/Frameless"><a href="/wiki/File:HCV_EM_picture_2.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/3/3b/HCV_EM_picture_2.png/220px-HCV_EM_picture_2.png" decoding="async" width="220" height="155" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/3/3b/HCV_EM_picture_2.png/330px-HCV_EM_picture_2.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/3/3b/HCV_EM_picture_2.png/440px-HCV_EM_picture_2.png 2x" data-file-width="703" data-file-height="494" /></a></span></td></tr><tr><td colspan="2" class="infobox-full-data"><a href="/wiki/Electron_micrograph" class="mw-redirect" title="Electron micrograph">Electron micrograph</a> of <a href="/wiki/Hepatitis_C_virus" title="Hepatitis C virus">hepatitis C virus</a> from cell culture (scale = 50&#160;<a href="/wiki/Nanometers" class="mw-redirect" title="Nanometers">nanometers</a>)</td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="/wiki/Gastroenterology" title="Gastroenterology">Gastroenterology</a>, <a href="/wiki/Infectious_disease_(medical_specialty)" class="mw-redirect" title="Infectious disease (medical specialty)">infectious disease</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Signs_and_symptoms" title="Signs and symptoms">Symptoms</a></th><td class="infobox-data">Typically none<sup id="cite_ref-CDC2016_1-0" class="reference"><a href="#cite_note-CDC2016-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Complication_(medicine)" title="Complication (medicine)">Complications</a></th><td class="infobox-data"><a href="/wiki/Liver_failure" title="Liver failure">Liver failure</a>, <a href="/wiki/Hepatocellular_carcinoma" title="Hepatocellular carcinoma">liver cancer</a>, <a href="/wiki/Esophageal_varices" title="Esophageal varices">esophageal</a> and <a href="/wiki/Gastric_varices" title="Gastric varices">gastric varices</a><sup id="cite_ref-Sherris2004_2-0" class="reference"><a href="#cite_note-Sherris2004-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Duration</th><td class="infobox-data">Long term (80%)<sup id="cite_ref-CDC2016_1-1" class="reference"><a href="#cite_note-CDC2016-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Causes</th><td class="infobox-data"><a href="/wiki/Hepatitis_C_virus" title="Hepatitis C virus">Hepatitis C virus</a> usually spread by blood-to-blood contact<sup id="cite_ref-CDC2016_1-2" class="reference"><a href="#cite_note-CDC2016-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Mah2010_3-0" class="reference"><a href="#cite_note-Mah2010-3"><span class="cite-bracket">&#91;</span>3<span class="cite-bracket">&#93;</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_diagnosis" title="Medical diagnosis">Diagnostic method</a></th><td class="infobox-data">Blood testing for <a href="/wiki/Antibodies" class="mw-redirect" title="Antibodies">antibodies</a> or viral <a href="/wiki/RNA" title="RNA">RNA</a><sup id="cite_ref-CDC2016_1-3" class="reference"><a href="#cite_note-CDC2016-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Prevention</th><td class="infobox-data">Sterile needles, testing donated blood<sup id="cite_ref-whofactsheet_4-0" class="reference"><a href="#cite_note-whofactsheet-4"><span class="cite-bracket">&#91;</span>4<span class="cite-bracket">&#93;</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Treatment</th><td class="infobox-data">Medications, <a href="/wiki/Liver_transplant" class="mw-redirect" title="Liver transplant">liver transplant</a><sup id="cite_ref-NEJM2011_5-0" class="reference"><a href="#cite_note-NEJM2011-5"><span class="cite-bracket">&#91;</span>5<span class="cite-bracket">&#93;</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medication" title="Medication">Medication</a></th><td class="infobox-data">Antivirals (<a href="/wiki/Sofosbuvir" title="Sofosbuvir">sofosbuvir</a>, <a href="/wiki/Simeprevir" title="Simeprevir">simeprevir</a>, others)<sup id="cite_ref-CDC2016_1-4" class="reference"><a href="#cite_note-CDC2016-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-whofactsheet_4-1" class="reference"><a href="#cite_note-whofactsheet-4"><span class="cite-bracket">&#91;</span>4<span class="cite-bracket">&#93;</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Frequency</th><td class="infobox-data">58 million (2019)<sup id="cite_ref-whofactsheet_4-2" class="reference"><a href="#cite_note-whofactsheet-4"><span class="cite-bracket">&#91;</span>4<span class="cite-bracket">&#93;</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Deaths</th><td class="infobox-data">290,000 (2019)<sup id="cite_ref-whofactsheet_4-3" class="reference"><a href="#cite_note-whofactsheet-4"><span class="cite-bracket">&#91;</span>4<span class="cite-bracket">&#93;</span></a></sup></td></tr></tbody></table> <p><b>Hepatitis C</b> is an <a href="/wiki/Infectious_disease" class="mw-redirect" title="Infectious disease">infectious disease</a> caused by the <a href="/wiki/Hepatitis_C_virus" title="Hepatitis C virus">hepatitis C virus</a> (HCV) that primarily affects the <a href="/wiki/Liver" title="Liver">liver</a>;<sup id="cite_ref-Sherris2004_2-1" class="reference"><a href="#cite_note-Sherris2004-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup> it is a type of <a href="/wiki/Viral_hepatitis" title="Viral hepatitis">viral hepatitis</a>.<sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">&#91;</span>6<span class="cite-bracket">&#93;</span></a></sup> During the initial infection period, people often have mild or no symptoms.<sup id="cite_ref-CDC2016_1-5" class="reference"><a href="#cite_note-CDC2016-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup> Early symptoms can include fever, dark urine, abdominal pain, and <a href="/wiki/Jaundice" title="Jaundice">yellow tinged skin</a>.<sup id="cite_ref-CDC2016_1-6" class="reference"><a href="#cite_note-CDC2016-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup> The virus persists in the liver, becoming <a href="/wiki/Chronic_condition" title="Chronic condition">chronic</a>, in about 70% of those initially infected.<sup id="cite_ref-whofactsheet_4-4" class="reference"><a href="#cite_note-whofactsheet-4"><span class="cite-bracket">&#91;</span>4<span class="cite-bracket">&#93;</span></a></sup> Early on, chronic infection typically has no symptoms.<sup id="cite_ref-CDC2016_1-7" class="reference"><a href="#cite_note-CDC2016-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup> Over many years however, it often leads to <a href="/wiki/Liver_disease" title="Liver disease">liver disease</a> and occasionally <a href="/wiki/Cirrhosis" title="Cirrhosis">cirrhosis</a>.<sup id="cite_ref-CDC2016_1-8" class="reference"><a href="#cite_note-CDC2016-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup> In some cases, those with cirrhosis will develop serious complications such as <a href="/wiki/Liver_failure" title="Liver failure">liver failure</a>, <a href="/wiki/Hepatocellular_carcinoma" title="Hepatocellular carcinoma">liver cancer</a>, or <a href="/wiki/Esophageal_varices" title="Esophageal varices">dilated blood vessels in the esophagus</a> and <a href="/wiki/Gastric_varices" title="Gastric varices">stomach</a>.<sup id="cite_ref-Sherris2004_2-2" class="reference"><a href="#cite_note-Sherris2004-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup> </p><p>HCV is spread primarily by blood-to-blood contact associated with <a href="/wiki/Injection_drug_use" class="mw-redirect" title="Injection drug use">injection drug use</a>, poorly sterilized medical equipment, <a href="/wiki/Needlestick_injuries" class="mw-redirect" title="Needlestick injuries">needlestick injuries</a> in healthcare, and <a href="/wiki/Blood_transfusions" class="mw-redirect" title="Blood transfusions">transfusions</a>.<sup id="cite_ref-CDC2016_1-9" class="reference"><a href="#cite_note-CDC2016-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Mah2010_3-1" class="reference"><a href="#cite_note-Mah2010-3"><span class="cite-bracket">&#91;</span>3<span class="cite-bracket">&#93;</span></a></sup> In regions where blood screening has been implemented, the risk of contracting HCV from a transfusion has dropped substantially to less than one per two million.<sup id="cite_ref-CDC2016_1-10" class="reference"><a href="#cite_note-CDC2016-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup> HCV may also be spread from an infected mother to her baby during birth.<sup id="cite_ref-CDC2016_1-11" class="reference"><a href="#cite_note-CDC2016-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup> It is not spread through breast milk, food, water or casual contact such as hugging, kissing and sharing food or drinks with an infected person.<sup id="cite_ref-whofactsheet_4-5" class="reference"><a href="#cite_note-whofactsheet-4"><span class="cite-bracket">&#91;</span>4<span class="cite-bracket">&#93;</span></a></sup> It is one of five known hepatitis viruses: <a href="/wiki/Hepatitis_A" title="Hepatitis A">A</a>, <a href="/wiki/Hepatitis_B" title="Hepatitis B">B</a>, C, <a href="/wiki/Hepatitis_D" title="Hepatitis D">D</a>, and <a href="/wiki/Hepatitis_E" title="Hepatitis E">E</a>.<sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">&#91;</span>7<span class="cite-bracket">&#93;</span></a></sup> Diagnosis is by blood testing to look for either <a href="/wiki/Antibodies" class="mw-redirect" title="Antibodies">antibodies</a> to the virus or viral <a href="/wiki/RNA" title="RNA">RNA</a>.<sup id="cite_ref-CDC2016_1-12" class="reference"><a href="#cite_note-CDC2016-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup> In the <a href="/wiki/United_States" title="United States">United States</a>, screening for HCV infection is recommended in all adults age 18 to 79 years old.<sup id="cite_ref-USPSTF_8-0" class="reference"><a href="#cite_note-USPSTF-8"><span class="cite-bracket">&#91;</span>8<span class="cite-bracket">&#93;</span></a></sup> There is no <a href="/wiki/Vaccine" title="Vaccine">vaccine</a> against hepatitis C.<sup id="cite_ref-CDC2016_1-13" class="reference"><a href="#cite_note-CDC2016-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Web2015_9-0" class="reference"><a href="#cite_note-Web2015-9"><span class="cite-bracket">&#91;</span>9<span class="cite-bracket">&#93;</span></a></sup> Prevention includes <a href="/wiki/Harm_reduction" title="Harm reduction">harm reduction</a> efforts among people who inject drugs, testing donated blood, and treatment of people with chronic infection.<sup id="cite_ref-whofactsheet_4-6" class="reference"><a href="#cite_note-whofactsheet-4"><span class="cite-bracket">&#91;</span>4<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-TA_10-0" class="reference"><a href="#cite_note-TA-10"><span class="cite-bracket">&#91;</span>10<span class="cite-bracket">&#93;</span></a></sup> Chronic infection can be cured more than 95% of the time with <a href="/wiki/Antiviral_medications" class="mw-redirect" title="Antiviral medications">antiviral medications</a> such as <a href="/wiki/Sofosbuvir" title="Sofosbuvir">sofosbuvir</a> or <a href="/wiki/Simeprevir" title="Simeprevir">simeprevir</a>.<sup id="cite_ref-CDC2016_1-14" class="reference"><a href="#cite_note-CDC2016-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-whofactsheet_4-7" class="reference"><a href="#cite_note-whofactsheet-4"><span class="cite-bracket">&#91;</span>4<span class="cite-bracket">&#93;</span></a></sup> <a href="/wiki/Peginterferon" class="mw-redirect" title="Peginterferon">Peginterferon</a> and <a href="/wiki/Ribavirin" title="Ribavirin">ribavirin</a> were earlier generation treatments that proved successful in &lt;50% of cases and caused greater side effects.<sup id="cite_ref-whofactsheet_4-8" class="reference"><a href="#cite_note-whofactsheet-4"><span class="cite-bracket">&#91;</span>4<span class="cite-bracket">&#93;</span></a></sup><sup class="reference nowrap"><span title="Page / location: 2015 version">&#58;&#8202;2015 version&#8202;</span></sup><sup id="cite_ref-Kim2016_11-0" class="reference"><a href="#cite_note-Kim2016-11"><span class="cite-bracket">&#91;</span>11<span class="cite-bracket">&#93;</span></a></sup> While access to the newer treatments was expensive, by 2022 prices had dropped dramatically in many countries (primarily low-income and lower-middle-income countries) due to the introduction of generic versions of medicines.<sup id="cite_ref-whofactsheet_4-9" class="reference"><a href="#cite_note-whofactsheet-4"><span class="cite-bracket">&#91;</span>4<span class="cite-bracket">&#93;</span></a></sup> Those who develop cirrhosis or liver cancer may require a <a href="/wiki/Liver_transplant" class="mw-redirect" title="Liver transplant">liver transplant</a>.<sup id="cite_ref-NEJM2011_5-1" class="reference"><a href="#cite_note-NEJM2011-5"><span class="cite-bracket">&#91;</span>5<span class="cite-bracket">&#93;</span></a></sup> Hepatitis C is one of the leading reasons for liver transplantation, though the virus usually recurs after transplantation.<sup id="cite_ref-NEJM2011_5-2" class="reference"><a href="#cite_note-NEJM2011-5"><span class="cite-bracket">&#91;</span>5<span class="cite-bracket">&#93;</span></a></sup> </p><p>An estimated 58 million people worldwide were infected with hepatitis C in 2019. Approximately 290,000 deaths from the virus, mainly from liver cancer and cirrhosis attributed to hepatitis C, also occurred in 2019.<sup id="cite_ref-:1_12-0" class="reference"><a href="#cite_note-:1-12"><span class="cite-bracket">&#91;</span>12<span class="cite-bracket">&#93;</span></a></sup> The existence of hepatitis C – originally identifiable only as a type of non-<a href="/wiki/Hepatitis_A" title="Hepatitis A">A</a> non-<a href="/wiki/Hepatitis_B" title="Hepatitis B">B</a> <a href="/wiki/Hepatitis" title="Hepatitis">hepatitis</a> – was suggested in the 1970s and proven in 1989.<sup id="cite_ref-pmid19781804_13-0" class="reference"><a href="#cite_note-pmid19781804-13"><span class="cite-bracket">&#91;</span>13<span class="cite-bracket">&#93;</span></a></sup> Hepatitis C infects only humans and <a href="/wiki/Common_chimpanzee" class="mw-redirect" title="Common chimpanzee">chimpanzees</a>.<sup id="cite_ref-14" class="reference"><a href="#cite_note-14"><span class="cite-bracket">&#91;</span>14<span class="cite-bracket">&#93;</span></a></sup> </p> <figure class="mw-default-size" typeof="mw:File/Thumb"><span><video id="mwe_player_0" poster="//upload.wikimedia.org/wikipedia/commons/thumb/a/ac/En.Wikipedia-VideoWiki-Hepatitis_C.webm/290px-seek%3D28-En.Wikipedia-VideoWiki-Hepatitis_C.webm.jpg" controls="" preload="none" data-mw-tmh="" class="mw-file-element" width="290" height="163" data-durationhint="206" data-mwtitle="En.Wikipedia-VideoWiki-Hepatitis_C.webm" data-mwprovider="wikimediacommons" resource="/wiki/File:En.Wikipedia-VideoWiki-Hepatitis_C.webm"><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/a/ac/En.Wikipedia-VideoWiki-Hepatitis_C.webm/En.Wikipedia-VideoWiki-Hepatitis_C.webm.480p.vp9.webm" type="video/webm; codecs=&quot;vp9, opus&quot;" data-transcodekey="480p.vp9.webm" data-width="854" data-height="480" /><source src="//upload.wikimedia.org/wikipedia/commons/a/ac/En.Wikipedia-VideoWiki-Hepatitis_C.webm" type="video/webm; codecs=&quot;vp9, opus&quot;" data-width="1067" data-height="600" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/a/ac/En.Wikipedia-VideoWiki-Hepatitis_C.webm/En.Wikipedia-VideoWiki-Hepatitis_C.webm.144p.mjpeg.mov" type="video/quicktime" data-transcodekey="144p.mjpeg.mov" data-width="256" data-height="144" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/a/ac/En.Wikipedia-VideoWiki-Hepatitis_C.webm/En.Wikipedia-VideoWiki-Hepatitis_C.webm.240p.vp9.webm" type="video/webm; codecs=&quot;vp9, opus&quot;" data-transcodekey="240p.vp9.webm" data-width="426" data-height="240" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/a/ac/En.Wikipedia-VideoWiki-Hepatitis_C.webm/En.Wikipedia-VideoWiki-Hepatitis_C.webm.360p.vp9.webm" type="video/webm; codecs=&quot;vp9, opus&quot;" data-transcodekey="360p.vp9.webm" data-width="640" data-height="360" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/a/ac/En.Wikipedia-VideoWiki-Hepatitis_C.webm/En.Wikipedia-VideoWiki-Hepatitis_C.webm.360p.webm" type="video/webm; codecs=&quot;vp8, vorbis&quot;" data-transcodekey="360p.webm" data-width="640" data-height="360" /><track src="https://commons.wikimedia.org/w/api.php?action=timedtext&amp;title=File%3AEn.Wikipedia-VideoWiki-Hepatitis_C.webm&amp;lang=en&amp;trackformat=vtt&amp;origin=%2A" kind="subtitles" type="text/vtt" srclang="en" label="English ‪(en)‬" data-dir="ltr" /></video></span><figcaption>Video summary (<a href="/wiki/Wikipedia:VideoWiki/Hepatitis_C" title="Wikipedia:VideoWiki/Hepatitis C">script</a>)</figcaption></figure> <style data-mw-deduplicate="TemplateStyles:r886046785">.mw-parser-output .toclimit-2 .toclevel-1 ul,.mw-parser-output .toclimit-3 .toclevel-2 ul,.mw-parser-output .toclimit-4 .toclevel-3 ul,.mw-parser-output .toclimit-5 .toclevel-4 ul,.mw-parser-output .toclimit-6 .toclevel-5 ul,.mw-parser-output .toclimit-7 .toclevel-6 ul{display:none}</style><div class="toclimit-3"><meta property="mw:PageProp/toc" /></div> <div class="mw-heading mw-heading2"><h2 id="Signs_and_symptoms">Signs and symptoms</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_C&amp;action=edit&amp;section=1" title="Edit section: Signs and symptoms"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Acute_infection">Acute infection</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_C&amp;action=edit&amp;section=2" title="Edit section: Acute infection"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Acute_(medicine)" title="Acute (medicine)">Acute</a> symptoms develop in some 20% of those infected.<sup id="cite_ref-whofactsheet_4-10" class="reference"><a href="#cite_note-whofactsheet-4"><span class="cite-bracket">&#91;</span>4<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-CDC2016_1-15" class="reference"><a href="#cite_note-CDC2016-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup> When this occurs, it is generally 4–12 weeks following infection (but it may take from 2 weeks to 6 months for acute symptoms to appear).<sup id="cite_ref-CDC2016_1-16" class="reference"><a href="#cite_note-CDC2016-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-whofactsheet_4-11" class="reference"><a href="#cite_note-whofactsheet-4"><span class="cite-bracket">&#91;</span>4<span class="cite-bracket">&#93;</span></a></sup> </p><p>Symptoms are generally mild and vague, and may include fatigue, <a href="/wiki/Nausea" title="Nausea">nausea</a> and vomiting, fever, <a href="/wiki/Myalgia" title="Myalgia">muscle</a> or <a href="/wiki/Arthralgia" title="Arthralgia">joint pains</a>, abdominal pain, <a href="/wiki/Anorexia_(symptom)" title="Anorexia (symptom)">decreased appetite</a> and weight loss, jaundice (occurs in ~25% of those infected), dark urine, and clay-coloured stools.<sup id="cite_ref-CDC2016_1-17" class="reference"><a href="#cite_note-CDC2016-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Book2011p4_15-0" class="reference"><a href="#cite_note-Book2011p4-15"><span class="cite-bracket">&#91;</span>15<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-AFP2010_16-0" class="reference"><a href="#cite_note-AFP2010-16"><span class="cite-bracket">&#91;</span>16<span class="cite-bracket">&#93;</span></a></sup> Acute liver failure due to acute hepatitis C is exceedingly rare.<sup id="cite_ref-Rao2022_17-0" class="reference"><a href="#cite_note-Rao2022-17"><span class="cite-bracket">&#91;</span>17<span class="cite-bracket">&#93;</span></a></sup> Symptoms and laboratory findings suggestive of liver disease should prompt further tests and can thus help establish a diagnosis of hepatitis C infection early on.<sup id="cite_ref-AFP2010_16-1" class="reference"><a href="#cite_note-AFP2010-16"><span class="cite-bracket">&#91;</span>16<span class="cite-bracket">&#93;</span></a></sup> </p><p>Following the acute phase, the infection may resolve spontaneously in 10–50% of affected people; this occurs more frequently in young people and females.<sup id="cite_ref-Book2011p4_15-1" class="reference"><a href="#cite_note-Book2011p4-15"><span class="cite-bracket">&#91;</span>15<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Chronic_infection">Chronic infection</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_C&amp;action=edit&amp;section=3" title="Edit section: Chronic infection"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>About 70% of those exposed to the virus develop a chronic infection.<sup id="cite_ref-whofactsheet_4-12" class="reference"><a href="#cite_note-whofactsheet-4"><span class="cite-bracket">&#91;</span>4<span class="cite-bracket">&#93;</span></a></sup> This is defined as the presence of detectable viral replication for at least six months. Though most experience minimal or no symptoms during the initial few decades of a chronic infection,<sup id="cite_ref-Book2011_18-0" class="reference"><a href="#cite_note-Book2011-18"><span class="cite-bracket">&#91;</span>18<span class="cite-bracket">&#93;</span></a></sup> chronic <span class="nowrap">hepatitis C</span> can be associated with fatigue<sup id="cite_ref-ID2010_19-0" class="reference"><a href="#cite_note-ID2010-19"><span class="cite-bracket">&#91;</span>19<span class="cite-bracket">&#93;</span></a></sup> and mild cognitive problems.<sup id="cite_ref-20" class="reference"><a href="#cite_note-20"><span class="cite-bracket">&#91;</span>20<span class="cite-bracket">&#93;</span></a></sup> After several years, chronic infection may cause <a href="/wiki/Cirrhosis" title="Cirrhosis">cirrhosis</a> or <a href="/wiki/Liver_cancer" title="Liver cancer">liver cancer</a>.<sup id="cite_ref-NEJM2011_5-3" class="reference"><a href="#cite_note-NEJM2011-5"><span class="cite-bracket">&#91;</span>5<span class="cite-bracket">&#93;</span></a></sup> The liver enzymes measured from blood samples are normal in 7–53%.<sup id="cite_ref-Nicot2011_21-0" class="reference"><a href="#cite_note-Nicot2011-21"><span class="cite-bracket">&#91;</span>21<span class="cite-bracket">&#93;</span></a></sup> (Elevated levels indicate liver cells are being damaged by the virus or other disease). Late relapses after apparent cure have been reported, but these can be difficult to distinguish from reinfection.<sup id="cite_ref-Nicot2011_21-1" class="reference"><a href="#cite_note-Nicot2011-21"><span class="cite-bracket">&#91;</span>21<span class="cite-bracket">&#93;</span></a></sup> </p><p><a href="/wiki/Steatohepatitis" title="Steatohepatitis">Fatty changes to the liver</a> occur in about half of those infected and are usually present before cirrhosis develops.<sup id="cite_ref-El-Zayadi2008_22-0" class="reference"><a href="#cite_note-El-Zayadi2008-22"><span class="cite-bracket">&#91;</span>22<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-23" class="reference"><a href="#cite_note-23"><span class="cite-bracket">&#91;</span>23<span class="cite-bracket">&#93;</span></a></sup> Usually (80% of the time) this change affects less than a third of the liver.<sup id="cite_ref-El-Zayadi2008_22-1" class="reference"><a href="#cite_note-El-Zayadi2008-22"><span class="cite-bracket">&#91;</span>22<span class="cite-bracket">&#93;</span></a></sup> Worldwide hepatitis C is the cause of 27% of cirrhosis cases and 25% of hepatocellular carcinoma.<sup id="cite_ref-World2007_24-0" class="reference"><a href="#cite_note-World2007-24"><span class="cite-bracket">&#91;</span>24<span class="cite-bracket">&#93;</span></a></sup> About 10–30% of those infected develop cirrhosis over 30 years.<sup id="cite_ref-NEJM2011_5-4" class="reference"><a href="#cite_note-NEJM2011-5"><span class="cite-bracket">&#91;</span>5<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-AFP2010_16-2" class="reference"><a href="#cite_note-AFP2010-16"><span class="cite-bracket">&#91;</span>16<span class="cite-bracket">&#93;</span></a></sup> Cirrhosis is more common in those also infected with <a href="/wiki/Hepatitis_B" title="Hepatitis B">hepatitis B</a>, <a href="/wiki/Schistosoma" title="Schistosoma">schistosoma</a>, or HIV, in <a href="/wiki/Alcoholic" class="mw-redirect" title="Alcoholic">alcoholics</a>, and in those of male sex.<sup id="cite_ref-AFP2010_16-3" class="reference"><a href="#cite_note-AFP2010-16"><span class="cite-bracket">&#91;</span>16<span class="cite-bracket">&#93;</span></a></sup> In those with hepatitis C, excess alcohol increases the risk of developing cirrhosis 5-fold.<sup id="cite_ref-25" class="reference"><a href="#cite_note-25"><span class="cite-bracket">&#91;</span>25<span class="cite-bracket">&#93;</span></a></sup> Those who develop cirrhosis have a 20-fold greater risk of <a href="/wiki/Hepatocellular_carcinoma" title="Hepatocellular carcinoma">hepatocellular carcinoma</a>. This transformation occurs at a rate of 1–3% per year.<sup id="cite_ref-NEJM2011_5-5" class="reference"><a href="#cite_note-NEJM2011-5"><span class="cite-bracket">&#91;</span>5<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-AFP2010_16-4" class="reference"><a href="#cite_note-AFP2010-16"><span class="cite-bracket">&#91;</span>16<span class="cite-bracket">&#93;</span></a></sup> Being infected with hepatitis B in addition to hepatitis C increases this risk further.<sup id="cite_ref-26" class="reference"><a href="#cite_note-26"><span class="cite-bracket">&#91;</span>26<span class="cite-bracket">&#93;</span></a></sup> </p><p>Liver cirrhosis may lead to <a href="/wiki/Portal_hypertension" title="Portal hypertension">portal hypertension</a>, <a href="/wiki/Ascites" title="Ascites">ascites</a> (accumulation of fluid in the abdomen), <a href="/wiki/Coagulopathy" title="Coagulopathy">easy bruising or bleeding</a>, varices (enlarged veins, especially in the stomach and esophagus), <a href="/wiki/Jaundice" title="Jaundice">jaundice</a>, and a syndrome of cognitive impairment known as <a href="/wiki/Hepatic_encephalopathy" title="Hepatic encephalopathy">hepatic encephalopathy</a>.<sup id="cite_ref-Tah2009_27-0" class="reference"><a href="#cite_note-Tah2009-27"><span class="cite-bracket">&#91;</span>27<span class="cite-bracket">&#93;</span></a></sup> Ascites occurs at some stage in more than half of those who have a chronic infection.<sup id="cite_ref-Zaltron2012_28-0" class="reference"><a href="#cite_note-Zaltron2012-28"><span class="cite-bracket">&#91;</span>28<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Extrahepatic_complications">Extrahepatic complications</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_C&amp;action=edit&amp;section=4" title="Edit section: Extrahepatic complications"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The most common problem due to <span class="nowrap">hepatitis C</span> but not involving the liver is mixed <a href="/wiki/Cryoglobulinemia" title="Cryoglobulinemia">cryoglobulinemia</a> (usually the type II form) – an <a href="/wiki/Vasculitis" title="Vasculitis">inflammation of small and medium-sized blood vessels</a>.<sup id="cite_ref-Cryo2013_29-0" class="reference"><a href="#cite_note-Cryo2013-29"><span class="cite-bracket">&#91;</span>29<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-30" class="reference"><a href="#cite_note-30"><span class="cite-bracket">&#91;</span>30<span class="cite-bracket">&#93;</span></a></sup> <span class="nowrap">Hepatitis C</span> is also associated with autoimmune disorders such as <a href="/wiki/Sj%C3%B6gren%27s_syndrome" class="mw-redirect" title="Sjögren&#39;s syndrome">Sjögren's syndrome</a>, <a href="/wiki/Lichen_planus" title="Lichen planus">lichen planus</a>, <a href="/wiki/Thrombocytopenia" title="Thrombocytopenia">a low platelet count</a>, <a href="/wiki/Porphyria_cutanea_tarda" title="Porphyria cutanea tarda">porphyria cutanea tarda</a>, <a href="/wiki/Necrolytic_acral_erythema" title="Necrolytic acral erythema">necrolytic acral erythema</a>, <a href="/wiki/Insulin_resistance" title="Insulin resistance">insulin resistance</a>, <a href="/wiki/Diabetes_mellitus" class="mw-redirect" title="Diabetes mellitus">diabetes mellitus</a>, <a href="/wiki/Diabetic_nephropathy" title="Diabetic nephropathy">diabetic nephropathy</a>, autoimmune <a href="/wiki/Thyroiditis" title="Thyroiditis">thyroiditis</a>, and B-cell <a href="/wiki/Lymphoproliferative_disorder" class="mw-redirect" title="Lymphoproliferative disorder">lymphoproliferative disorders</a>.<sup id="cite_ref-Extrahepatic_31-0" class="reference"><a href="#cite_note-Extrahepatic-31"><span class="cite-bracket">&#91;</span>31<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Ko2012_32-0" class="reference"><a href="#cite_note-Ko2012-32"><span class="cite-bracket">&#91;</span>32<span class="cite-bracket">&#93;</span></a></sup> 20–30% of people infected have <a href="/wiki/Rheumatoid_factor" title="Rheumatoid factor">rheumatoid factor</a> – a type of antibody.<sup id="cite_ref-Dammacco2000_33-0" class="reference"><a href="#cite_note-Dammacco2000-33"><span class="cite-bracket">&#91;</span>33<span class="cite-bracket">&#93;</span></a></sup> Possible associations include <a href="/wiki/Prurigo_nodularis" title="Prurigo nodularis">Hyde's prurigo nodularis</a><sup id="cite_ref-34" class="reference"><a href="#cite_note-34"><span class="cite-bracket">&#91;</span>34<span class="cite-bracket">&#93;</span></a></sup> and <a href="/wiki/Membranoproliferative_glomerulonephritis" title="Membranoproliferative glomerulonephritis">membranoproliferative glomerulonephritis</a>.<sup id="cite_ref-ID2010_19-1" class="reference"><a href="#cite_note-ID2010-19"><span class="cite-bracket">&#91;</span>19<span class="cite-bracket">&#93;</span></a></sup> <a href="/wiki/Cardiomyopathy" title="Cardiomyopathy">Cardiomyopathy</a> with associated <a href="/wiki/Heart_arrhythmia" class="mw-redirect" title="Heart arrhythmia">abnormal heart rhythms</a> has also been reported.<sup id="cite_ref-Matsumori2006_35-0" class="reference"><a href="#cite_note-Matsumori2006-35"><span class="cite-bracket">&#91;</span>35<span class="cite-bracket">&#93;</span></a></sup> A variety of central and peripheral nervous system disorders has been reported.<sup id="cite_ref-36" class="reference"><a href="#cite_note-36"><span class="cite-bracket">&#91;</span>36<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Monaco2012_37-0" class="reference"><a href="#cite_note-Monaco2012-37"><span class="cite-bracket">&#91;</span>37<span class="cite-bracket">&#93;</span></a></sup> Chronic infection seems to be associated with an increased risk of <a href="/wiki/Pancreatic_cancer" title="Pancreatic cancer">pancreatic cancer</a>.<sup id="cite_ref-Web2015_9-1" class="reference"><a href="#cite_note-Web2015-9"><span class="cite-bracket">&#91;</span>9<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Xu2013_38-0" class="reference"><a href="#cite_note-Xu2013-38"><span class="cite-bracket">&#91;</span>38<span class="cite-bracket">&#93;</span></a></sup> People may experience other issues in the mouth such as <a href="/wiki/Xerostomia" title="Xerostomia">dryness</a>, <a href="/wiki/Sialadenitis" title="Sialadenitis">salivary duct stones</a>, and crusted lesions around the mouth.<sup id="cite_ref-39" class="reference"><a href="#cite_note-39"><span class="cite-bracket">&#91;</span>39<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-40" class="reference"><a href="#cite_note-40"><span class="cite-bracket">&#91;</span>40<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-41" class="reference"><a href="#cite_note-41"><span class="cite-bracket">&#91;</span>41<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Occult_infection">Occult infection</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_C&amp;action=edit&amp;section=5" title="Edit section: Occult infection"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Persons who have been infected with hepatitis C may appear to clear the virus but remain infected.<sup id="cite_ref-Sugden2012_42-0" class="reference"><a href="#cite_note-Sugden2012-42"><span class="cite-bracket">&#91;</span>42<span class="cite-bracket">&#93;</span></a></sup> The virus is not detectable with conventional testing but can be found with ultra-sensitive tests.<sup id="cite_ref-Carreño2006_43-0" class="reference"><a href="#cite_note-Carreño2006-43"><span class="cite-bracket">&#91;</span>43<span class="cite-bracket">&#93;</span></a></sup> The original method of detection was by demonstrating the viral <a href="/wiki/Genome" title="Genome">genome</a> within liver biopsies, but newer methods include an antibody test for the virus' core protein and the detection of the viral genome after first concentrating the viral particles by <a href="/wiki/Ultracentrifugation" class="mw-redirect" title="Ultracentrifugation">ultracentrifugation</a>.<sup id="cite_ref-CarreñoGarcía2011_44-0" class="reference"><a href="#cite_note-CarreñoGarcía2011-44"><span class="cite-bracket">&#91;</span>44<span class="cite-bracket">&#93;</span></a></sup> A form of infection with persistently moderately elevated serum liver enzymes but without antibodies to hepatitis C has also been reported.<sup id="cite_ref-Pham2010_45-0" class="reference"><a href="#cite_note-Pham2010-45"><span class="cite-bracket">&#91;</span>45<span class="cite-bracket">&#93;</span></a></sup> This form is known as cryptogenic occult infection. </p><p>Several clinical pictures have been associated with this type of infection.<sup id="cite_ref-Carreño2012_46-0" class="reference"><a href="#cite_note-Carreño2012-46"><span class="cite-bracket">&#91;</span>46<span class="cite-bracket">&#93;</span></a></sup> It may be found in people with anti-hepatitis-C antibodies but with normal serum levels of liver enzymes; in antibody-negative people with ongoing elevated liver enzymes of unknown cause; in healthy populations without evidence of liver disease; and in groups at risk for HCV infection including those on hemodialysis or family members of people with occult HCV. The clinical relevance of this form of infection is under investigation.<sup id="cite_ref-Carreño2008_47-0" class="reference"><a href="#cite_note-Carreño2008-47"><span class="cite-bracket">&#91;</span>47<span class="cite-bracket">&#93;</span></a></sup> The consequences of occult infection appear to be less severe than with chronic infection but can vary from minimal to hepatocellular carcinoma.<sup id="cite_ref-CarreñoGarcía2011_44-1" class="reference"><a href="#cite_note-CarreñoGarcía2011-44"><span class="cite-bracket">&#91;</span>44<span class="cite-bracket">&#93;</span></a></sup> </p><p>The rate of occult infection in those apparently cured is controversial but appears to be low.<sup id="cite_ref-Nicot2011_21-2" class="reference"><a href="#cite_note-Nicot2011-21"><span class="cite-bracket">&#91;</span>21<span class="cite-bracket">&#93;</span></a></sup> 40% of those with hepatitis but with both negative hepatitis C serology and the absence of detectable viral genome in the serum have hepatitis C virus in the liver on biopsy.<sup id="cite_ref-Scott2007_48-0" class="reference"><a href="#cite_note-Scott2007-48"><span class="cite-bracket">&#91;</span>48<span class="cite-bracket">&#93;</span></a></sup> How commonly this occurs in children is unknown.<sup id="cite_ref-Robinson2008_49-0" class="reference"><a href="#cite_note-Robinson2008-49"><span class="cite-bracket">&#91;</span>49<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Virology">Virology</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_C&amp;action=edit&amp;section=6" title="Edit section: Virology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Hepatitis_C_virus" title="Hepatitis C virus">Hepatitis C virus</a></div> <p>The <a href="/wiki/Hepatitis_C_virus" title="Hepatitis C virus">hepatitis C virus</a> (HCV) is a small, enveloped, single-stranded, positive-sense <a href="/wiki/RNA_virus" title="RNA virus">RNA virus</a>.<sup id="cite_ref-NEJM2011_5-6" class="reference"><a href="#cite_note-NEJM2011-5"><span class="cite-bracket">&#91;</span>5<span class="cite-bracket">&#93;</span></a></sup> It is a member of the genus <i><a href="/wiki/Hepacivirus" title="Hepacivirus">Hepacivirus</a></i> in the family <i><a href="/wiki/Flaviviridae" title="Flaviviridae">Flaviviridae</a></i>.<sup id="cite_ref-ID2010_19-2" class="reference"><a href="#cite_note-ID2010-19"><span class="cite-bracket">&#91;</span>19<span class="cite-bracket">&#93;</span></a></sup> There are seven major genotypes of HCV, which are known as genotypes one to seven.<sup id="cite_ref-Nakano2011_50-0" class="reference"><a href="#cite_note-Nakano2011-50"><span class="cite-bracket">&#91;</span>50<span class="cite-bracket">&#93;</span></a></sup> The genotypes are divided into several subtypes with the number of subtypes depending on the genotype. In the United States, about 70% of cases are caused by genotype 1, 20% by genotype 2 and about 1% by each of the other genotypes.<sup id="cite_ref-AFP2010_16-5" class="reference"><a href="#cite_note-AFP2010-16"><span class="cite-bracket">&#91;</span>16<span class="cite-bracket">&#93;</span></a></sup> Genotype 1 is also the most common in South America and Europe.<sup id="cite_ref-NEJM2011_5-7" class="reference"><a href="#cite_note-NEJM2011-5"><span class="cite-bracket">&#91;</span>5<span class="cite-bracket">&#93;</span></a></sup> </p><p>The half life of the virus particles in the serum is around 3 hours and may be as short as 45 minutes.<sup id="cite_ref-Lerat2004_51-0" class="reference"><a href="#cite_note-Lerat2004-51"><span class="cite-bracket">&#91;</span>51<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-52" class="reference"><a href="#cite_note-52"><span class="cite-bracket">&#91;</span>52<span class="cite-bracket">&#93;</span></a></sup> In an infected person, about 10<sup>12</sup> virus particles are produced each day.<sup id="cite_ref-Lerat2004_51-1" class="reference"><a href="#cite_note-Lerat2004-51"><span class="cite-bracket">&#91;</span>51<span class="cite-bracket">&#93;</span></a></sup> In addition to replicating in the liver the virus can multiply in lymphocytes.<sup id="cite_ref-Zignego2012_53-0" class="reference"><a href="#cite_note-Zignego2012-53"><span class="cite-bracket">&#91;</span>53<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Transmission">Transmission</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_C&amp;action=edit&amp;section=7" title="Edit section: Transmission"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Hepatitis_C_infection_by_source_(CDC)_-_en.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/e/e7/Hepatitis_C_infection_by_source_%28CDC%29_-_en.svg/310px-Hepatitis_C_infection_by_source_%28CDC%29_-_en.svg.png" decoding="async" width="310" height="215" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/e/e7/Hepatitis_C_infection_by_source_%28CDC%29_-_en.svg/465px-Hepatitis_C_infection_by_source_%28CDC%29_-_en.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/e/e7/Hepatitis_C_infection_by_source_%28CDC%29_-_en.svg/620px-Hepatitis_C_infection_by_source_%28CDC%29_-_en.svg.png 2x" data-file-width="576" data-file-height="400" /></a><figcaption>Hepatitis C infection in the United States by source</figcaption></figure> <p><a href="/wiki/Percutaneous" title="Percutaneous">Percutaneous</a> contact with contaminated blood is responsible for most infections; however, the method of transmission is strongly dependent on both geographic region and economic status.<sup id="cite_ref-54" class="reference"><a href="#cite_note-54"><span class="cite-bracket">&#91;</span>54<span class="cite-bracket">&#93;</span></a></sup> Indeed, the primary route of transmission in the <a href="/wiki/Developed_world" class="mw-redirect" title="Developed world">developed world</a> is <a href="/wiki/Injection_drug_use" class="mw-redirect" title="Injection drug use">injection drug use</a>, while in the <a href="/wiki/Developing_world" class="mw-redirect" title="Developing world">developing world</a> the main methods are <a href="/wiki/Blood_transfusions" class="mw-redirect" title="Blood transfusions">blood transfusions</a> and unsafe medical procedures.<sup id="cite_ref-Mah2010_3-2" class="reference"><a href="#cite_note-Mah2010-3"><span class="cite-bracket">&#91;</span>3<span class="cite-bracket">&#93;</span></a></sup> The cause of transmission remains unknown in 20% of cases;<sup id="cite_ref-Pon2011_55-0" class="reference"><a href="#cite_note-Pon2011-55"><span class="cite-bracket">&#91;</span>55<span class="cite-bracket">&#93;</span></a></sup> however, many of these are believed to be accounted for by injection drug use.<sup id="cite_ref-Book2011p4_15-2" class="reference"><a href="#cite_note-Book2011p4-15"><span class="cite-bracket">&#91;</span>15<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Body_modification">Body modification</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_C&amp;action=edit&amp;section=8" title="Edit section: Body modification"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Tattooing" class="mw-redirect" title="Tattooing">Tattooing</a> is associated with two to threefold increased risk of <span class="nowrap">hepatitis C</span>.<sup id="cite_ref-Tato2010_56-0" class="reference"><a href="#cite_note-Tato2010-56"><span class="cite-bracket">&#91;</span>56<span class="cite-bracket">&#93;</span></a></sup> This could be due to either improperly sterilized equipment or contamination of the dyes being used.<sup id="cite_ref-Tato2010_56-1" class="reference"><a href="#cite_note-Tato2010-56"><span class="cite-bracket">&#91;</span>56<span class="cite-bracket">&#93;</span></a></sup> Tattoos or <a href="/wiki/Body_piercing" title="Body piercing">piercings</a> performed either before the mid-1980s, "underground", or nonprofessionally are of particular concern, since sterile techniques in such settings may be lacking. The risk also appears to be greater for larger tattoos.<sup id="cite_ref-Tato2010_56-2" class="reference"><a href="#cite_note-Tato2010-56"><span class="cite-bracket">&#91;</span>56<span class="cite-bracket">&#93;</span></a></sup> It is estimated that nearly half of prison inmates share unsterilized tattooing equipment.<sup id="cite_ref-Tato2010_56-3" class="reference"><a href="#cite_note-Tato2010-56"><span class="cite-bracket">&#91;</span>56<span class="cite-bracket">&#93;</span></a></sup> It is rare for tattoos in a licensed facility to be directly associated with HCV infection.<sup id="cite_ref-57" class="reference"><a href="#cite_note-57"><span class="cite-bracket">&#91;</span>57<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Drug_use">Drug use</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_C&amp;action=edit&amp;section=9" title="Edit section: Drug use"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size mw-halign-left" typeof="mw:File/Thumb"><a href="/wiki/File:Cocaine_lines_2.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/9/92/Cocaine_lines_2.jpg/220px-Cocaine_lines_2.jpg" decoding="async" width="220" height="209" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/9/92/Cocaine_lines_2.jpg/330px-Cocaine_lines_2.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/9/92/Cocaine_lines_2.jpg/440px-Cocaine_lines_2.jpg 2x" data-file-width="1143" data-file-height="1087" /></a><figcaption>Lines of cocaine prepared for snorting. <a href="/wiki/Contaminated_currency" title="Contaminated currency">Contaminated currency</a> such as banknotes might serve as a <a href="/wiki/Fomite" title="Fomite">fomite</a> of diseases like hepatitis C<sup id="cite_ref-LV_58-0" class="reference"><a href="#cite_note-LV-58"><span class="cite-bracket">&#91;</span>58<span class="cite-bracket">&#93;</span></a></sup></figcaption></figure> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">See also: <a href="/wiki/Needle_sharing" title="Needle sharing">Needle sharing</a></div> <p><a href="/wiki/Injection_drug_use" class="mw-redirect" title="Injection drug use">Injection drug use</a> (IDU) is a major risk factor for <span class="nowrap">hepatitis C</span> in many parts of the world.<sup id="cite_ref-China2008_59-0" class="reference"><a href="#cite_note-China2008-59"><span class="cite-bracket">&#91;</span>59<span class="cite-bracket">&#93;</span></a></sup> Of 77 countries reviewed, 25 (including the United States) were found to have a prevalence of <span class="nowrap">hepatitis C</span> of 60–80% among people who use injection drugs.<sup id="cite_ref-Lancet2011_60-0" class="reference"><a href="#cite_note-Lancet2011-60"><span class="cite-bracket">&#91;</span>60<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-China2008_59-1" class="reference"><a href="#cite_note-China2008-59"><span class="cite-bracket">&#91;</span>59<span class="cite-bracket">&#93;</span></a></sup> Twelve countries had rates greater than 80%.<sup id="cite_ref-Lancet2011_60-1" class="reference"><a href="#cite_note-Lancet2011-60"><span class="cite-bracket">&#91;</span>60<span class="cite-bracket">&#93;</span></a></sup> It is believed that ten million intravenous drug users are infected with <span class="nowrap">hepatitis C</span>; China (1.6 million), the United States (1.5 million), and Russia (1.3 million) have the highest absolute totals.<sup id="cite_ref-Lancet2011_60-2" class="reference"><a href="#cite_note-Lancet2011-60"><span class="cite-bracket">&#91;</span>60<span class="cite-bracket">&#93;</span></a></sup> <a href="/wiki/Infectious_diseases_within_American_prisons#Hepatitis_C" title="Infectious diseases within American prisons">Occurrence of <span class="nowrap">hepatitis C</span> among prison inmates in the United States</a> is 10 to 20 times that of the occurrence observed in the general population; this has been attributed to high-risk behavior in prisons such as IDU and tattooing with non-sterile equipment.<sup id="cite_ref-Jail2010_61-0" class="reference"><a href="#cite_note-Jail2010-61"><span class="cite-bracket">&#91;</span>61<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-62" class="reference"><a href="#cite_note-62"><span class="cite-bracket">&#91;</span>62<span class="cite-bracket">&#93;</span></a></sup> Shared intranasal drug use may also be a risk factor.<sup id="cite_ref-Moyer2013_63-0" class="reference"><a href="#cite_note-Moyer2013-63"><span class="cite-bracket">&#91;</span>63<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Fomites">Fomites</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_C&amp;action=edit&amp;section=10" title="Edit section: Fomites"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>A <a href="/wiki/Fomite" title="Fomite">fomite</a> (<span class="rt-commentedText nowrap"><span class="IPA nopopups noexcerpt" lang="en-fonipa"><a href="/wiki/Help:IPA/English" title="Help:IPA/English">/<span style="border-bottom:1px dotted"><span title="/ˈ/: primary stress follows">ˈ</span><span title="&#39;f&#39; in &#39;find&#39;">f</span><span title="/oʊ/: &#39;o&#39; in &#39;code&#39;">oʊ</span><span title="&#39;m&#39; in &#39;my&#39;">m</span><span title="/aɪ/: &#39;i&#39; in &#39;tide&#39;">aɪ</span><span title="&#39;t&#39; in &#39;tie&#39;">t</span></span>/</a></span></span>) or fomes (<span class="rt-commentedText nowrap"><span class="IPA nopopups noexcerpt" lang="en-fonipa"><a href="/wiki/Help:IPA/English" title="Help:IPA/English">/<span style="border-bottom:1px dotted"><span title="/ˈ/: primary stress follows">ˈ</span><span title="&#39;f&#39; in &#39;find&#39;">f</span><span title="/oʊ/: &#39;o&#39; in &#39;code&#39;">oʊ</span><span title="&#39;m&#39; in &#39;my&#39;">m</span><span title="/iː/: &#39;ee&#39; in &#39;fleece&#39;">iː</span><span title="&#39;z&#39; in &#39;zoom&#39;">z</span></span>/</a></span></span>) is any <a href="/wiki/Inanimate_object" class="mw-redirect" title="Inanimate object">inanimate object</a> that, when contaminated with or exposed to <a href="/wiki/Infectious_agents" class="mw-redirect" title="Infectious agents">infectious agents</a> (such as <a href="/wiki/Pathogenic_bacteria" title="Pathogenic bacteria">pathogenic bacteria</a>, <a href="/wiki/Viruses" class="mw-redirect" title="Viruses">viruses</a> or <a href="/wiki/Fungi" class="mw-redirect" title="Fungi">fungi</a>), can transfer <a href="/wiki/Disease" title="Disease">disease</a> to a new <a href="/wiki/Host_(biology)" title="Host (biology)">host</a>.<sup id="cite_ref-Cramer2019_64-0" class="reference"><a href="#cite_note-Cramer2019-64"><span class="cite-bracket">&#91;</span>64<span class="cite-bracket">&#93;</span></a></sup> </p><p>Personal-care items such as razors, toothbrushes, and manicuring or pedicuring equipment can be contaminated with blood. Sharing such items can potentially lead to exposure to HCV.<sup id="cite_ref-pmid16907842_65-0" class="reference"><a href="#cite_note-pmid16907842-65"><span class="cite-bracket">&#91;</span>65<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-CDC12_66-0" class="reference"><a href="#cite_note-CDC12-66"><span class="cite-bracket">&#91;</span>66<span class="cite-bracket">&#93;</span></a></sup> Appropriate caution should be taken regarding any medical condition that results in <a href="/wiki/Bleeding" title="Bleeding">bleeding</a>, such as cuts and sores.<sup id="cite_ref-CDC12_66-1" class="reference"><a href="#cite_note-CDC12-66"><span class="cite-bracket">&#91;</span>66<span class="cite-bracket">&#93;</span></a></sup> HCV is not spread through casual contact, such as hugging, kissing, or sharing eating or cooking utensils,<sup id="cite_ref-CDC12_66-2" class="reference"><a href="#cite_note-CDC12-66"><span class="cite-bracket">&#91;</span>66<span class="cite-bracket">&#93;</span></a></sup> nor is it transmitted through food or water.<sup id="cite_ref-67" class="reference"><a href="#cite_note-67"><span class="cite-bracket">&#91;</span>67<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Healthcare_exposure">Healthcare exposure</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_C&amp;action=edit&amp;section=11" title="Edit section: Healthcare exposure"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Blood_transfusion" title="Blood transfusion">Blood transfusion</a>, transfusion of blood products, or <a href="/wiki/Organ_transplants" class="mw-redirect" title="Organ transplants">organ transplants</a> without HCV screening carry significant risks of infection.<sup id="cite_ref-AFP2010_16-6" class="reference"><a href="#cite_note-AFP2010-16"><span class="cite-bracket">&#91;</span>16<span class="cite-bracket">&#93;</span></a></sup> The United States instituted universal screening in 1992,<sup id="cite_ref-Rosen2011_68-0" class="reference"><a href="#cite_note-Rosen2011-68"><span class="cite-bracket">&#91;</span>68<span class="cite-bracket">&#93;</span></a></sup> and Canada instituted universal screening in 1990.<sup id="cite_ref-69" class="reference"><a href="#cite_note-69"><span class="cite-bracket">&#91;</span>69<span class="cite-bracket">&#93;</span></a></sup> This decreased the risk from one in 200 units<sup id="cite_ref-Rosen2011_68-1" class="reference"><a href="#cite_note-Rosen2011-68"><span class="cite-bracket">&#91;</span>68<span class="cite-bracket">&#93;</span></a></sup> to between one in 10,000 to one in 10,000,000 per unit of blood.<sup id="cite_ref-Book2011p4_15-3" class="reference"><a href="#cite_note-Book2011p4-15"><span class="cite-bracket">&#91;</span>15<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Pon2011_55-1" class="reference"><a href="#cite_note-Pon2011-55"><span class="cite-bracket">&#91;</span>55<span class="cite-bracket">&#93;</span></a></sup> This low risk remains as there is a period of about 11–70 days between the potential <a href="/wiki/Blood_donor" class="mw-redirect" title="Blood donor">blood donor</a>'s acquiring <span class="nowrap">hepatitis C</span> and the blood's testing positive depending on the method.<sup id="cite_ref-Pon2011_55-2" class="reference"><a href="#cite_note-Pon2011-55"><span class="cite-bracket">&#91;</span>55<span class="cite-bracket">&#93;</span></a></sup> Some countries do not screen for <span class="nowrap">hepatitis C</span> due to the cost.<sup id="cite_ref-World2007_24-1" class="reference"><a href="#cite_note-World2007-24"><span class="cite-bracket">&#91;</span>24<span class="cite-bracket">&#93;</span></a></sup> </p><p>Those who have experienced a <a href="/wiki/Needle_stick_injury" class="mw-redirect" title="Needle stick injury">needle stick injury</a> from someone who was HCV positive have about a 1.8% chance of subsequently contracting the disease themselves.<sup id="cite_ref-AFP2010_16-7" class="reference"><a href="#cite_note-AFP2010-16"><span class="cite-bracket">&#91;</span>16<span class="cite-bracket">&#93;</span></a></sup> The risk is greater if the needle in question is hollow and the puncture wound is deep.<sup id="cite_ref-World2007_24-2" class="reference"><a href="#cite_note-World2007-24"><span class="cite-bracket">&#91;</span>24<span class="cite-bracket">&#93;</span></a></sup> There is a risk from mucosal exposures to blood, but this risk is low, and there is no risk if blood exposure occurs on intact skin.<sup id="cite_ref-World2007_24-3" class="reference"><a href="#cite_note-World2007-24"><span class="cite-bracket">&#91;</span>24<span class="cite-bracket">&#93;</span></a></sup> </p><p>Hospital equipment has also been documented as a method of transmission of <span class="nowrap">hepatitis C</span>, including reuse of needles and syringes, multiple-use medication vials, infusion bags, and improperly sterilized surgical equipment, among others.<sup id="cite_ref-World2007_24-4" class="reference"><a href="#cite_note-World2007-24"><span class="cite-bracket">&#91;</span>24<span class="cite-bracket">&#93;</span></a></sup> Limitations in the implementation and enforcement of stringent standard precautions in public and private medical and dental facilities are known to have been the primary cause of the spread of HCV in <a href="/wiki/Egypt" title="Egypt">Egypt</a>, the country that had the highest rate of infection in the world in 2012, and currently </p><p>Egypt becomes the first country to achieve WHO validation on the path to elimination of hepatitis C.<sup id="cite_ref-70" class="reference"><a href="#cite_note-70"><span class="cite-bracket">&#91;</span>70<span class="cite-bracket">&#93;</span></a></sup> </p><p>For more, see <a href="/wiki/HONOReform" title="HONOReform">HONOReform (Hepatitis Outbreaks National Organization for Reform)</a>. </p> <div class="mw-heading mw-heading3"><h3 id="Mother-to-child_transmission">Mother-to-child transmission</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_C&amp;action=edit&amp;section=12" title="Edit section: Mother-to-child transmission"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Mother-to-child_transmission" class="mw-redirect" title="Mother-to-child transmission">Mother-to-child transmission</a> of <span class="nowrap">hepatitis C</span> occurs in fewer than 10% of pregnancies.<sup id="cite_ref-Preg10_71-0" class="reference"><a href="#cite_note-Preg10-71"><span class="cite-bracket">&#91;</span>71<span class="cite-bracket">&#93;</span></a></sup> There are no measures that alter this risk.<sup id="cite_ref-Preg10_71-1" class="reference"><a href="#cite_note-Preg10-71"><span class="cite-bracket">&#91;</span>71<span class="cite-bracket">&#93;</span></a></sup> It is not clear when transmission occurs during pregnancy, but it may occur both during gestation and at delivery.<sup id="cite_ref-Pon2011_55-3" class="reference"><a href="#cite_note-Pon2011-55"><span class="cite-bracket">&#91;</span>55<span class="cite-bracket">&#93;</span></a></sup> A long labor is associated with a greater risk of transmission.<sup id="cite_ref-World2007_24-5" class="reference"><a href="#cite_note-World2007-24"><span class="cite-bracket">&#91;</span>24<span class="cite-bracket">&#93;</span></a></sup> There is no evidence that <a href="/wiki/Breastfeeding" title="Breastfeeding">breastfeeding</a> spreads HCV; however, to be cautious, an infected mother is advised to avoid breastfeeding if her nipples are cracked and bleeding,<sup id="cite_ref-72" class="reference"><a href="#cite_note-72"><span class="cite-bracket">&#91;</span>72<span class="cite-bracket">&#93;</span></a></sup> or if her viral loads are high.<sup id="cite_ref-Pon2011_55-4" class="reference"><a href="#cite_note-Pon2011-55"><span class="cite-bracket">&#91;</span>55<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Sexual_intercourse">Sexual intercourse</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_C&amp;action=edit&amp;section=13" title="Edit section: Sexual intercourse"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Sexual transmission of hepatitis C is uncommon.<sup id="cite_ref-Kim2016_11-1" class="reference"><a href="#cite_note-Kim2016-11"><span class="cite-bracket">&#91;</span>11<span class="cite-bracket">&#93;</span></a></sup> Studies examining the risk of HCV transmission between <a href="/wiki/Heterosexual" class="mw-redirect" title="Heterosexual">heterosexual</a> partners, when one is infected and the other is not, have found very low risks.<sup id="cite_ref-Kim2016_11-2" class="reference"><a href="#cite_note-Kim2016-11"><span class="cite-bracket">&#91;</span>11<span class="cite-bracket">&#93;</span></a></sup> Sexual practices that involve higher levels of trauma to the <a href="/wiki/Anogenital_area" class="mw-redirect" title="Anogenital area">anogenital</a> mucosa, such as <a href="/wiki/Anal_penetration" class="mw-redirect" title="Anal penetration">anal penetrative sex</a>, or that occur when there is a concurrent <a href="/wiki/Sexually_transmitted_infection" title="Sexually transmitted infection">sexually transmitted infection</a>, including <a href="/wiki/HIV" title="HIV">HIV</a> or <a href="/wiki/Genital_ulcer" title="Genital ulcer">genital ulceration</a>, present greater risks.<sup id="cite_ref-Kim2016_11-3" class="reference"><a href="#cite_note-Kim2016-11"><span class="cite-bracket">&#91;</span>11<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Sex2010_73-0" class="reference"><a href="#cite_note-Sex2010-73"><span class="cite-bracket">&#91;</span>73<span class="cite-bracket">&#93;</span></a></sup> The <a href="/wiki/United_States_Department_of_Veterans_Affairs" title="United States Department of Veterans Affairs">United States Department of Veterans Affairs</a> recommends <a href="/wiki/Condom" title="Condom">condom</a> use to prevent <span class="nowrap">hepatitis C</span> transmission in those with multiple partners, but not those in relationships that involve only a single partner.<sup id="cite_ref-74" class="reference"><a href="#cite_note-74"><span class="cite-bracket">&#91;</span>74<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Diagnosis">Diagnosis</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_C&amp;action=edit&amp;section=14" title="Edit section: Diagnosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Hepatitis_C_serology.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/1/10/Hepatitis_C_serology.png/310px-Hepatitis_C_serology.png" decoding="async" width="310" height="195" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/1/10/Hepatitis_C_serology.png/465px-Hepatitis_C_serology.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/1/10/Hepatitis_C_serology.png/620px-Hepatitis_C_serology.png 2x" data-file-width="881" data-file-height="554" /></a><figcaption>Serologic profile of hepatitis C infection</figcaption></figure> <p>There are a number of diagnostic tests for <span class="nowrap">hepatitis C</span>, including HCV <a href="/wiki/Antibody" title="Antibody">antibody</a> <a href="/wiki/ELISA" title="ELISA">enzyme immunoassay</a> (ELISA), <a href="/wiki/Western_blot" title="Western blot">recombinant immunoblot assay</a>, and quantitative HCV <a href="/wiki/RNA" title="RNA">RNA</a> <a href="/wiki/Polymerase_chain_reaction" title="Polymerase chain reaction">polymerase chain reaction</a> (PCR).<sup id="cite_ref-AFP2010_16-8" class="reference"><a href="#cite_note-AFP2010-16"><span class="cite-bracket">&#91;</span>16<span class="cite-bracket">&#93;</span></a></sup> HCV <a href="/wiki/RNA" title="RNA">RNA</a> can be detected by PCR typically one to two weeks after infection, while antibodies can take substantially longer to form and thus be detected.<sup id="cite_ref-Tah2009_27-1" class="reference"><a href="#cite_note-Tah2009-27"><span class="cite-bracket">&#91;</span>27<span class="cite-bracket">&#93;</span></a></sup> </p><p>Diagnosing patients is generally a challenge as patients with acute illness generally present with mild, non-specific flu-like symptoms,<sup id="cite_ref-75" class="reference"><a href="#cite_note-75"><span class="cite-bracket">&#91;</span>75<span class="cite-bracket">&#93;</span></a></sup> while the transition from acute to chronic is sub-clinical.<sup id="cite_ref-76" class="reference"><a href="#cite_note-76"><span class="cite-bracket">&#91;</span>76<span class="cite-bracket">&#93;</span></a></sup> Chronic <span class="nowrap">hepatitis C</span> is defined as infection with the <span class="nowrap">hepatitis C</span> virus persisting for more than six months based on the presence of its RNA.<sup id="cite_ref-Book2011_18-1" class="reference"><a href="#cite_note-Book2011-18"><span class="cite-bracket">&#91;</span>18<span class="cite-bracket">&#93;</span></a></sup> Chronic infections are typically asymptomatic during the first few decades,<sup id="cite_ref-Book2011_18-2" class="reference"><a href="#cite_note-Book2011-18"><span class="cite-bracket">&#91;</span>18<span class="cite-bracket">&#93;</span></a></sup> and thus are most commonly discovered following the investigation of <a href="/wiki/Liver_function_tests" title="Liver function tests">elevated liver enzyme levels</a> or during a routine screening of high-risk individuals. Testing is not able to distinguish between acute and chronic infections.<sup id="cite_ref-World2007_24-6" class="reference"><a href="#cite_note-World2007-24"><span class="cite-bracket">&#91;</span>24<span class="cite-bracket">&#93;</span></a></sup> Diagnosis in infants is difficult as maternal antibodies may persist for up to 18 months.<sup id="cite_ref-Robinson2008_49-1" class="reference"><a href="#cite_note-Robinson2008-49"><span class="cite-bracket">&#91;</span>49<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Serology">Serology</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_C&amp;action=edit&amp;section=15" title="Edit section: Serology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><span class="nowrap">Hepatitis C</span> testing typically begins with <a href="/wiki/Serology" title="Serology">blood testing</a> to detect the presence of antibodies to the HCV, using an enzyme immunoassay.<sup id="cite_ref-AFP2010_16-9" class="reference"><a href="#cite_note-AFP2010-16"><span class="cite-bracket">&#91;</span>16<span class="cite-bracket">&#93;</span></a></sup> If this test is positive, a confirmatory test is then performed to verify the immunoassay and to determine the <a href="/wiki/Viral_load" title="Viral load">viral load</a>.<sup id="cite_ref-AFP2010_16-10" class="reference"><a href="#cite_note-AFP2010-16"><span class="cite-bracket">&#91;</span>16<span class="cite-bracket">&#93;</span></a></sup> A recombinant immunoblot assay is used to verify the immunoassay and the viral load is determined by an HCV RNA polymerase chain reaction.<sup id="cite_ref-AFP2010_16-11" class="reference"><a href="#cite_note-AFP2010-16"><span class="cite-bracket">&#91;</span>16<span class="cite-bracket">&#93;</span></a></sup> If there is no RNA and the immunoblot is positive, it means that the person tested had a previous infection but cleared it either with treatment or spontaneously; if the immunoblot is negative, it means that the immunoassay was wrong.<sup id="cite_ref-AFP2010_16-12" class="reference"><a href="#cite_note-AFP2010-16"><span class="cite-bracket">&#91;</span>16<span class="cite-bracket">&#93;</span></a></sup> It takes about 6–8 weeks following infection before the immunoassay will test positive.<sup id="cite_ref-ID2010_19-3" class="reference"><a href="#cite_note-ID2010-19"><span class="cite-bracket">&#91;</span>19<span class="cite-bracket">&#93;</span></a></sup> A number of tests are available as <a href="/wiki/Point_of_care_testing" class="mw-redirect" title="Point of care testing">point-of-care testing</a> (POCT), which can provide results within 30 minutes.<sup id="cite_ref-77" class="reference"><a href="#cite_note-77"><span class="cite-bracket">&#91;</span>77<span class="cite-bracket">&#93;</span></a></sup> </p><p>Liver enzymes are variable during the initial part of the infection<sup id="cite_ref-Book2011_18-3" class="reference"><a href="#cite_note-Book2011-18"><span class="cite-bracket">&#91;</span>18<span class="cite-bracket">&#93;</span></a></sup> and on average begin to rise at seven weeks after infection.<sup id="cite_ref-ID2010_19-4" class="reference"><a href="#cite_note-ID2010-19"><span class="cite-bracket">&#91;</span>19<span class="cite-bracket">&#93;</span></a></sup> The elevation of liver enzymes does not closely follow disease severity.<sup id="cite_ref-ID2010_19-5" class="reference"><a href="#cite_note-ID2010-19"><span class="cite-bracket">&#91;</span>19<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Biopsy">Biopsy</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_C&amp;action=edit&amp;section=16" title="Edit section: Biopsy"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Liver_biopsy" title="Liver biopsy">Liver biopsies</a> are used to determine the degree of liver damage present; however, there are risks from the procedure.<sup id="cite_ref-NEJM2011_5-8" class="reference"><a href="#cite_note-NEJM2011-5"><span class="cite-bracket">&#91;</span>5<span class="cite-bracket">&#93;</span></a></sup> The typical changes seen are <a href="/wiki/Lymphocyte" title="Lymphocyte">lymphocytes</a> within the parenchyma, <a href="/wiki/Lymphoid_follicles" class="mw-redirect" title="Lymphoid follicles">lymphoid follicles</a> in <a href="/wiki/Portal_triad" class="mw-redirect" title="Portal triad">portal triad</a>, and changes to the bile ducts.<sup id="cite_ref-NEJM2011_5-9" class="reference"><a href="#cite_note-NEJM2011-5"><span class="cite-bracket">&#91;</span>5<span class="cite-bracket">&#93;</span></a></sup> There are a number of blood tests available that try to determine the degree of <a href="/wiki/Hepatic_fibrosis" class="mw-redirect" title="Hepatic fibrosis">hepatic fibrosis</a> and alleviate the need for biopsy.<sup id="cite_ref-NEJM2011_5-10" class="reference"><a href="#cite_note-NEJM2011-5"><span class="cite-bracket">&#91;</span>5<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Screening">Screening</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_C&amp;action=edit&amp;section=17" title="Edit section: Screening"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>It is believed that only 5–50% of those infected in the United States and Canada are aware of their status.<sup id="cite_ref-Tato2010_56-4" class="reference"><a href="#cite_note-Tato2010-56"><span class="cite-bracket">&#91;</span>56<span class="cite-bracket">&#93;</span></a></sup> Routine screening for those between the ages of 18 and 79 was recommended by the <a href="/wiki/United_States_Preventive_Services_Task_Force" title="United States Preventive Services Task Force">United States Preventive Services Task Force</a> in 2020.<sup id="cite_ref-USPSTF_8-1" class="reference"><a href="#cite_note-USPSTF-8"><span class="cite-bracket">&#91;</span>8<span class="cite-bracket">&#93;</span></a></sup> Previously, testing was recommended for those at high risk, including injection drug users, those who have received blood transfusions before 1992,<sup id="cite_ref-Moyer2013_63-1" class="reference"><a href="#cite_note-Moyer2013-63"><span class="cite-bracket">&#91;</span>63<span class="cite-bracket">&#93;</span></a></sup> those who have been incarcerated, those on long-term <a href="/wiki/Hemodialysis" title="Hemodialysis">hemodialysis</a>,<sup id="cite_ref-Moyer2013_63-2" class="reference"><a href="#cite_note-Moyer2013-63"><span class="cite-bracket">&#91;</span>63<span class="cite-bracket">&#93;</span></a></sup> and those with tattoos.<sup id="cite_ref-Tato2010_56-5" class="reference"><a href="#cite_note-Tato2010-56"><span class="cite-bracket">&#91;</span>56<span class="cite-bracket">&#93;</span></a></sup> Screening is also recommended for those with elevated liver enzymes, as this is frequently the only sign of chronic hepatitis.<sup id="cite_ref-78" class="reference"><a href="#cite_note-78"><span class="cite-bracket">&#91;</span>78<span class="cite-bracket">&#93;</span></a></sup> As of 2012<sup class="plainlinks noexcerpt noprint asof-tag update" style="display:none;"><a class="external text" href="https://en.wikipedia.org/w/index.php?title=Hepatitis_C&amp;action=edit">&#91;update&#93;</a></sup>, the U.S. <a href="/wiki/Centers_for_Disease_Control_and_Prevention" title="Centers for Disease Control and Prevention">Centers for Disease Control and Prevention</a> (CDC) recommends a single screening test for those born between 1945 and 1965.<sup id="cite_ref-79" class="reference"><a href="#cite_note-79"><span class="cite-bracket">&#91;</span>79<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-80" class="reference"><a href="#cite_note-80"><span class="cite-bracket">&#91;</span>80<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-81" class="reference"><a href="#cite_note-81"><span class="cite-bracket">&#91;</span>81<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-82" class="reference"><a href="#cite_note-82"><span class="cite-bracket">&#91;</span>82<span class="cite-bracket">&#93;</span></a></sup> In Canada, a one-time screening is recommended for those born between 1945 and 1975.<sup id="cite_ref-83" class="reference"><a href="#cite_note-83"><span class="cite-bracket">&#91;</span>83<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Prevention">Prevention</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_C&amp;action=edit&amp;section=18" title="Edit section: Prevention"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">See also: <a href="/wiki/Hepatitis_C_vaccine" title="Hepatitis C vaccine">Hepatitis C vaccine</a></div> <p>As of 2022, no approved <a href="/wiki/Vaccine" title="Vaccine">vaccine</a> protects against contracting <span class="nowrap">hepatitis C</span>.<sup id="cite_ref-84" class="reference"><a href="#cite_note-84"><span class="cite-bracket">&#91;</span>84<span class="cite-bracket">&#93;</span></a></sup> A combination of <a href="/wiki/Harm_reduction" title="Harm reduction">harm reduction</a> strategies, such as the <a href="/wiki/Needle_exchange_programs" class="mw-redirect" title="Needle exchange programs">provision of new needles and syringes</a> and treatment of <a href="/wiki/Substance_abuse" title="Substance abuse">substance use</a>, decreases the risk of <span class="nowrap">hepatitis C</span> in people using injection drugs by about 75%.<sup id="cite_ref-85" class="reference"><a href="#cite_note-85"><span class="cite-bracket">&#91;</span>85<span class="cite-bracket">&#93;</span></a></sup> The screening of blood donors is important at a national level, as is adhering to <a href="/wiki/Universal_precautions" title="Universal precautions">universal precautions</a> within healthcare facilities.<sup id="cite_ref-ID2010_19-6" class="reference"><a href="#cite_note-ID2010-19"><span class="cite-bracket">&#91;</span>19<span class="cite-bracket">&#93;</span></a></sup> In countries where there is an insufficient supply of sterile <a href="/wiki/Syringes" class="mw-redirect" title="Syringes">syringes</a>, medications should be given orally rather than via injection (when possible).<sup id="cite_ref-World2007_24-7" class="reference"><a href="#cite_note-World2007-24"><span class="cite-bracket">&#91;</span>24<span class="cite-bracket">&#93;</span></a></sup> Recent research also suggests that treating people with active infection, thereby reducing the potential for transmission, may be an effective preventive measure.<sup id="cite_ref-TA_10-1" class="reference"><a href="#cite_note-TA-10"><span class="cite-bracket">&#91;</span>10<span class="cite-bracket">&#93;</span></a></sup> </p><p>Hepatitis C vaccine phase 1 clinical trials are set to begin in the summer of 2023.<sup id="cite_ref-86" class="reference"><a href="#cite_note-86"><span class="cite-bracket">&#91;</span>86<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Treatment">Treatment</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_C&amp;action=edit&amp;section=19" title="Edit section: Treatment"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Those with chronic <span class="nowrap">hepatitis C</span> are advised to avoid <a href="/wiki/Alcohol_(drug)" title="Alcohol (drug)">alcohol</a> and medications that are <a href="/wiki/Hepatotoxicity" title="Hepatotoxicity">toxic to the liver</a>.<sup id="cite_ref-AFP2010_16-13" class="reference"><a href="#cite_note-AFP2010-16"><span class="cite-bracket">&#91;</span>16<span class="cite-bracket">&#93;</span></a></sup> They should also be <a href="/wiki/Vaccinated" class="mw-redirect" title="Vaccinated">vaccinated</a> against <a href="/wiki/Hepatitis_A" title="Hepatitis A">hepatitis A</a> and <a href="/wiki/Hepatitis_B" title="Hepatitis B">hepatitis B</a> due to the increased risk if also infected.<sup id="cite_ref-AFP2010_16-14" class="reference"><a href="#cite_note-AFP2010-16"><span class="cite-bracket">&#91;</span>16<span class="cite-bracket">&#93;</span></a></sup> Use of <a href="/wiki/Acetaminophen" class="mw-redirect" title="Acetaminophen">acetaminophen</a> is generally considered safe at reduced doses.<sup id="cite_ref-Kim2016_11-4" class="reference"><a href="#cite_note-Kim2016-11"><span class="cite-bracket">&#91;</span>11<span class="cite-bracket">&#93;</span></a></sup> <a href="/wiki/Nonsteroidal_anti-inflammatory_drug" title="Nonsteroidal anti-inflammatory drug">Nonsteroidal anti-inflammatory drugs</a> (NSAIDs) are not recommended in those with advanced liver disease due to an increased risk of bleeding.<sup id="cite_ref-Kim2016_11-5" class="reference"><a href="#cite_note-Kim2016-11"><span class="cite-bracket">&#91;</span>11<span class="cite-bracket">&#93;</span></a></sup> <a href="/wiki/Ultrasound" title="Ultrasound">Ultrasound</a> surveillance for <a href="/wiki/Hepatocellular_carcinoma" title="Hepatocellular carcinoma">hepatocellular carcinoma</a> is recommended in those with accompanying cirrhosis.<sup id="cite_ref-AFP2010_16-15" class="reference"><a href="#cite_note-AFP2010-16"><span class="cite-bracket">&#91;</span>16<span class="cite-bracket">&#93;</span></a></sup> <a href="/wiki/Coffee" title="Coffee">Coffee</a> consumption has been associated with<sup class="noprint Inline-Template" style="margin-left:0.1em; white-space:nowrap;">&#91;<i><a href="/wiki/Wikipedia:Vagueness" title="Wikipedia:Vagueness"><span title="This information is too vague. (July 2021)">vague</span></a></i>&#93;</sup> a slower rate of liver <a href="/wiki/Fibrosis" title="Fibrosis">scarring</a> in those infected with HCV.<sup id="cite_ref-Kim2016_11-6" class="reference"><a href="#cite_note-Kim2016-11"><span class="cite-bracket">&#91;</span>11<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Medications">Medications</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_C&amp;action=edit&amp;section=20" title="Edit section: Medications"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size mw-halign-right" typeof="mw:File/Thumb"><a href="/wiki/File:Ribavirin.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/e/e1/Ribavirin.svg/220px-Ribavirin.svg.png" decoding="async" width="220" height="212" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/e/e1/Ribavirin.svg/330px-Ribavirin.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/e/e1/Ribavirin.svg/440px-Ribavirin.svg.png 2x" data-file-width="512" data-file-height="493" /></a><figcaption><a href="/wiki/Ribavirin" title="Ribavirin">Ribavirin</a></figcaption></figure> <p>More than 95% of chronic cases clear with treatment.<sup id="cite_ref-whofactsheet_4-13" class="reference"><a href="#cite_note-whofactsheet-4"><span class="cite-bracket">&#91;</span>4<span class="cite-bracket">&#93;</span></a></sup> Treatment with <a href="/wiki/Antiviral_medication" class="mw-redirect" title="Antiviral medication">antiviral medication</a> is recommended for all people with proven chronic hepatitis C who are not at high risk of death from other causes.<sup id="cite_ref-IDSA2015_87-0" class="reference"><a href="#cite_note-IDSA2015-87"><span class="cite-bracket">&#91;</span>87<span class="cite-bracket">&#93;</span></a></sup> People with the highest complication risk, which is based on the degree of liver scarring, should be treated first.<sup id="cite_ref-IDSA2015_87-1" class="reference"><a href="#cite_note-IDSA2015-87"><span class="cite-bracket">&#91;</span>87<span class="cite-bracket">&#93;</span></a></sup> The initial recommended treatment depends on the type of hepatitis C virus, if the person has received previous hepatitis C treatment, and whether the person has cirrhosis.<sup id="cite_ref-IDSA2017_88-0" class="reference"><a href="#cite_note-IDSA2017-88"><span class="cite-bracket">&#91;</span>88<span class="cite-bracket">&#93;</span></a></sup> <a href="/wiki/Direct-acting_antivirals" class="mw-redirect" title="Direct-acting antivirals">Direct-acting antivirals</a> are the preferred treatment and have been validated by testing for virus particles in patients' blood.<sup id="cite_ref-89" class="reference"><a href="#cite_note-89"><span class="cite-bracket">&#91;</span>89<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="No_prior_treatment">No prior treatment</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_C&amp;action=edit&amp;section=21" title="Edit section: No prior treatment"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li>HCV genotype 1a (no cirrhosis): 8 weeks of <a href="/wiki/Glecaprevir/pibrentasvir" title="Glecaprevir/pibrentasvir">glecaprevir/pibrentasvir</a> or <a href="/wiki/Ledipasvir/sofosbuvir" title="Ledipasvir/sofosbuvir">ledipasvir/sofosbuvir</a> (the latter for people who do not have <a href="/wiki/HIV/AIDS" title="HIV/AIDS">HIV/AIDS</a>, are not <a href="/wiki/African-American" class="mw-redirect" title="African-American">African-American</a>, and have less than 6 million HCV viral copies per milliliter of blood) or 12 weeks of <a href="/wiki/Elbasvir/grazoprevir" title="Elbasvir/grazoprevir">elbasvir/grazoprevir</a>, ledipasvir/sofosbuvir, or <a href="/wiki/Sofosbuvir/velpatasvir" title="Sofosbuvir/velpatasvir">sofosbuvir/velpatasvir</a>.<sup id="cite_ref-HCVGuidelinesGenotype1a_90-0" class="reference"><a href="#cite_note-HCVGuidelinesGenotype1a-90"><span class="cite-bracket">&#91;</span>90<span class="cite-bracket">&#93;</span></a></sup> <a href="/wiki/Sofosbuvir" title="Sofosbuvir">Sofosbuvir</a> with either <a href="/wiki/Daclatasvir" title="Daclatasvir">daclatasvir</a> or <a href="/wiki/Simeprevir" title="Simeprevir">simeprevir</a> may also be used.<sup id="cite_ref-IDSA2017_88-1" class="reference"><a href="#cite_note-IDSA2017-88"><span class="cite-bracket">&#91;</span>88<span class="cite-bracket">&#93;</span></a></sup></li> <li>HCV genotype 1a (with compensated cirrhosis): 8 weeks of glecaprevir/pibrentasvir or 12 weeks of elbasvir/grazoprevir, ledipasvir/sofosbuvir, or sofosbuvir/velpatasvir. An alternative treatment regimen of elbasvir/grazoprevir with weight-based ribavirin for 16 weeks can be used if the HCV is found to have antiviral resistance mutations against NS5A protease inhibitors.<sup id="cite_ref-HCVGuidelinesGenotype1acompensated_91-0" class="reference"><a href="#cite_note-HCVGuidelinesGenotype1acompensated-91"><span class="cite-bracket">&#91;</span>91<span class="cite-bracket">&#93;</span></a></sup></li> <li>HCV genotype 1b (no cirrhosis): 8 weeks of glecaprevir/pibrentasvir or ledipasvir/sofosbuvir (with the aforementioned limitations for the latter as above) or 12 weeks of elbasvir/grazoprevir, ledipasvir/sofosbuvir, or sofosbuvir/velpatasvir. Alternative regimens include 12 weeks of <a href="/wiki/Ombitasvir/paritaprevir/ritonavir" title="Ombitasvir/paritaprevir/ritonavir">ombitasvir/paritaprevir/ritonavir</a> with <a href="/wiki/Dasabuvir" title="Dasabuvir">dasabuvir</a> or 12 weeks of sofosbuvir with either daclatasvir or simeprevir.<sup id="cite_ref-HCVGuidelinesGenotype1b_92-0" class="reference"><a href="#cite_note-HCVGuidelinesGenotype1b-92"><span class="cite-bracket">&#91;</span>92<span class="cite-bracket">&#93;</span></a></sup></li> <li>HCV genotype 1b (with compensated cirrhosis): 8 weeks of glecaprevir/pibrentasvir or 12 weeks of elbasvir/grazoprevir, ledipasvir/sofosbuvir, or sofosbuvir/velpatasvir. A 12-week course of paritaprevir/ritonavir/ombitasvir with dasabuvir may also be used.<sup id="cite_ref-HCVGuidelinesGenotype1bcompensated_93-0" class="reference"><a href="#cite_note-HCVGuidelinesGenotype1bcompensated-93"><span class="cite-bracket">&#91;</span>93<span class="cite-bracket">&#93;</span></a></sup></li> <li>HCV genotype 2 (no cirrhosis): 8 weeks of glecaprevir/pibrentasvir or 12 weeks of sofosbuvir/velpatasvir. Alternatively, 12 weeks of sofosbuvir/daclatasvir can be used.<sup id="cite_ref-HCVGuidelinesGenotype2_94-0" class="reference"><a href="#cite_note-HCVGuidelinesGenotype2-94"><span class="cite-bracket">&#91;</span>94<span class="cite-bracket">&#93;</span></a></sup></li> <li>HCV genotype 2 (with compensated cirrhosis): 8 weeks of glecaprevir/pibrentasvir or 12 weeks of sofosbuvir/<a href="/wiki/Velpatasvir" title="Velpatasvir">velpatasvir</a>. An alternative regimen of sofosbuvir/daclatasvir can be used for 16–24 weeks.<sup id="cite_ref-HCVGuidelinesGenotype2compensated_95-0" class="reference"><a href="#cite_note-HCVGuidelinesGenotype2compensated-95"><span class="cite-bracket">&#91;</span>95<span class="cite-bracket">&#93;</span></a></sup></li> <li>HCV genotype 3 (no cirrhosis): 8 weeks of glecaprevir/pibrentasvir or 12 weeks of sofosbuvir/velpatasvir or sofosbuvir and daclatasvir.<sup id="cite_ref-HCVGuidelinesGenotype3_96-0" class="reference"><a href="#cite_note-HCVGuidelinesGenotype3-96"><span class="cite-bracket">&#91;</span>96<span class="cite-bracket">&#93;</span></a></sup></li> <li>HCV genotype 3 (with compensated cirrhosis): 8 weeks of glecaprevir/pibrentasvir or 12 weeks of sofosbuvir/velpatasvir, or if certain antiviral mutations are present, 12 weeks of sofosbuvir/velpatasvir/<a href="/wiki/Voxilaprevir" title="Voxilaprevir">voxilaprevir</a> (when certain antiviral mutations are present), or 24 weeks of sofosbuvir and daclatasvir.<sup id="cite_ref-HCVGuidelinesGenotype3compensated_97-0" class="reference"><a href="#cite_note-HCVGuidelinesGenotype3compensated-97"><span class="cite-bracket">&#91;</span>97<span class="cite-bracket">&#93;</span></a></sup></li> <li>HCV genotype 4 (no cirrhosis): 8 weeks of glecaprevir/pibrentasvir or 12 weeks of sofosbuvir/velpatasvir, elbasvir/grazoprevir, or ledipasvir/sofosbuvir. A 12-week regimen of ombitasvir/paritaprevir/ritonavir is also acceptable in combination with weight-based <a href="/wiki/Ribavirin" title="Ribavirin">ribavirin</a>.<sup id="cite_ref-HCVGuidelinesGenotype4_98-0" class="reference"><a href="#cite_note-HCVGuidelinesGenotype4-98"><span class="cite-bracket">&#91;</span>98<span class="cite-bracket">&#93;</span></a></sup></li> <li>HCV genotype 4 (with compensated cirrhosis): 8 weeks of glecaprevir/pibrentasvir or 12 weeks of sofosbuvir/velpatasvir, elbasvir/grazoprevir, or ledipasvir/sofosbuvir is recommended. A 12-week course of ombitasvir/paritaprevir/ritonavir with weight-based ribavirin is an acceptable alternative.<sup id="cite_ref-HCVGuidelinesGenotype4compensated_99-0" class="reference"><a href="#cite_note-HCVGuidelinesGenotype4compensated-99"><span class="cite-bracket">&#91;</span>99<span class="cite-bracket">&#93;</span></a></sup></li> <li>HCV genotype 5 or 6 (with or without compensated cirrhosis): 8 weeks of glecaprevir/pibrentasvir is recommended. If cirrhosis is present, then a 12-week course of sofosbuvir/velpatasvir, or ledipasvir/sofosbuvir is an alternative option.<sup id="cite_ref-HCVGuidelinesGenotypes5and6_100-0" class="reference"><a href="#cite_note-HCVGuidelinesGenotypes5and6-100"><span class="cite-bracket">&#91;</span>100<span class="cite-bracket">&#93;</span></a></sup></li></ul> <p>More than 95% of people with chronic infection can be cured when treated with medications;<sup id="cite_ref-CDC2019_101-0" class="reference"><a href="#cite_note-CDC2019-101"><span class="cite-bracket">&#91;</span>101<span class="cite-bracket">&#93;</span></a></sup> this could be expensive, but by 2022 prices had dropped dramatically.<sup id="cite_ref-whofactsheet_4-14" class="reference"><a href="#cite_note-whofactsheet-4"><span class="cite-bracket">&#91;</span>4<span class="cite-bracket">&#93;</span></a></sup> The combination of <a href="/wiki/Sofosbuvir/velpatasvir/voxilaprevir" title="Sofosbuvir/velpatasvir/voxilaprevir">sofosbuvir, velpatasvir, and voxilaprevir</a> may be used in those who have previously been treated with sofosbuvir or other drugs that inhibit NS5A and were not cured.<sup id="cite_ref-102" class="reference"><a href="#cite_note-102"><span class="cite-bracket">&#91;</span>102<span class="cite-bracket">&#93;</span></a></sup> </p><p>Prior to 2011, treatments consisted of a combination of <a href="/wiki/Pegylated_interferon" title="Pegylated interferon">pegylated interferon</a> alpha and ribavirin for a period of 24 or 48 weeks, depending on HCV <a href="/wiki/Genotype" title="Genotype">genotype</a>.<sup id="cite_ref-AFP2010_16-16" class="reference"><a href="#cite_note-AFP2010-16"><span class="cite-bracket">&#91;</span>16<span class="cite-bracket">&#93;</span></a></sup> This treatment produces cure rates of 70–80% for genotype 2 and 3, respectively, and 45–70% for genotypes 1 and 4.<sup id="cite_ref-NEJM2013_103-0" class="reference"><a href="#cite_note-NEJM2013-103"><span class="cite-bracket">&#91;</span>103<span class="cite-bracket">&#93;</span></a></sup> Adverse effects with these treatments were common, with 50–60% of those being treated experiencing <a href="/wiki/Influenza-like_illness" title="Influenza-like illness">flu-like symptoms</a> and nearly a third experiencing depression or other emotional issues.<sup id="cite_ref-AFP2010_16-17" class="reference"><a href="#cite_note-AFP2010-16"><span class="cite-bracket">&#91;</span>16<span class="cite-bracket">&#93;</span></a></sup> Treatment during the first six months of infection (the acute stage) is more effective than when <span class="nowrap">hepatitis C</span> has entered the chronic stage.<sup id="cite_ref-Tah2009_27-2" class="reference"><a href="#cite_note-Tah2009-27"><span class="cite-bracket">&#91;</span>27<span class="cite-bracket">&#93;</span></a></sup> In those with chronic hepatitis B, treatment for hepatitis C results in reactivation of hepatitis B about 25% of the time.<sup id="cite_ref-Mücke2018_104-0" class="reference"><a href="#cite_note-Mücke2018-104"><span class="cite-bracket">&#91;</span>104<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Surgery">Surgery</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_C&amp;action=edit&amp;section=22" title="Edit section: Surgery"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Cirrhosis due to hepatitis C is a common reason for <a href="/wiki/Liver_transplant" class="mw-redirect" title="Liver transplant">liver transplantation</a>,<sup id="cite_ref-Tah2009_27-3" class="reference"><a href="#cite_note-Tah2009-27"><span class="cite-bracket">&#91;</span>27<span class="cite-bracket">&#93;</span></a></sup> though the virus usually (80–90% of cases) recurs afterwards.<sup id="cite_ref-NEJM2011_5-11" class="reference"><a href="#cite_note-NEJM2011-5"><span class="cite-bracket">&#91;</span>5<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-105" class="reference"><a href="#cite_note-105"><span class="cite-bracket">&#91;</span>105<span class="cite-bracket">&#93;</span></a></sup> Infection of the graft leads to 10–30% of people developing cirrhosis within five years.<sup id="cite_ref-Ciria2013_106-0" class="reference"><a href="#cite_note-Ciria2013-106"><span class="cite-bracket">&#91;</span>106<span class="cite-bracket">&#93;</span></a></sup> Treatment with pegylated interferon and ribavirin post-transplant decreases the risk of recurrence to 70%.<sup id="cite_ref-Coilly2013_107-0" class="reference"><a href="#cite_note-Coilly2013-107"><span class="cite-bracket">&#91;</span>107<span class="cite-bracket">&#93;</span></a></sup> A 2013 review found no clear evidence as to whether antiviral medication is useful if the graft became reinfected.<sup id="cite_ref-108" class="reference"><a href="#cite_note-108"><span class="cite-bracket">&#91;</span>108<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Alternative_medicine">Alternative medicine</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_C&amp;action=edit&amp;section=23" title="Edit section: Alternative medicine"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Several <a href="/wiki/Alternative_medicine" title="Alternative medicine">alternative therapies</a> are claimed by their proponents to be helpful for <span class="nowrap">hepatitis C</span>, including <a href="/wiki/Silybum_marianum" title="Silybum marianum">milk thistle</a>, <a href="/wiki/Ginseng" title="Ginseng">ginseng</a>, and <a href="/wiki/Colloidal_silver" class="mw-redirect" title="Colloidal silver">colloidal silver</a>.<sup id="cite_ref-NCCAM_109-0" class="reference"><a href="#cite_note-NCCAM-109"><span class="cite-bracket">&#91;</span>109<span class="cite-bracket">&#93;</span></a></sup> However, no alternative therapy has been shown to improve outcomes for <span class="nowrap">hepatitis C</span> patients, and no evidence exists that alternative therapies have any effect on the virus.<sup id="cite_ref-NCCAM_109-1" class="reference"><a href="#cite_note-NCCAM-109"><span class="cite-bracket">&#91;</span>109<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-110" class="reference"><a href="#cite_note-110"><span class="cite-bracket">&#91;</span>110<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-111" class="reference"><a href="#cite_note-111"><span class="cite-bracket">&#91;</span>111<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Prognosis">Prognosis</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_C&amp;action=edit&amp;section=24" title="Edit section: Prognosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><span class="anchor" id="Sustained_viral_response"></span> </p> <figure class="mw-default-size mw-halign-left" typeof="mw:File/Thumb"><a href="/wiki/File:Hepatitis_C_world_map_-_DALY_-_WHO2004.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/4/4d/Hepatitis_C_world_map_-_DALY_-_WHO2004.svg/290px-Hepatitis_C_world_map_-_DALY_-_WHO2004.svg.png" decoding="async" width="290" height="128" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/4/4d/Hepatitis_C_world_map_-_DALY_-_WHO2004.svg/435px-Hepatitis_C_world_map_-_DALY_-_WHO2004.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/4/4d/Hepatitis_C_world_map_-_DALY_-_WHO2004.svg/580px-Hepatitis_C_world_map_-_DALY_-_WHO2004.svg.png 2x" data-file-width="940" data-file-height="415" /></a><figcaption><a href="/wiki/Disability-adjusted_life_year" title="Disability-adjusted life year">Disability-adjusted life year</a> for hepatitis C in 2004 per 100,000&#160;inhabitants <style data-mw-deduplicate="TemplateStyles:r1216972533">.mw-parser-output .col-begin{border-collapse:collapse;padding:0;color:inherit;width:100%;border:0;margin:0}.mw-parser-output .col-begin-small{font-size:90%}.mw-parser-output .col-break{vertical-align:top;text-align:left}.mw-parser-output .col-break-2{width:50%}.mw-parser-output .col-break-3{width:33.3%}.mw-parser-output .col-break-4{width:25%}.mw-parser-output .col-break-5{width:20%}@media(max-width:720px){.mw-parser-output .col-begin,.mw-parser-output .col-begin>tbody,.mw-parser-output .col-begin>tbody>tr,.mw-parser-output .col-begin>tbody>tr>td{display:block!important;width:100%!important}.mw-parser-output .col-break{padding-left:0!important}}</style><div> <table class="col-begin" role="presentation"> <tbody><tr> <td class="col-break"> <style data-mw-deduplicate="TemplateStyles:r981673959">.mw-parser-output .legend{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .legend-color{display:inline-block;min-width:1.25em;height:1.25em;line-height:1.25;margin:1px 0;text-align:center;border:1px solid black;background-color:transparent;color:black}.mw-parser-output .legend-text{}</style><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#b3b3b3; color:black;">&#160;</span>&#160;no data</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#ffff65; color:black;">&#160;</span>&#160;&lt;10</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#fff200; color:black;">&#160;</span>&#160;10–15</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#ffdc00; color:black;">&#160;</span>&#160;15–20</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#ffc600; color:black;">&#160;</span>&#160;20–25</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#ffb000; color:black;">&#160;</span>&#160;25–30</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#ff9a00; color:black;">&#160;</span>&#160;30–35</div> </td> <td class="col-break"> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#ff8400; color:black;">&#160;</span>&#160;35–40</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#ff6e00; color:black;">&#160;</span>&#160;40–45</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#ff5800; color:black;">&#160;</span>&#160;45–50</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#ff4200; color:black;">&#160;</span>&#160;50–75</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#ff2c00; color:black;">&#160;</span>&#160;75–100</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#cb0000; color:white;">&#160;</span>&#160;&gt;100</div> &#32; </td></tr></tbody></table></div></figcaption></figure> <p>The responses to treatment is measured by <i>sustained viral response</i> (SVR), defined as the absence of detectable <a href="/wiki/RNA" title="RNA">RNA</a> of the <a href="/wiki/Hepatitis_C_virus" title="Hepatitis C virus">hepatitis C virus</a> in <a href="/wiki/Serum_(blood)" title="Serum (blood)">blood serum</a> for at least 24 weeks after discontinuing treatment,<sup id="cite_ref-112" class="reference"><a href="#cite_note-112"><span class="cite-bracket">&#91;</span>112<span class="cite-bracket">&#93;</span></a></sup> and rapid virological response (RVR), defined as undetectable levels achieved within four weeks of treatment. Successful treatment decreases the future risk of hepatocellular carcinoma by 75%.<sup id="cite_ref-113" class="reference"><a href="#cite_note-113"><span class="cite-bracket">&#91;</span>113<span class="cite-bracket">&#93;</span></a></sup> </p><p>Prior to 2012, sustained response occurred in about 40–50% of those with HCV genotype 1 who received 48 weeks of treatment.<sup id="cite_ref-NEJM2011_5-12" class="reference"><a href="#cite_note-NEJM2011-5"><span class="cite-bracket">&#91;</span>5<span class="cite-bracket">&#93;</span></a></sup> A sustained response was seen in 70–80% of people with HCV genotypes 2 and 3 following 24 weeks of treatment.<sup id="cite_ref-NEJM2011_5-13" class="reference"><a href="#cite_note-NEJM2011-5"><span class="cite-bracket">&#91;</span>5<span class="cite-bracket">&#93;</span></a></sup> A sustained response occurs for about 65% of those with genotype 4 after 48 weeks of treatment. For those with HCV genotype 6, a 48-week treatment protocol of pegylated interferon and ribavirin results in a higher rate of sustained responses than for genotype 1 (86% vs. 52%). Further studies are needed to determine results for shorter 24-week treatments and for those given at lower dosages.<sup id="cite_ref-114" class="reference"><a href="#cite_note-114"><span class="cite-bracket">&#91;</span>114<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Spontaneous_resolution">Spontaneous resolution</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_C&amp;action=edit&amp;section=25" title="Edit section: Spontaneous resolution"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Around 30% (15–45%) of those with acute HCV infections will spontaneously clear the virus within six months, before the infection is considered chronic.<sup id="cite_ref-whofactsheet_4-15" class="reference"><a href="#cite_note-whofactsheet-4"><span class="cite-bracket">&#91;</span>4<span class="cite-bracket">&#93;</span></a></sup> Spontaneous resolution following acute infection appears more common in females and in patients who are younger, and may be influenced by certain genetic factors.<sup id="cite_ref-Book2011p4_15-4" class="reference"><a href="#cite_note-Book2011p4-15"><span class="cite-bracket">&#91;</span>15<span class="cite-bracket">&#93;</span></a></sup> Chronic HCV infection may also resolve spontaneously months or years after the acute phase has passed, though this is unusual.<sup id="cite_ref-Book2011p4_15-5" class="reference"><a href="#cite_note-Book2011p4-15"><span class="cite-bracket">&#91;</span>15<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Epidemiology">Epidemiology</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_C&amp;action=edit&amp;section=26" title="Edit section: Epidemiology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1251242444">.mw-parser-output .ambox{border:1px solid #a2a9b1;border-left:10px solid #36c;background-color:#fbfbfb;box-sizing:border-box}.mw-parser-output .ambox+link+.ambox,.mw-parser-output .ambox+link+style+.ambox,.mw-parser-output .ambox+link+link+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+style+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+link+.ambox{margin-top:-1px}html body.mediawiki .mw-parser-output .ambox.mbox-small-left{margin:4px 1em 4px 0;overflow:hidden;width:238px;border-collapse:collapse;font-size:88%;line-height:1.25em}.mw-parser-output .ambox-speedy{border-left:10px solid #b32424;background-color:#fee7e6}.mw-parser-output .ambox-delete{border-left:10px solid #b32424}.mw-parser-output .ambox-content{border-left:10px solid #f28500}.mw-parser-output .ambox-style{border-left:10px solid #fc3}.mw-parser-output .ambox-move{border-left:10px solid #9932cc}.mw-parser-output .ambox-protection{border-left:10px solid #a2a9b1}.mw-parser-output .ambox .mbox-text{border:none;padding:0.25em 0.5em;width:100%}.mw-parser-output .ambox .mbox-image{border:none;padding:2px 0 2px 0.5em;text-align:center}.mw-parser-output .ambox .mbox-imageright{border:none;padding:2px 0.5em 2px 0;text-align:center}.mw-parser-output .ambox .mbox-empty-cell{border:none;padding:0;width:1px}.mw-parser-output .ambox .mbox-image-div{width:52px}@media(min-width:720px){.mw-parser-output .ambox{margin:0 10%}}@media print{body.ns-0 .mw-parser-output .ambox{display:none!important}}</style><table class="box-Update plainlinks metadata ambox ambox-content ambox-Update" role="presentation"><tbody><tr><td class="mbox-image"><div class="mbox-image-div"><span typeof="mw:File"><span><img alt="" src="//upload.wikimedia.org/wikipedia/commons/thumb/5/53/Ambox_current_red_Americas.svg/42px-Ambox_current_red_Americas.svg.png" decoding="async" width="42" height="34" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/5/53/Ambox_current_red_Americas.svg/63px-Ambox_current_red_Americas.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/5/53/Ambox_current_red_Americas.svg/84px-Ambox_current_red_Americas.svg.png 2x" data-file-width="360" data-file-height="290" /></span></span></div></td><td class="mbox-text"><div class="mbox-text-span">This section needs to be <b>updated</b>.<span class="hide-when-compact"> Please help update this article to reflect recent events or newly available information.</span> <span class="date-container"><i>(<span class="date">July 2020</span>)</i></span></div></td></tr></tbody></table> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Countries_Most_Affected_by_Hepatitis_C_in_2019.png" class="mw-file-description"><img alt="World map showing hepatitis C infection rate by country in 2019" src="//upload.wikimedia.org/wikipedia/commons/thumb/3/39/Countries_Most_Affected_by_Hepatitis_C_in_2019.png/220px-Countries_Most_Affected_by_Hepatitis_C_in_2019.png" decoding="async" width="220" height="117" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/3/39/Countries_Most_Affected_by_Hepatitis_C_in_2019.png/330px-Countries_Most_Affected_by_Hepatitis_C_in_2019.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/3/39/Countries_Most_Affected_by_Hepatitis_C_in_2019.png/440px-Countries_Most_Affected_by_Hepatitis_C_in_2019.png 2x" data-file-width="1089" data-file-height="577" /></a><figcaption>Percentage of people infected with hepatitis C by country in 2019</figcaption></figure> <p>The <a href="/wiki/World_Health_Organization" title="World Health Organization">World Health Organization</a> estimated in a 2021 report that 58 million people globally were living with chronic hepatitis C as of 2019.<sup id="cite_ref-:1_12-1" class="reference"><a href="#cite_note-:1-12"><span class="cite-bracket">&#91;</span>12<span class="cite-bracket">&#93;</span></a></sup> About 1.5 million people are infected per year, and about 290,000 people die yearly from hepatitis C–related diseases, mainly from liver cancer and cirrhosis.<sup id="cite_ref-whofactsheet_4-16" class="reference"><a href="#cite_note-whofactsheet-4"><span class="cite-bracket">&#91;</span>4<span class="cite-bracket">&#93;</span></a></sup> </p><p>Hepatitis C infection rates increased substantially in the 20th century due to a combination of intravenous drug abuse and the reuse of poorly sterilized medical equipment.<sup id="cite_ref-World2007_24-8" class="reference"><a href="#cite_note-World2007-24"><span class="cite-bracket">&#91;</span>24<span class="cite-bracket">&#93;</span></a></sup> However, advancements in treatment have led to notable declines in chronic infections and deaths from the virus. As a result, the number of chronic patients receiving treatment worldwide has grown from about 950,000 in 2015 to 9.4 million in 2019. During the same period, hepatitis C deaths declined from about 400,000 to 290,000.<sup id="cite_ref-whofactsheet_4-17" class="reference"><a href="#cite_note-whofactsheet-4"><span class="cite-bracket">&#91;</span>4<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-:1_12-2" class="reference"><a href="#cite_note-:1-12"><span class="cite-bracket">&#91;</span>12<span class="cite-bracket">&#93;</span></a></sup> </p><p>Previously, a 2013 study found high infection rates (&gt;3.5% population infected) in Central and East Asia, North Africa and the Middle East, intermediate infection rates (1.5–3.5%) in South and Southeast Asia, sub-Saharan Africa, Andean, Central and Southern Latin America, Caribbean, Oceania, Australasia and Central, Eastern and Western Europe; and low infection rates (&lt;1.5%) in Asia-Pacific, Tropical Latin America and North America.<sup id="cite_ref-Mohd2013_115-0" class="reference"><a href="#cite_note-Mohd2013-115"><span class="cite-bracket">&#91;</span>115<span class="cite-bracket">&#93;</span></a></sup> </p><p>Among those chronically infected, the risk of <a href="/wiki/Cirrhosis" title="Cirrhosis">cirrhosis</a> after 20 years varies between studies but has been estimated at ~10–15% for men and ~1–5% for women. The reason for this difference is not known. Once cirrhosis is established, the rate of developing <a href="/wiki/Hepatocellular_carcinoma" title="Hepatocellular carcinoma">hepatocellular carcinoma</a> is ~1–4% per year.<sup id="cite_ref-Yu2009_116-0" class="reference"><a href="#cite_note-Yu2009-116"><span class="cite-bracket">&#91;</span>116<span class="cite-bracket">&#93;</span></a></sup> Rates of new infections have decreased in the Western world since the 1990s due to improved screening of blood before transfusion.<sup id="cite_ref-Tah2009_27-4" class="reference"><a href="#cite_note-Tah2009-27"><span class="cite-bracket">&#91;</span>27<span class="cite-bracket">&#93;</span></a></sup> </p><p>In Egypt, following <a href="/wiki/Egypt_Vision_2030" title="Egypt Vision 2030">Egypt's 2030 Vision</a>, the country managed to bring down the infection rates of hepatitis C from 22% in 2011 to just 2% in 2021.<sup id="cite_ref-egypttoday.com_117-0" class="reference"><a href="#cite_note-egypttoday.com-117"><span class="cite-bracket">&#91;</span>117<span class="cite-bracket">&#93;</span></a></sup> It was believed that the high prevalence in Egypt was linked to a discontinued mass-treatment campaign for <a href="/wiki/Schistosomiasis" title="Schistosomiasis">schistosomiasis</a>, using improperly sterilized glass syringes.<sup id="cite_ref-World2007_24-9" class="reference"><a href="#cite_note-World2007-24"><span class="cite-bracket">&#91;</span>24<span class="cite-bracket">&#93;</span></a></sup> </p><p>In the United States, about 2% of people have chronic <span class="nowrap">hepatitis C</span>.<sup id="cite_ref-AFP2010_16-18" class="reference"><a href="#cite_note-AFP2010-16"><span class="cite-bracket">&#91;</span>16<span class="cite-bracket">&#93;</span></a></sup> In 2014, an estimated 30,500 new acute hepatitis C cases occurred (0.7 per 100,000 population), an increase from 2010 to 2012.<sup id="cite_ref-118" class="reference"><a href="#cite_note-118"><span class="cite-bracket">&#91;</span>118<span class="cite-bracket">&#93;</span></a></sup> The number of deaths from hepatitis C has increased to 15,800 in 2008<sup id="cite_ref-119" class="reference"><a href="#cite_note-119"><span class="cite-bracket">&#91;</span>119<span class="cite-bracket">&#93;</span></a></sup> having overtaken HIV/AIDS as a cause of death in the US in 2007.<sup id="cite_ref-120" class="reference"><a href="#cite_note-120"><span class="cite-bracket">&#91;</span>120<span class="cite-bracket">&#93;</span></a></sup> In 2014, it was the single greatest cause of infectious death in the United States.<sup id="cite_ref-CDC2016a_121-0" class="reference"><a href="#cite_note-CDC2016a-121"><span class="cite-bracket">&#91;</span>121<span class="cite-bracket">&#93;</span></a></sup> This mortality rate is expected to increase, as those infected by transfusion before HCV testing become apparent.<sup id="cite_ref-Cola2004_122-0" class="reference"><a href="#cite_note-Cola2004-122"><span class="cite-bracket">&#91;</span>122<span class="cite-bracket">&#93;</span></a></sup> In Europe, the percentage of people with chronic infections has been estimated to be between 0.13 and 3.26%.<sup id="cite_ref-123" class="reference"><a href="#cite_note-123"><span class="cite-bracket">&#91;</span>123<span class="cite-bracket">&#93;</span></a></sup> </p><p>In the United Kingdom, about 118,000 people were chronically infected in 2019.<sup id="cite_ref-124" class="reference"><a href="#cite_note-124"><span class="cite-bracket">&#91;</span>124<span class="cite-bracket">&#93;</span></a></sup> About half of people using a needle exchange in London in 2017–18 tested positive for hepatitis C of which half were unaware that they had it.<sup id="cite_ref-125" class="reference"><a href="#cite_note-125"><span class="cite-bracket">&#91;</span>125<span class="cite-bracket">&#93;</span></a></sup> As part of a bid to eradicate hepatitis C by 2025, <a href="/wiki/NHS_England" title="NHS England">NHS England</a> conducted a large procurement exercise in 2019. <a href="/wiki/Merck_Sharp_%26_Dohme" class="mw-redirect" title="Merck Sharp &amp; Dohme">Merck Sharp &amp; Dohme</a>, <a href="/wiki/Gilead_Sciences" title="Gilead Sciences">Gilead Sciences</a>, and <a href="/wiki/Abbvie" class="mw-redirect" title="Abbvie">Abbvie</a> were awarded contracts, which, together, are worth up to £1 billion over five years.<sup id="cite_ref-126" class="reference"><a href="#cite_note-126"><span class="cite-bracket">&#91;</span>126<span class="cite-bracket">&#93;</span></a></sup> </p><p>The total number of people with this infection is higher in some countries in Africa and Asia.<sup id="cite_ref-127" class="reference"><a href="#cite_note-127"><span class="cite-bracket">&#91;</span>127<span class="cite-bracket">&#93;</span></a></sup> Countries with particularly high rates of infection include Pakistan (4.8%) and China (3.2%).<sup id="cite_ref-WHO2011_128-0" class="reference"><a href="#cite_note-WHO2011-128"><span class="cite-bracket">&#91;</span>128<span class="cite-bracket">&#93;</span></a></sup> </p><p>Since 2014, extremely effective treatments have been available to eradicate the disease within 8–12 weeks in most people.<sup id="cite_ref-:0_129-0" class="reference"><a href="#cite_note-:0-129"><span class="cite-bracket">&#91;</span>129<span class="cite-bracket">&#93;</span></a></sup> In 2015, about 950,000 people were treated while 1.7 million new infections occurred, meaning that overall the number of people with HCV increased.<sup id="cite_ref-:0_129-1" class="reference"><a href="#cite_note-:0-129"><span class="cite-bracket">&#91;</span>129<span class="cite-bracket">&#93;</span></a></sup> These numbers differ by country and improved in 2016, with some countries achieving higher cure rates than new infection rates (mostly high income countries).<sup id="cite_ref-:0_129-2" class="reference"><a href="#cite_note-:0-129"><span class="cite-bracket">&#91;</span>129<span class="cite-bracket">&#93;</span></a></sup> By 2018, twelve countries are on track to achieve HCV elimination.<sup id="cite_ref-:0_129-3" class="reference"><a href="#cite_note-:0-129"><span class="cite-bracket">&#91;</span>129<span class="cite-bracket">&#93;</span></a></sup> While antiviral agents will curb new infections, it is less clear whether they impact overall deaths and morbidity.<sup id="cite_ref-:0_129-4" class="reference"><a href="#cite_note-:0-129"><span class="cite-bracket">&#91;</span>129<span class="cite-bracket">&#93;</span></a></sup> Furthermore, for them to be effective, people need to be aware of their infection – it is estimated that worldwide only 20% of infected people are aware of their infection (in the US, fewer than half were aware).<sup id="cite_ref-:0_129-5" class="reference"><a href="#cite_note-:0-129"><span class="cite-bracket">&#91;</span>129<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="History">History</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_C&amp;action=edit&amp;section=27" title="Edit section: History"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:15_Hegasy_Nobel_Prize_2020_HepC.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/c/cd/15_Hegasy_Nobel_Prize_2020_HepC.jpg/330px-15_Hegasy_Nobel_Prize_2020_HepC.jpg" decoding="async" width="330" height="233" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/c/cd/15_Hegasy_Nobel_Prize_2020_HepC.jpg/495px-15_Hegasy_Nobel_Prize_2020_HepC.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/c/cd/15_Hegasy_Nobel_Prize_2020_HepC.jpg/660px-15_Hegasy_Nobel_Prize_2020_HepC.jpg 2x" data-file-width="3508" data-file-height="2480" /></a><figcaption>Nobel Prize in Physiology or Medicine 2020: Seminal experiments by HJ Alter, M Houghton and CM Rice leading to the discovery of HCV as the causative agent of non-A, non-B hepatitis</figcaption></figure> <p>In the mid-1970s, <a href="/wiki/Harvey_J._Alter" title="Harvey J. Alter">Harvey J. Alter</a>, Chief of the Infectious Disease Section in the Department of Transfusion Medicine at the <a href="/wiki/National_Institutes_of_Health" title="National Institutes of Health">National Institutes of Health</a>, and his research team demonstrated how most post-<a href="/wiki/Blood_transfusion" title="Blood transfusion">transfusion</a> hepatitis cases were not due to <a href="/wiki/Hepatitis_A" title="Hepatitis A">hepatitis A</a> or <a href="/wiki/Hepatitis_B" title="Hepatitis B">B</a> viruses. Despite this discovery, international research efforts to identify the virus, initially called <i>non-A, non-B hepatitis</i> (NANBH), failed for the next decade. In 1987, <a href="/wiki/Michael_Houghton_(virologist)" class="mw-redirect" title="Michael Houghton (virologist)">Michael Houghton</a>, <a href="/wiki/Qui-Lim_Choo" title="Qui-Lim Choo">Qui-Lim Choo</a>, and <a href="/wiki/George_Kuo" title="George Kuo">George Kuo</a> at <a href="/wiki/Chiron_Corporation" title="Chiron Corporation">Chiron Corporation</a>, collaborating with <a href="/wiki/Daniel_W._Bradley" title="Daniel W. Bradley">Daniel W. Bradley</a> at the <a href="/wiki/Centers_for_Disease_Control_and_Prevention" title="Centers for Disease Control and Prevention">Centers for Disease Control and Prevention</a>, used a novel <a href="/wiki/Molecular_cloning" title="Molecular cloning">molecular cloning</a> approach to identify the unknown organism and develop a diagnostic test.<sup id="cite_ref-Boyer_130-0" class="reference"><a href="#cite_note-Boyer-130"><span class="cite-bracket">&#91;</span>130<span class="cite-bracket">&#93;</span></a></sup> In 1988, Alter confirmed the virus by verifying its presence in a panel of NANBH specimens, and Chiron announced its discovery at a Washington, D.C. press conference in May 1988. </p><p>At the time, Chiron was in talks with the Japanese health ministry to sell a biotech version of the hepatitis B vaccine. Simultaneously, <a href="/wiki/Hirohito" title="Hirohito">Emperor Hirohito</a> had developed cancer and required numerous blood transfusions. The Japanese health ministry placed a screening order for Chiron's experimental NANBH test. Chiron's Japanese marketing subsidiary, Diagnostic Systems KK, introduced the term "Hepatitis C" in November 1988 in Tokyo news reports publicizing the testing of the emperor's blood.<sup id="cite_ref-131" class="reference"><a href="#cite_note-131"><span class="cite-bracket">&#91;</span>131<span class="cite-bracket">&#93;</span></a></sup> Chiron sold a screening order to the Japanese health ministry in November 1988, earning the company <a href="/wiki/US$" class="mw-redirect" title="US$">US$</a>60 million a year. However, because Chiron had not published any of its research and did not make a culture model available to other researchers to verify Chiron's discovery, hepatitis C earned the nickname "The Emperor's New Virus." </p><p>In April 1989, the "discovery" of HCV was published in two articles in the journal <i><a href="/wiki/Science_(journal)" title="Science (journal)">Science</a></i>.<sup id="cite_ref-choo_132-0" class="reference"><a href="#cite_note-choo-132"><span class="cite-bracket">&#91;</span>132<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-kuo_133-0" class="reference"><a href="#cite_note-kuo-133"><span class="cite-bracket">&#91;</span>133<span class="cite-bracket">&#93;</span></a></sup> Chiron filed for several patents on the virus and its diagnosis.<sup id="cite_ref-houghton_134-0" class="reference"><a href="#cite_note-houghton-134"><span class="cite-bracket">&#91;</span>134<span class="cite-bracket">&#93;</span></a></sup> A competing patent application by the CDC was dropped in 1990 after Chiron paid $1.9 million to the CDC and $337,500 to Bradley. In 1994, Bradley sued Chiron, seeking to invalidate the patent, have himself included as a co-inventor, and receive damages and royalty income. The court ruled against him, which was sustained on appeal in 1998.<sup id="cite_ref-135" class="reference"><a href="#cite_note-135"><span class="cite-bracket">&#91;</span>135<span class="cite-bracket">&#93;</span></a></sup> Because of the unique molecular "isolation" of the hepatitis C virus, although Houghton and Kuo's team at Chiron had discovered strong biochemical markers for the virus and the test proved effective at reducing cases of post-transfusion hepatitis, the existence of a hepatitis C virus was essentially inferred.<sup id="cite_ref-136" class="reference"><a href="#cite_note-136"><span class="cite-bracket">&#91;</span>136<span class="cite-bracket">&#93;</span></a></sup> In 1992, the <i>San Francisco Chronicle</i> reported that the virus had never been observed under an electron microscope.<sup id="cite_ref-137" class="reference"><a href="#cite_note-137"><span class="cite-bracket">&#91;</span>137<span class="cite-bracket">&#93;</span></a></sup> In 1997, the American FDA approved the first hepatitis C drug on the basis of a <a href="/wiki/Surrogate_marker" class="mw-redirect" title="Surrogate marker">surrogate marker</a> called "Sustained Virological Response." In response, the pharmaceutical industry established a nationwide network of "<a href="/wiki/Astroturfing" title="Astroturfing">Astro-Turf</a>" patient advocacy groups to raise awareness (and fear) of the disease.<sup id="cite_ref-138" class="reference"><a href="#cite_note-138"><span class="cite-bracket">&#91;</span>138<span class="cite-bracket">&#93;</span></a></sup> </p><p>Hepatitis C was finally "discovered" in 2005 when a Japanese team was able to propagate a molecular clone in a cell culture called <a href="/wiki/Huh7" title="Huh7">Huh7</a>.<sup id="cite_ref-139" class="reference"><a href="#cite_note-139"><span class="cite-bracket">&#91;</span>139<span class="cite-bracket">&#93;</span></a></sup> This discovery enabled proper characterization of the viral particle and rapid research into the development of protease inhibitors replacing early interferon treatments. The first of these, <a href="/wiki/Sofosbuvir" title="Sofosbuvir">sofosbuvir</a>, was approved on December 6, 2013. These drugs are marketed as "cures;" however, because they were approved on the basis of surrogate markers and not clinical endpoints such as prolonging life or improving liver health, many experts question their value.<sup id="cite_ref-140" class="reference"><a href="#cite_note-140"><span class="cite-bracket">&#91;</span>140<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-141" class="reference"><a href="#cite_note-141"><span class="cite-bracket">&#91;</span>141<span class="cite-bracket">&#93;</span></a></sup> </p><p>After blood screening began, a notable hepatitis C prevalence was discovered in Egypt, which claimed six million individuals were infected by unsterile needles in a late 1970s mass chemotherapy campaign to eliminate <a href="/wiki/Schistosomiasis" title="Schistosomiasis">schistosomiasis</a> (snail fever).<sup id="cite_ref-142" class="reference"><a href="#cite_note-142"><span class="cite-bracket">&#91;</span>142<span class="cite-bracket">&#93;</span></a></sup> </p><p>On October 5, 2020, Houghton and Alter, together with <a href="/wiki/Charles_M._Rice" title="Charles M. Rice">Charles M. Rice</a>, were awarded the <a href="/wiki/Nobel_Prize_in_Physiology_or_Medicine" title="Nobel Prize in Physiology or Medicine">Nobel Prize in Physiology or Medicine</a> for their work.<sup id="cite_ref-143" class="reference"><a href="#cite_note-143"><span class="cite-bracket">&#91;</span>143<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-144" class="reference"><a href="#cite_note-144"><span class="cite-bracket">&#91;</span>144<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Society_and_culture">Society and culture</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_C&amp;action=edit&amp;section=28" title="Edit section: Society and culture"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1251242444"><table class="box-Update plainlinks metadata ambox ambox-content ambox-Update" role="presentation"><tbody><tr><td class="mbox-image"><div class="mbox-image-div"><span typeof="mw:File"><span><img alt="" src="//upload.wikimedia.org/wikipedia/commons/thumb/5/53/Ambox_current_red_Americas.svg/42px-Ambox_current_red_Americas.svg.png" decoding="async" width="42" height="34" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/5/53/Ambox_current_red_Americas.svg/63px-Ambox_current_red_Americas.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/5/53/Ambox_current_red_Americas.svg/84px-Ambox_current_red_Americas.svg.png 2x" data-file-width="360" data-file-height="290" /></span></span></div></td><td class="mbox-text"><div class="mbox-text-span">This section needs to be <b>updated</b>.<span class="hide-when-compact"> Please help update this article to reflect recent events or newly available information.</span> <span class="date-container"><i>(<span class="date">July 2020</span>)</i></span></div></td></tr></tbody></table> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">See also: <a href="/wiki/List_of_people_with_hepatitis_C" title="List of people with hepatitis C">List of people with hepatitis C</a></div> <p><a href="/wiki/World_Hepatitis_Day" title="World Hepatitis Day">World Hepatitis Day</a>, held on July 28, is coordinated by the World Hepatitis Alliance.<sup id="cite_ref-145" class="reference"><a href="#cite_note-145"><span class="cite-bracket">&#91;</span>145<span class="cite-bracket">&#93;</span></a></sup> The economic costs of hepatitis C are significant both to the individual and to society. In the United States, the average lifetime cost of the disease was estimated at US$33,407 in 2003<sup id="cite_ref-Cost2006_146-0" class="reference"><a href="#cite_note-Cost2006-146"><span class="cite-bracket">&#91;</span>146<span class="cite-bracket">&#93;</span></a></sup> with the cost of a liver transplant as of 2011<sup class="plainlinks noexcerpt noprint asof-tag update" style="display:none;"><a class="external text" href="https://en.wikipedia.org/w/index.php?title=Hepatitis_C&amp;action=edit">&#91;update&#93;</a></sup> costing approximately US$200,000.<sup id="cite_ref-Cost2011_147-0" class="reference"><a href="#cite_note-Cost2011-147"><span class="cite-bracket">&#91;</span>147<span class="cite-bracket">&#93;</span></a></sup> In Canada, the cost of a course of antiviral treatment is as high as 30,000 CAD in 2003,<sup id="cite_ref-148" class="reference"><a href="#cite_note-148"><span class="cite-bracket">&#91;</span>148<span class="cite-bracket">&#93;</span></a></sup> while the United States costs are between 9,200 and US$17,600 in 1998.<sup id="cite_ref-Cost2006_146-1" class="reference"><a href="#cite_note-Cost2006-146"><span class="cite-bracket">&#91;</span>146<span class="cite-bracket">&#93;</span></a></sup> In many areas of the world, people are unable to afford treatment with antivirals as they either lack insurance coverage or the insurance they have will not pay for antivirals.<sup id="cite_ref-149" class="reference"><a href="#cite_note-149"><span class="cite-bracket">&#91;</span>149<span class="cite-bracket">&#93;</span></a></sup> In the <a href="/wiki/National_Health_Service_(England)" title="National Health Service (England)">English National Health Service</a> treatment rates for hepatitis C were higher among less deprived groups in 2010–2012.<sup id="cite_ref-UK2015_150-0" class="reference"><a href="#cite_note-UK2015-150"><span class="cite-bracket">&#91;</span>150<span class="cite-bracket">&#93;</span></a></sup> </p><p>Hepatitis C–infected Spanish anaesthetist <a href="/wiki/Juan_Maeso" title="Juan Maeso">Juan Maeso</a> was jailed for the maximum possible period of 20 years for infecting 275 patients between 1988 and 1997, as he used the same needles to give both himself and the patients opioids.<sup id="cite_ref-151" class="reference"><a href="#cite_note-151"><span class="cite-bracket">&#91;</span>151<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-152" class="reference"><a href="#cite_note-152"><span class="cite-bracket">&#91;</span>152<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Special_populations">Special populations</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_C&amp;action=edit&amp;section=29" title="Edit section: Special populations"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Children_and_pregnancy">Children and pregnancy</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_C&amp;action=edit&amp;section=30" title="Edit section: Children and pregnancy"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/HCV_in_children_and_pregnancy" title="HCV in children and pregnancy">HCV in children and pregnancy</a></div> <p>Compared with adults, infection in children is much less understood. Worldwide the prevalence of <span class="nowrap">hepatitis C</span> virus infection in pregnant women and children has been estimated to 1–8% and 0.05–5% respectively.<sup id="cite_ref-Arshad2011_153-0" class="reference"><a href="#cite_note-Arshad2011-153"><span class="cite-bracket">&#91;</span>153<span class="cite-bracket">&#93;</span></a></sup> The <a href="/wiki/Vertically_transmitted_infection" title="Vertically transmitted infection">vertical transmission</a> rate has been estimated to be 3–5% and there is a high rate of spontaneous clearance (25–50%) in the children. Higher rates have been reported for both vertical transmission (18%, 6–36%, and 41%)<sup id="cite_ref-Hunt1997_154-0" class="reference"><a href="#cite_note-Hunt1997-154"><span class="cite-bracket">&#91;</span>154<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Thomas1998_155-0" class="reference"><a href="#cite_note-Thomas1998-155"><span class="cite-bracket">&#91;</span>155<span class="cite-bracket">&#93;</span></a></sup> and prevalence in children (15%).<sup id="cite_ref-Fischler2007_156-0" class="reference"><a href="#cite_note-Fischler2007-156"><span class="cite-bracket">&#91;</span>156<span class="cite-bracket">&#93;</span></a></sup> </p><p>In developed countries, transmission around the time of birth is now the leading cause of HCV infection. In the absence of virus in the mother's blood, transmission seems to be rare.<sup id="cite_ref-Thomas1998_155-1" class="reference"><a href="#cite_note-Thomas1998-155"><span class="cite-bracket">&#91;</span>155<span class="cite-bracket">&#93;</span></a></sup> Factors associated with an increased rate of infection include membrane rupture of longer than 6 hours before delivery and procedures exposing the infant to maternal blood.<sup id="cite_ref-Indolfi2009_157-0" class="reference"><a href="#cite_note-Indolfi2009-157"><span class="cite-bracket">&#91;</span>157<span class="cite-bracket">&#93;</span></a></sup> Cesarean sections are not recommended. Breastfeeding is considered safe if the nipples are not damaged. Infection around the time of birth in one child does not increase the risk in a subsequent pregnancy. All genotypes appear to have the same risk of transmission. </p><p>HCV infection is frequently found in children who have previously been presumed to have non-A, non-B hepatitis and cryptogenic liver disease.<sup id="cite_ref-González-Peralta1997_158-0" class="reference"><a href="#cite_note-González-Peralta1997-158"><span class="cite-bracket">&#91;</span>158<span class="cite-bracket">&#93;</span></a></sup> The presentation in childhood may be asymptomatic or with elevated liver function tests.<sup id="cite_ref-Suskind2004_159-0" class="reference"><a href="#cite_note-Suskind2004-159"><span class="cite-bracket">&#91;</span>159<span class="cite-bracket">&#93;</span></a></sup> While infection is commonly asymptomatic, both cirrhosis with liver failure and hepatocellular carcinoma may occur in childhood. </p> <div class="mw-heading mw-heading3"><h3 id="Immunosuppressed">Immunosuppressed</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_C&amp;action=edit&amp;section=31" title="Edit section: Immunosuppressed"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">See also: <a href="/wiki/Hepatitis_C_and_HIV_coinfection" title="Hepatitis C and HIV coinfection">Hepatitis C and HIV coinfection</a></div> <p>The rate of <span class="nowrap">hepatitis C</span> in immunosuppressed people is higher. This is particularly true in those with <a href="/wiki/Human_immunodeficiency_virus" class="mw-redirect" title="Human immunodeficiency virus">human immunodeficiency virus</a> infection, recipients of <a href="/wiki/Organ_transplant" class="mw-redirect" title="Organ transplant">organ transplants</a>, and those with <a href="/wiki/Hypogammaglobulinemia" title="Hypogammaglobulinemia">hypogammaglobulinemia</a>.<sup id="cite_ref-Einav2002_160-0" class="reference"><a href="#cite_note-Einav2002-160"><span class="cite-bracket">&#91;</span>160<span class="cite-bracket">&#93;</span></a></sup> Infection in these people is associated with an unusually rapid progression to cirrhosis. People with stable HIV who never received medication for HCV, may be treated with a combination of <a href="/wiki/Peginterferon" class="mw-redirect" title="Peginterferon">peginterferon</a> plus <a href="/wiki/Ribavirin" title="Ribavirin">ribavirin</a> with caution to the possible side effects.<sup id="cite_ref-161" class="reference"><a href="#cite_note-161"><span class="cite-bracket">&#91;</span>161<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Research">Research</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_C&amp;action=edit&amp;section=32" title="Edit section: Research"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>As of 2011<sup class="plainlinks noexcerpt noprint asof-tag update" style="display:none;"><a class="external text" href="https://en.wikipedia.org/w/index.php?title=Hepatitis_C&amp;action=edit">&#91;update&#93;</a></sup>, there are about one hundred medications in development for <span class="nowrap">hepatitis C</span>.<sup id="cite_ref-Cost2011_147-1" class="reference"><a href="#cite_note-Cost2011-147"><span class="cite-bracket">&#91;</span>147<span class="cite-bracket">&#93;</span></a></sup> These include vaccines to treat hepatitis, <a href="/wiki/Immunomodulators" class="mw-redirect" title="Immunomodulators">immunomodulators</a>, and <a href="/wiki/Cyclophilin" title="Cyclophilin">cyclophilin</a> inhibitors, among others.<sup id="cite_ref-162" class="reference"><a href="#cite_note-162"><span class="cite-bracket">&#91;</span>162<span class="cite-bracket">&#93;</span></a></sup> These potential new treatments have come about due to a better understanding of the <span class="nowrap">hepatitis C</span> virus.<sup id="cite_ref-163" class="reference"><a href="#cite_note-163"><span class="cite-bracket">&#91;</span>163<span class="cite-bracket">&#93;</span></a></sup> There are a number of vaccines under development and some have shown encouraging results.<sup id="cite_ref-Vac2016_164-0" class="reference"><a href="#cite_note-Vac2016-164"><span class="cite-bracket">&#91;</span>164<span class="cite-bracket">&#93;</span></a></sup> </p><p>The combination of <a href="/wiki/Sofosbuvir" title="Sofosbuvir">sofosbuvir</a> and <a href="/wiki/Velpatasvir" title="Velpatasvir">velpatasvir</a> in one trial (reported in 2015) resulted in cure rates of 99%.<sup id="cite_ref-165" class="reference"><a href="#cite_note-165"><span class="cite-bracket">&#91;</span>165<span class="cite-bracket">&#93;</span></a></sup> More studies are needed to investigate the role of the preventive antiviral medication against HCV recurrence after transplantation.<sup id="cite_ref-166" class="reference"><a href="#cite_note-166"><span class="cite-bracket">&#91;</span>166<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Animal_models">Animal models</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_C&amp;action=edit&amp;section=33" title="Edit section: Animal models"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>One barrier to finding treatments for <span class="nowrap">hepatitis C</span> is the lack of a suitable animal model. Despite moderate success, research highlights the need for pre-clinical testing in mammalian systems such as <a href="/wiki/Mouse" title="Mouse">mouse</a>, particularly for the development of vaccines in poorer communities. <a href="/wiki/Common_chimpanzee" class="mw-redirect" title="Common chimpanzee">Chimpanzees</a> remain the only available living system to study, yet their use has ethical concerns and regulatory restrictions. While scientists have made use of human cell culture systems such as hepatocytes, questions have been raised about their accuracy in reflecting the body's response to infection.<sup id="cite_ref-Sand2013_167-0" class="reference"><a href="#cite_note-Sand2013-167"><span class="cite-bracket">&#91;</span>167<span class="cite-bracket">&#93;</span></a></sup> </p><p>One aspect of hepatitis research is to reproduce infections in mammalian models. A strategy is to introduce liver tissues from humans into mice, a technique known as xenotransplantation. This is done by generating chimeric mice and exposing the mice to HCV infection. This engineering process is known to create humanized mice, and provide opportunities to study hepatitis C within the 3D architectural design of the liver and evaluating antiviral compounds.<sup id="cite_ref-Sand2013_167-1" class="reference"><a href="#cite_note-Sand2013-167"><span class="cite-bracket">&#91;</span>167<span class="cite-bracket">&#93;</span></a></sup> Alternatively, generating inbred mice with susceptibility to HCV would simplify the process of studying mouse models. </p> <div class="mw-heading mw-heading2"><h2 id="See_also">See also</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_C&amp;action=edit&amp;section=34" title="Edit section: See also"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a href="/wiki/PSI-6130" title="PSI-6130">PSI-6130</a>, an experimental drug treatment</li></ul> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hepatitis_C&amp;action=edit&amp;section=35" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-CDC2016-1"><span class="mw-cite-backlink">^ <a href="#cite_ref-CDC2016_1-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-CDC2016_1-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-CDC2016_1-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-CDC2016_1-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-CDC2016_1-4"><sup><i><b>e</b></i></sup></a> <a href="#cite_ref-CDC2016_1-5"><sup><i><b>f</b></i></sup></a> <a href="#cite_ref-CDC2016_1-6"><sup><i><b>g</b></i></sup></a> <a href="#cite_ref-CDC2016_1-7"><sup><i><b>h</b></i></sup></a> <a href="#cite_ref-CDC2016_1-8"><sup><i><b>i</b></i></sup></a> <a href="#cite_ref-CDC2016_1-9"><sup><i><b>j</b></i></sup></a> <a href="#cite_ref-CDC2016_1-10"><sup><i><b>k</b></i></sup></a> <a href="#cite_ref-CDC2016_1-11"><sup><i><b>l</b></i></sup></a> <a href="#cite_ref-CDC2016_1-12"><sup><i><b>m</b></i></sup></a> <a href="#cite_ref-CDC2016_1-13"><sup><i><b>n</b></i></sup></a> <a href="#cite_ref-CDC2016_1-14"><sup><i><b>o</b></i></sup></a> <a href="#cite_ref-CDC2016_1-15"><sup><i><b>p</b></i></sup></a> <a href="#cite_ref-CDC2016_1-16"><sup><i><b>q</b></i></sup></a> <a href="#cite_ref-CDC2016_1-17"><sup><i><b>r</b></i></sup></a></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.cdc.gov/hepatitis/hcv/hcvfaq.htm#section1">"Q&amp;A for Health Professionals"</a>. <i>Viral Hepatitis</i>. Centers for Disease Control and Prevention<span class="reference-accessdate">. Retrieved <span class="nowrap">28 September</span> 2020</span>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=unknown&amp;rft.jtitle=Viral+Hepatitis&amp;rft.atitle=Q%26A+for+Health+Professionals&amp;rft_id=https%3A%2F%2Fwww.cdc.gov%2Fhepatitis%2Fhcv%2Fhcvfaq.htm%23section1&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AHepatitis+C" class="Z3988"></span></span> </li> <li id="cite_note-Sherris2004-2"><span class="mw-cite-backlink">^ <a href="#cite_ref-Sherris2004_2-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Sherris2004_2-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-Sherris2004_2-2"><sup><i><b>c</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFRyanRay2004" class="citation book cs1">Ryan KJ, Ray CG, eds. (2004). <span class="id-lock-limited" title="Free access subject to limited trial, subscription normally required"><a rel="nofollow" class="external text" href="https://archive.org/details/sherrismedicalmi00ryan"><i>Sherris Medical Microbiology</i></a></span> (4th&#160;ed.). McGraw Hill. pp.&#160;<a rel="nofollow" class="external text" href="https://archive.org/details/sherrismedicalmi00ryan/page/n568">551</a>–52. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a>&#160;<a href="/wiki/Special:BookSources/978-0-8385-8529-0" title="Special:BookSources/978-0-8385-8529-0"><bdi>978-0-8385-8529-0</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&amp;rft.genre=book&amp;rft.btitle=Sherris+Medical+Microbiology&amp;rft.pages=551-52&amp;rft.edition=4th&amp;rft.pub=McGraw+Hill&amp;rft.date=2004&amp;rft.isbn=978-0-8385-8529-0&amp;rft_id=https%3A%2F%2Farchive.org%2Fdetails%2Fsherrismedicalmi00ryan&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AHepatitis+C" class="Z3988"></span></span> </li> <li id="cite_note-Mah2010-3"><span class="mw-cite-backlink">^ <a href="#cite_ref-Mah2010_3-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Mah2010_3-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-Mah2010_3-2"><sup><i><b>c</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFMaheshwariThuluvath2010" class="citation journal cs1">Maheshwari A, Thuluvath PJ (February 2010). "Management of acute hepatitis C". <i>Clinics in Liver Disease</i>. <b>14</b> (1): 169–76, x. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.cld.2009.11.007">10.1016/j.cld.2009.11.007</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a>&#160;<a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/20123448">20123448</a>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=Clinics+in+Liver+Disease&amp;rft.atitle=Management+of+acute+hepatitis+C&amp;rft.volume=14&amp;rft.issue=1&amp;rft.pages=169-76%2C+x&amp;rft.date=2010-02&amp;rft_id=info%3Adoi%2F10.1016%2Fj.cld.2009.11.007&amp;rft_id=info%3Apmid%2F20123448&amp;rft.aulast=Maheshwari&amp;rft.aufirst=A&amp;rft.au=Thuluvath%2C+PJ&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AHepatitis+C" class="Z3988"></span></span> </li> <li id="cite_note-whofactsheet-4"><span class="mw-cite-backlink">^ <a href="#cite_ref-whofactsheet_4-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-whofactsheet_4-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-whofactsheet_4-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-whofactsheet_4-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-whofactsheet_4-4"><sup><i><b>e</b></i></sup></a> <a href="#cite_ref-whofactsheet_4-5"><sup><i><b>f</b></i></sup></a> <a href="#cite_ref-whofactsheet_4-6"><sup><i><b>g</b></i></sup></a> <a href="#cite_ref-whofactsheet_4-7"><sup><i><b>h</b></i></sup></a> <a href="#cite_ref-whofactsheet_4-8"><sup><i><b>i</b></i></sup></a> <a href="#cite_ref-whofactsheet_4-9"><sup><i><b>j</b></i></sup></a> <a href="#cite_ref-whofactsheet_4-10"><sup><i><b>k</b></i></sup></a> <a href="#cite_ref-whofactsheet_4-11"><sup><i><b>l</b></i></sup></a> <a href="#cite_ref-whofactsheet_4-12"><sup><i><b>m</b></i></sup></a> <a href="#cite_ref-whofactsheet_4-13"><sup><i><b>n</b></i></sup></a> <a href="#cite_ref-whofactsheet_4-14"><sup><i><b>o</b></i></sup></a> <a href="#cite_ref-whofactsheet_4-15"><sup><i><b>p</b></i></sup></a> <a href="#cite_ref-whofactsheet_4-16"><sup><i><b>q</b></i></sup></a> <a href="#cite_ref-whofactsheet_4-17"><sup><i><b>r</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.who.int/en/news-room/fact-sheets/detail/hepatitis-c">"Hepatitis C Fact sheet"</a>. <i>WHO</i>. 24 June 2022. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20160131041006/http://www.who.int/mediacentre/factsheets/fs164/en/">Archived</a> from the original on 31 January 2016.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=unknown&amp;rft.jtitle=WHO&amp;rft.atitle=Hepatitis+C+Fact+sheet&amp;rft.date=2022-06-24&amp;rft_id=https%3A%2F%2Fwww.who.int%2Fen%2Fnews-room%2Ffact-sheets%2Fdetail%2Fhepatitis-c&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AHepatitis+C" class="Z3988"></span> Updated as required.</span> </li> <li id="cite_note-NEJM2011-5"><span class="mw-cite-backlink">^ <a href="#cite_ref-NEJM2011_5-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-NEJM2011_5-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-NEJM2011_5-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-NEJM2011_5-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-NEJM2011_5-4"><sup><i><b>e</b></i></sup></a> <a href="#cite_ref-NEJM2011_5-5"><sup><i><b>f</b></i></sup></a> <a href="#cite_ref-NEJM2011_5-6"><sup><i><b>g</b></i></sup></a> <a href="#cite_ref-NEJM2011_5-7"><sup><i><b>h</b></i></sup></a> <a href="#cite_ref-NEJM2011_5-8"><sup><i><b>i</b></i></sup></a> <a href="#cite_ref-NEJM2011_5-9"><sup><i><b>j</b></i></sup></a> <a href="#cite_ref-NEJM2011_5-10"><sup><i><b>k</b></i></sup></a> <a href="#cite_ref-NEJM2011_5-11"><sup><i><b>l</b></i></sup></a> <a href="#cite_ref-NEJM2011_5-12"><sup><i><b>m</b></i></sup></a> <a href="#cite_ref-NEJM2011_5-13"><sup><i><b>n</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFRosen2011" class="citation journal cs1">Rosen HR (June 2011). 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"Hepatitis C - contamination of toothbrushes: myth or reality?". <i>Journal of Viral Hepatitis</i>. <b>13</b> (9): 571–3. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1111%2Fj.1365-2893.2006.00735.x">10.1111/j.1365-2893.2006.00735.x</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a>&#160;<a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/16907842">16907842</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a>&#160;<a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:24264376">24264376</a>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=Journal+of+Viral+Hepatitis&amp;rft.atitle=Hepatitis+C+-+contamination+of+toothbrushes%3A+myth+or+reality%3F&amp;rft.volume=13&amp;rft.issue=9&amp;rft.pages=571-3&amp;rft.date=2006-09&amp;rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A24264376%23id-name%3DS2CID&amp;rft_id=info%3Apmid%2F16907842&amp;rft_id=info%3Adoi%2F10.1111%2Fj.1365-2893.2006.00735.x&amp;rft.aulast=Lock&amp;rft.aufirst=G&amp;rft.au=Dirscherl%2C+M&amp;rft.au=Obermeier%2C+F&amp;rft.au=Gelbmann%2C+CM&amp;rft.au=Hellerbrand%2C+C&amp;rft.au=Kn%C3%B6ll%2C+A&amp;rft.au=Sch%C3%B6lmerich%2C+J&amp;rft.au=Jilg%2C+W&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AHepatitis+C" class="Z3988"></span></span> </li> <li id="cite_note-CDC12-66"><span class="mw-cite-backlink">^ <a href="#cite_ref-CDC12_66-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-CDC12_66-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-CDC12_66-2"><sup><i><b>c</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.cdc.gov/hepatitis/HCV/HCVfaq.htm">"Hepatitis C FAQs for Health Professionals"</a>. Centers for Disease Control and Prevention (CDC). <a rel="nofollow" class="external text" href="https://web.archive.org/web/20120104063744/http://www.cdc.gov/hepatitis/hcv/hcvfaq.htm">Archived</a> from the original on 4 January 2012<span class="reference-accessdate">. Retrieved <span class="nowrap">2 January</span> 2012</span>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&amp;rft.genre=unknown&amp;rft.btitle=Hepatitis+C+FAQs+for+Health+Professionals&amp;rft.pub=Centers+for+Disease+Control+and+Prevention+%28CDC%29&amp;rft_id=https%3A%2F%2Fwww.cdc.gov%2Fhepatitis%2FHCV%2FHCVfaq.htm&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AHepatitis+C" class="Z3988"></span></span> </li> <li id="cite_note-67"><span class="mw-cite-backlink"><b><a href="#cite_ref-67">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFWongLee2006" class="citation journal cs1">Wong T, Lee SS (February 2006). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1389829">"Hepatitis C: a review for primary care physicians"</a>. <i>CMAJ</i>. <b>174</b> (5): 649–59. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1503%2Fcmaj.1030034">10.1503/cmaj.1030034</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a>&#160;<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1389829">1389829</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a>&#160;<a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/16505462">16505462</a>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=CMAJ&amp;rft.atitle=Hepatitis+C%3A+a+review+for+primary+care+physicians&amp;rft.volume=174&amp;rft.issue=5&amp;rft.pages=649-59&amp;rft.date=2006-02&amp;rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC1389829%23id-name%3DPMC&amp;rft_id=info%3Apmid%2F16505462&amp;rft_id=info%3Adoi%2F10.1503%2Fcmaj.1030034&amp;rft.aulast=Wong&amp;rft.aufirst=T&amp;rft.au=Lee%2C+SS&amp;rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC1389829&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AHepatitis+C" class="Z3988"></span></span> </li> <li id="cite_note-Rosen2011-68"><span class="mw-cite-backlink">^ <a href="#cite_ref-Rosen2011_68-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Rosen2011_68-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFMarx2010" class="citation book cs1">Marx J (2010). <span class="id-lock-limited" title="Free access subject to limited trial, subscription normally required"><a rel="nofollow" class="external text" href="https://archive.org/details/rosensemergencym00mdjo"><i>Rosen's emergency medicine: concepts and clinical practice</i></a></span> (7th&#160;ed.). Philadelphia, PA: Mosby/Elsevier. p.&#160;<a rel="nofollow" class="external text" href="https://archive.org/details/rosensemergencym00mdjo/page/n1176">1154</a>. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a>&#160;<a href="/wiki/Special:BookSources/978-0-323-05472-0" title="Special:BookSources/978-0-323-05472-0"><bdi>978-0-323-05472-0</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&amp;rft.genre=book&amp;rft.btitle=Rosen%27s+emergency+medicine%3A+concepts+and+clinical+practice&amp;rft.place=Philadelphia%2C+PA&amp;rft.pages=1154&amp;rft.edition=7th&amp;rft.pub=Mosby%2FElsevier&amp;rft.date=2010&amp;rft.isbn=978-0-323-05472-0&amp;rft.aulast=Marx&amp;rft.aufirst=J&amp;rft_id=https%3A%2F%2Farchive.org%2Fdetails%2Frosensemergencym00mdjo&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AHepatitis+C" class="Z3988"></span></span> </li> <li id="cite_note-69"><span class="mw-cite-backlink"><b><a href="#cite_ref-69">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFDayPaulWilliams2009" class="citation book cs1">Day RA, Paul P, Williams B (2009). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=SB_-CRXvZPYC&amp;pg=PA1237"><i>Brunner &amp; Suddarth's textbook of Canadian medical-surgical nursing</i></a> (Canadian 2nd&#160;ed.). Philadelphia, PA: Lippincott Williams &amp; Wilkins. p.&#160;1237. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a>&#160;<a href="/wiki/Special:BookSources/978-0-7817-9989-8" title="Special:BookSources/978-0-7817-9989-8"><bdi>978-0-7817-9989-8</bdi></a>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20160425134413/https://books.google.com/books?id=SB_-CRXvZPYC&amp;pg=PA1237">Archived</a> from the original on 2016-04-25.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&amp;rft.genre=book&amp;rft.btitle=Brunner+%26+Suddarth%27s+textbook+of+Canadian+medical-surgical+nursing&amp;rft.place=Philadelphia%2C+PA&amp;rft.pages=1237&amp;rft.edition=Canadian+2nd&amp;rft.pub=Lippincott+Williams+%26+Wilkins&amp;rft.date=2009&amp;rft.isbn=978-0-7817-9989-8&amp;rft.aulast=Day&amp;rft.aufirst=RA&amp;rft.au=Paul%2C+P&amp;rft.au=Williams%2C+B&amp;rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3DSB_-CRXvZPYC%26pg%3DPA1237&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AHepatitis+C" class="Z3988"></span></span> </li> <li id="cite_note-70"><span class="mw-cite-backlink"><b><a href="#cite_ref-70">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.emro.who.int/media/news/egypt-becomes-the-first-country-to-achieve-who-validation-on-the-path-to-elimination-of-hepatitis-c.html">"Egypt becomes the first country to achieve WHO validation on the path to elimination of hepatitis C"</a>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&amp;rft.genre=unknown&amp;rft.btitle=Egypt+becomes+the+first+country+to+achieve+WHO+validation+on+the+path+to+elimination+of+hepatitis+C&amp;rft_id=https%3A%2F%2Fwww.emro.who.int%2Fmedia%2Fnews%2Fegypt-becomes-the-first-country-to-achieve-who-validation-on-the-path-to-elimination-of-hepatitis-c.html&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AHepatitis+C" class="Z3988"></span></span> </li> <li id="cite_note-Preg10-71"><span class="mw-cite-backlink">^ <a href="#cite_ref-Preg10_71-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Preg10_71-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFLamGotschLangan2010" class="citation journal cs1">Lam NC, Gotsch PB, Langan RC (November 2010). <a rel="nofollow" class="external text" href="http://www.aafp.org/afp/2010/1115/p1225.pdf">"Caring for pregnant women and newborns with hepatitis B or C"</a> <span class="cs1-format">(PDF)</span>. <i>American Family Physician</i>. <b>82</b> (10): 1225–9. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a>&#160;<a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/21121533">21121533</a>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20130521080102/http://www.aafp.org/afp/2010/1115/p1225.pdf">Archived</a> <span class="cs1-format">(PDF)</span> from the original on 2013-05-21.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=American+Family+Physician&amp;rft.atitle=Caring+for+pregnant+women+and+newborns+with+hepatitis+B+or+C&amp;rft.volume=82&amp;rft.issue=10&amp;rft.pages=1225-9&amp;rft.date=2010-11&amp;rft_id=info%3Apmid%2F21121533&amp;rft.aulast=Lam&amp;rft.aufirst=NC&amp;rft.au=Gotsch%2C+PB&amp;rft.au=Langan%2C+RC&amp;rft_id=http%3A%2F%2Fwww.aafp.org%2Fafp%2F2010%2F1115%2Fp1225.pdf&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AHepatitis+C" class="Z3988"></span></span> </li> <li id="cite_note-72"><span class="mw-cite-backlink"><b><a href="#cite_ref-72">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFMast2004" class="citation book cs1">Mast EE (2004). 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Associated Press. 15 May 2007. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20160822072146/http://www.washingtonpost.com/wp-dyn/content/article/2007/05/15/AR2007051500921.html">Archived</a> from the original on 22 August 2016.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=The+Washington+Post&amp;rft.atitle=Spanish+Anesthetist+Infected+Patients&amp;rft.date=2007-05-15&amp;rft_id=https%3A%2F%2Fwww.washingtonpost.com%2Fwp-dyn%2Fcontent%2Farticle%2F2007%2F05%2F15%2FAR2007051500921.html&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AHepatitis+C" class="Z3988"></span></span> </li> <li id="cite_note-152"><span class="mw-cite-backlink"><b><a href="#cite_ref-152">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation news cs1"><a rel="nofollow" class="external text" href="http://news.bbc.co.uk/1/hi/world/europe/6657509.stm">"Spanish Hep C anaesthetist jailed"</a>. <i>BBC</i>. 15 May 2007. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20071023220711/http://news.bbc.co.uk/1/hi/world/europe/6657509.stm">Archived</a> from the original on 23 October 2007.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=BBC&amp;rft.atitle=Spanish+Hep+C+anaesthetist+jailed&amp;rft.date=2007-05-15&amp;rft_id=http%3A%2F%2Fnews.bbc.co.uk%2F1%2Fhi%2Fworld%2Feurope%2F6657509.stm&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AHepatitis+C" class="Z3988"></span></span> </li> <li id="cite_note-Arshad2011-153"><span class="mw-cite-backlink"><b><a href="#cite_ref-Arshad2011_153-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFArshadEl-KamaryJhaveri2011" class="citation journal cs1">Arshad M, El-Kamary SS, Jhaveri R (April 2011). 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id="mwe_player_1" controls="" preload="none" data-mw-tmh="" class="mw-file-element" width="200" style="width:200px;" data-durationhint="141" data-mwtitle="Hep_C_en.ogg" data-mwprovider="wikimediacommons"><source src="//upload.wikimedia.org/wikipedia/commons/3/3a/Hep_C_en.ogg" type="audio/ogg; codecs=&quot;vorbis&quot;" data-width="0" data-height="0" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/3/3a/Hep_C_en.ogg/Hep_C_en.ogg.mp3" type="audio/mpeg" data-transcodekey="mp3" data-width="0" data-height="0" /></audio></span><figcaption></figcaption></figure> </div><div class="spoken-wikipedia-icon"><span typeof="mw:File"><span title="Spoken Wikipedia"><img alt="Spoken Wikipedia icon" src="//upload.wikimedia.org/wikipedia/commons/thumb/4/47/Sound-icon.svg/45px-Sound-icon.svg.png" decoding="async" width="45" height="34" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/4/47/Sound-icon.svg/68px-Sound-icon.svg.png 1.5x, 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Testing, Managing, and Treating Hepatitis C"</a>. 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U.S. National Library of Medicine.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=unknown&amp;rft.jtitle=MedlinePlus&amp;rft.atitle=Hepatitis+C&amp;rft_id=https%3A%2F%2Fmedlineplus.gov%2Fhepatitisc.html&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AHepatitis+C" class="Z3988"></span></li></ul> <div class="navbox-styles"><style data-mw-deduplicate="TemplateStyles:r1236075235">.mw-parser-output .navbox{box-sizing:border-box;border:1px solid #a2a9b1;width:100%;clear:both;font-size:88%;text-align:center;padding:1px;margin:1em auto 0}.mw-parser-output .navbox .navbox{margin-top:0}.mw-parser-output .navbox+.navbox,.mw-parser-output .navbox+.navbox-styles+.navbox{margin-top:-1px}.mw-parser-output .navbox-inner,.mw-parser-output .navbox-subgroup{width:100%}.mw-parser-output .navbox-group,.mw-parser-output .navbox-title,.mw-parser-output .navbox-abovebelow{padding:0.25em 1em;line-height:1.5em;text-align:center}.mw-parser-output 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class="external text" href="https://icd.who.int/browse10/2019/en#/B17.1">B17.1</a>, <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/B18.2">B18.2</a></li><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/List_of_ICD-9_codes" title="List of ICD-9 codes">9-CM</a></b>: <a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=070.70">070.70</a>,<a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=070.4">070.4</a>, <a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=070.5">070.5</a></li><li><b><a href="/wiki/Online_Mendelian_Inheritance_in_Man" title="Online Mendelian Inheritance in Man">OMIM</a></b>: <a rel="nofollow" class="external text" href="https://omim.org/entry/609532">609532</a></li><li><b><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a></b>: <a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D006526">D006526</a></li><li><b><a href="/wiki/Diseases_Database" title="Diseases Database">DiseasesDB</a></b>: <a rel="nofollow" class="external text" href="http://www.diseasesdatabase.com/ddb5783.htm">5783</a></li><li><b><a href="/wiki/SNOMED_CT" title="SNOMED CT">SNOMED CT</a></b>: <a rel="nofollow" class="external text" href="http://snomed.info/id/186643004">186643004</a></li></ul></div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">External resources</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/MedlinePlus" title="MedlinePlus">MedlinePlus</a></b>: <a rel="nofollow" class="external text" href="https://www.nlm.nih.gov/medlineplus/ency/article/000284.htm">000284</a></li><li><b><a href="/wiki/EMedicine" title="EMedicine">eMedicine</a></b>: <a rel="nofollow" class="external text" href="https://emedicine.medscape.com/med/993-overview">med/993</a> <a rel="nofollow" class="external text" href="https://www.emedicine.com/ped/topic979.htm#">ped/979</a></li><li><b><a href="/wiki/Patient_UK" title="Patient UK">Patient UK</a></b>: <a rel="nofollow" class="external text" href="https://patient.info/doctor/hepatitis-c-pro">Hepatitis C</a></li></ul></div></div></td></tr></tbody></table></div> <style data-mw-deduplicate="TemplateStyles:r1130092004">.mw-parser-output .portal-bar{font-size:88%;font-weight:bold;display:flex;justify-content:center;align-items:baseline}.mw-parser-output .portal-bar-bordered{padding:0 2em;background-color:#fdfdfd;border:1px solid #a2a9b1;clear:both;margin:1em auto 0}.mw-parser-output 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style="padding:0 0.25em"> <dl><dt><a href="/wiki/DNA_virus" title="DNA virus">DNA virus</a></dt> <dd><i><a href="/wiki/Hepatitis_B_virus" title="Hepatitis B virus">HBV</a></i> <dl><dd><a href="/wiki/Hepatocellular_carcinoma" title="Hepatocellular carcinoma">Hepatocellular carcinoma</a></dd></dl></dd> <dd><i><a href="/wiki/Papillomaviridae" title="Papillomaviridae">HPV</a></i> <dl><dd><a href="/wiki/Cervical_cancer" title="Cervical cancer">Cervical cancer</a></dd> <dd><a href="/wiki/Anal_cancer" title="Anal cancer">Anal cancer</a></dd> <dd><a href="/wiki/Penile_cancer" title="Penile cancer">Penile cancer</a></dd> <dd><a href="/wiki/Vulvar_cancer" title="Vulvar cancer">Vulvar cancer</a></dd> <dd><a href="/wiki/Vaginal_cancer" title="Vaginal cancer">Vaginal cancer</a></dd> <dd><a href="/wiki/HPV-positive_oropharyngeal_cancer" title="HPV-positive oropharyngeal cancer">Oropharyngeal cancer</a></dd></dl></dd> <dd><i><a href="/wiki/Kaposi%27s_sarcoma-associated_herpesvirus" title="Kaposi&#39;s sarcoma-associated herpesvirus">KSHV</a></i> <dl><dd><a href="/wiki/Kaposi%27s_sarcoma" title="Kaposi&#39;s sarcoma">Kaposi's sarcoma</a></dd></dl></dd> <dd><i><a href="/wiki/Epstein%E2%80%93Barr_virus" title="Epstein–Barr virus">EBV</a></i> <dl><dd><a href="/wiki/Nasopharyngeal_carcinoma" title="Nasopharyngeal carcinoma">Nasopharyngeal carcinoma</a></dd> <dd><a href="/wiki/Burkitt%27s_lymphoma" class="mw-redirect" title="Burkitt&#39;s lymphoma">Burkitt's lymphoma</a></dd> <dd><a href="/wiki/Hodgkin_lymphoma" title="Hodgkin lymphoma">Hodgkin lymphoma</a></dd> <dd><a href="/wiki/Follicular_dendritic_cell_sarcoma" title="Follicular dendritic cell sarcoma">Follicular dendritic cell sarcoma</a></dd> <dd><a href="/wiki/Extranodal_NK/T-cell_lymphoma,_nasal_type" title="Extranodal NK/T-cell lymphoma, nasal type">Extranodal NK/T-cell lymphoma, nasal type</a></dd></dl></dd> <dd><i><a href="/wiki/Merkel_cell_polyomavirus" title="Merkel cell polyomavirus">MCPyV</a></i> <dl><dd><a href="/wiki/Merkel-cell_carcinoma" title="Merkel-cell carcinoma">Merkel-cell carcinoma</a></dd></dl></dd></dl> <dl><dt><a href="/wiki/RNA_virus" title="RNA virus">RNA virus</a></dt> <dd><i><a href="/wiki/Hepatitis_C_virus" title="Hepatitis C virus">HCV</a></i> <dl><dd><a href="/wiki/Hepatocellular_carcinoma" title="Hepatocellular carcinoma">Hepatocellular carcinoma</a></dd> <dd><a href="/wiki/Splenic_marginal_zone_lymphoma" title="Splenic marginal zone lymphoma">Splenic marginal zone lymphoma</a></dd></dl></dd> <dd><i><a href="/wiki/Human_T-lymphotropic_virus_1" title="Human T-lymphotropic virus 1">HTLV-I</a></i> <dl><dd><a href="/wiki/Adult_T-cell_leukemia/lymphoma" title="Adult T-cell leukemia/lymphoma">Adult T-cell leukemia/lymphoma</a></dd></dl></dd></dl> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Immune_disorder" title="Immune disorder">Immune disorders</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/HIV" title="HIV">HIV</a></i> <ul><li><a href="/wiki/HIV/AIDS" title="HIV/AIDS">AIDS</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Central_nervous_system_viral_disease" title="Central nervous system viral disease">Central<br /> nervous system</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Viral_encephalitis" title="Viral encephalitis">Encephalitis</a>/<br /><a href="/wiki/Viral_meningitis" title="Viral meningitis">meningitis</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <dl><dt><a href="/wiki/DNA_virus" title="DNA virus">DNA virus</a></dt> <dd><i><a href="/wiki/Human_polyomavirus_2" title="Human polyomavirus 2">Human polyomavirus 2</a></i> <dl><dd><a href="/wiki/Progressive_multifocal_leukoencephalopathy" title="Progressive multifocal leukoencephalopathy">Progressive multifocal leukoencephalopathy</a></dd></dl></dd></dl> <dl><dt><a href="/wiki/RNA_virus" title="RNA virus">RNA virus</a></dt> <dd><i><a href="/wiki/Measles_morbillivirus" class="mw-redirect" title="Measles morbillivirus">MeV</a></i> <dl><dd><a href="/wiki/Subacute_sclerosing_panencephalitis" title="Subacute sclerosing panencephalitis">Subacute sclerosing panencephalitis</a></dd></dl></dd> <dd><i><a href="/wiki/Lymphocytic_choriomeningitis" title="Lymphocytic choriomeningitis">LCV</a></i> <dl><dd><a href="/wiki/Lymphocytic_choriomeningitis" title="Lymphocytic choriomeningitis">Lymphocytic choriomeningitis</a></dd></dl></dd> <dd><a href="/wiki/Arbovirus_encephalitis" class="mw-redirect" title="Arbovirus encephalitis">Arbovirus encephalitis</a></dd> <dd><i><a href="/wiki/Orthomyxoviridae" title="Orthomyxoviridae">Orthomyxoviridae</a></i> (probable) <dl><dd><a href="/wiki/Encephalitis_lethargica" title="Encephalitis lethargica">Encephalitis lethargica</a></dd></dl></dd> <dd><i><a href="/wiki/Rabies_virus" title="Rabies virus">RV</a></i> <dl><dd><a href="/wiki/Rabies" title="Rabies">Rabies</a></dd></dl></dd> <dd><a href="/wiki/Chandipura_vesiculovirus" title="Chandipura vesiculovirus">Chandipura vesiculovirus</a></dd> <dd><a href="/wiki/Herpesviral_meningitis" class="mw-redirect" title="Herpesviral meningitis">Herpesviral meningitis</a></dd> <dd><a href="/wiki/Ramsay_Hunt_syndrome_type_2" title="Ramsay Hunt syndrome type 2">Ramsay Hunt syndrome type 2</a></dd></dl> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Myelitis" title="Myelitis">Myelitis</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Poliovirus" title="Poliovirus">Poliovirus</a></i> <ul><li><a href="/wiki/Polio" title="Polio">Poliomyelitis</a></li> <li><a href="/wiki/Post-polio_syndrome" title="Post-polio syndrome">Post-polio syndrome</a></li></ul></li> <li><i><a href="/wiki/Human_T-lymphotropic_virus_1" title="Human T-lymphotropic virus 1">HTLV-I</a></i> <ul><li><a href="/wiki/Tropical_spastic_paraparesis" title="Tropical spastic paraparesis">Tropical spastic paraparesis</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Eye_disease" title="Eye disease">Eye</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Cytomegalovirus" title="Cytomegalovirus">Cytomegalovirus</a></i> <ul><li><a href="/wiki/Cytomegalovirus_retinitis" title="Cytomegalovirus retinitis">Cytomegalovirus retinitis</a></li></ul></li> <li><i><a href="/wiki/Herpes_simplex_virus" title="Herpes simplex virus">HSV</a></i> <ul><li><a href="/wiki/Herpes_simplex_keratitis" title="Herpes simplex keratitis">Herpes of the eye</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Cardiovascular_disease" title="Cardiovascular disease">Cardiovascular</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Coxsackie_B_virus" title="Coxsackie B virus">CBV</a></i> <ul><li><a href="/wiki/Pericarditis" title="Pericarditis">Pericarditis</a></li> <li><a href="/wiki/Myocarditis" title="Myocarditis">Myocarditis</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Respiratory_system" title="Respiratory system">Respiratory system</a>/<br /><a href="/wiki/Common_cold" title="Common cold">acute viral<br />nasopharyngitis</a>/<br /><a href="/wiki/Viral_pneumonia" title="Viral pneumonia">viral pneumonia</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/DNA_virus" title="DNA virus">DNA virus</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Epstein%E2%80%93Barr_virus" title="Epstein–Barr virus">Epstein–Barr virus</a></i> <ul><li><a href="/wiki/Epstein%E2%80%93Barr_virus_infection" title="Epstein–Barr virus infection">EBV infection</a>/<a href="/wiki/Infectious_mononucleosis" title="Infectious mononucleosis">Infectious mononucleosis</a></li></ul></li> <li><i><a href="/wiki/Cytomegalovirus" title="Cytomegalovirus">Cytomegalovirus</a></i></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/RNA_virus" title="RNA virus">RNA virus</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/RNA_virus#Group_IV_–_positive-sense_ssRNA_viruses" title="RNA virus">IV</a>: <i><a href="/wiki/Human_coronavirus" class="mw-redirect" title="Human coronavirus">Human coronavirus</a> <a href="/wiki/Human_coronavirus_229E" title="Human coronavirus 229E">229E</a>/<a href="/wiki/Human_coronavirus_NL63" title="Human coronavirus NL63">NL63</a>/<a href="/wiki/Human_coronavirus_HKU1" title="Human coronavirus HKU1">HKU1</a>/<a href="/wiki/Human_coronavirus_OC43" title="Human coronavirus OC43">OC43</a></i> <ul><li><a href="/wiki/Common_cold" title="Common cold">Common cold</a></li></ul></li> <li><i><a href="/wiki/Middle_East_respiratory_syndrome%E2%80%93related_coronavirus" class="mw-redirect" title="Middle East respiratory syndrome–related coronavirus">MERS coronavirus</a></i> <ul><li><a href="/wiki/Middle_East_respiratory_syndrome" class="mw-redirect" title="Middle East respiratory syndrome">Middle East respiratory syndrome</a></li></ul></li> <li><i><a href="/wiki/Severe_acute_respiratory_syndrome_coronavirus" class="mw-redirect" title="Severe acute respiratory syndrome coronavirus">SARS coronavirus</a></i> <ul><li><a href="/wiki/Severe_acute_respiratory_syndrome" class="mw-redirect" title="Severe acute respiratory syndrome">Severe acute respiratory syndrome</a></li></ul></li> <li><i><a href="/wiki/SARS-CoV-2" title="SARS-CoV-2">SARS-CoV-2</a></i> <ul><li><a href="/wiki/COVID-19" title="COVID-19">COVID-19</a></li></ul></li></ul> <ul><li><a href="/wiki/RNA_virus#Group_V_–_negative-sense_ssRNA_viruses" title="RNA virus">V</a>, <i><a href="/wiki/Orthomyxoviridae" title="Orthomyxoviridae">Orthomyxoviridae</a></i>: <i><a href="/wiki/Influenza_A_virus" title="Influenza A virus">Influenza virus A</a>/<a href="/wiki/Influenza_B_virus" title="Influenza B virus">B</a>/<a href="/wiki/Influenza_C_virus" title="Influenza C virus">C</a>/<a href="/wiki/Influenza_D_virus" title="Influenza D virus">D</a></i> <ul><li><a href="/wiki/Influenza" title="Influenza">Influenza</a>/<a href="/wiki/Avian_influenza" title="Avian influenza">Avian influenza</a></li></ul></li></ul> <ul><li>V, <i><a href="/wiki/Paramyxoviridae" title="Paramyxoviridae">Paramyxoviridae</a></i>: <i><a href="/wiki/Human_parainfluenza_viruses" title="Human parainfluenza viruses">Human parainfluenza viruses</a></i> <ul><li><a href="/wiki/Human_parainfluenza_viruses" title="Human parainfluenza viruses">Parainfluenza</a></li></ul></li> <li><i><a href="/wiki/Human_orthopneumovirus" class="mw-redirect" title="Human orthopneumovirus">Human orthopneumovirus</a></i></li> <li><i><a href="/wiki/Human_metapneumovirus" title="Human metapneumovirus">hMPV</a></i></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Human_digestive_system" title="Human digestive system">Human<br /> digestive system</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Pharynx" title="Pharynx">Pharynx</a>/<a href="/wiki/Esophagus" title="Esophagus">Esophagus</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Mumps_virus" title="Mumps virus">MuV</a></i> <ul><li><a href="/wiki/Mumps" title="Mumps">Mumps</a></li></ul></li> <li><i><a href="/wiki/Cytomegalovirus" title="Cytomegalovirus">Cytomegalovirus</a></i> <ul><li><a href="/wiki/Cytomegalovirus_esophagitis" title="Cytomegalovirus esophagitis">Cytomegalovirus esophagitis</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Gastroenteritis#Viral" title="Gastroenteritis">Gastroenteritis</a>/<br /><a href="/wiki/Gastroenteritis#Virus" title="Gastroenteritis">diarrhea</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <dl><dt><a href="/wiki/DNA_virus" title="DNA virus">DNA virus</a></dt> <dd><i><a href="/wiki/Adenoviridae" title="Adenoviridae">Adenovirus</a></i> <dl><dd><a href="/wiki/Adenovirus_infection" title="Adenovirus infection">Adenovirus infection</a></dd></dl></dd></dl> <dl><dt><a href="/wiki/RNA_virus" title="RNA virus">RNA virus</a></dt> <dd><i><a href="/wiki/Rotavirus" title="Rotavirus">Rotavirus</a></i> (<a href="/wiki/Rotaviral_gastroenteritis" class="mw-redirect" title="Rotaviral gastroenteritis">Gastroenteritis</a>)</dd> <dd><i><a href="/wiki/Norovirus" title="Norovirus">Norovirus</a></i></dd> <dd><i><a href="/wiki/Astrovirus" title="Astrovirus">Astrovirus</a></i></dd> <dd><i><a href="/wiki/Coronavirus" title="Coronavirus">Coronavirus</a></i></dd></dl> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Viral_hepatitis" title="Viral hepatitis">Hepatitis</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <dl><dt><a href="/wiki/DNA_virus" title="DNA virus">DNA virus</a></dt> <dd><i><a href="/wiki/Hepatitis_B_virus" title="Hepatitis B virus">HBV</a></i> (<a href="/wiki/Hepatitis_B" title="Hepatitis B">B</a>)</dd></dl> <dl><dt><a href="/wiki/RNA_virus" title="RNA virus">RNA virus</a></dt> <dd><i><a href="/wiki/Coxsackie_B_virus" title="Coxsackie B virus">CBV</a></i></dd> <dd><i><a href="/wiki/Hepatitis_A#Virology" title="Hepatitis A">HAV</a></i> (<a href="/wiki/Hepatitis_A" title="Hepatitis A">A</a>)</dd> <dd><i><a href="/wiki/Hepatitis_C_virus" title="Hepatitis C virus">HCV</a></i> (<a class="mw-selflink selflink">C</a>)</dd> <dd><i><a href="/wiki/Hepatitis_D" title="Hepatitis D">HDV</a></i> (<a href="/wiki/Hepatitis_D" title="Hepatitis D">D</a>)</dd> <dd><i><a href="/wiki/Orthohepevirus_A" title="Orthohepevirus A">HEV</a></i> (<a href="/wiki/Hepatitis_E" title="Hepatitis E">E</a>)</dd></dl> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Pancreatitis" title="Pancreatitis">Pancreatitis</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Coxsackie_B_virus" title="Coxsackie B virus">CBV</a></i></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Genitourinary_system" title="Genitourinary system">Urogenital</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/BK_virus" title="BK virus">BK virus</a></i></li> <li><i><a href="/wiki/Mumps_virus" title="Mumps virus">MuV</a></i> <ul><li><a href="/wiki/Mumps" title="Mumps">Mumps</a></li></ul></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Diseases_of_the_human_digestive_system" style="padding:3px"><table class="nowraplinks mw-collapsible mw-collapsed navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Digestive_system_diseases" title="Template:Digestive system diseases"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Digestive_system_diseases" title="Template talk:Digestive system diseases"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Digestive_system_diseases" title="Special:EditPage/Template:Digestive system diseases"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Diseases_of_the_human_digestive_system" style="font-size:114%;margin:0 4em">Diseases of the <a href="/wiki/Human_digestive_system" title="Human digestive system">human digestive system</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Gastrointestinal_tract#Upper_gastrointestinal_tract" title="Gastrointestinal tract">Upper GI tract</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Esophageal_disease" title="Esophageal disease">Esophagus</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Esophagitis" title="Esophagitis">Esophagitis</a> <ul><li><a href="/wiki/Esophageal_candidiasis" title="Esophageal candidiasis">Candidal</a></li> <li><a href="/wiki/Eosinophilic_esophagitis" title="Eosinophilic esophagitis">Eosinophilic</a></li> <li><a href="/wiki/Herpetiform_esophagitis" class="mw-redirect" title="Herpetiform esophagitis">Herpetiform</a></li></ul></li> <li><i>Rupture</i> <ul><li><a href="/wiki/Boerhaave_syndrome" class="mw-redirect" title="Boerhaave syndrome">Boerhaave syndrome</a></li> <li><a href="/wiki/Mallory%E2%80%93Weiss_syndrome" title="Mallory–Weiss syndrome">Mallory–Weiss syndrome</a></li></ul></li> <li><a href="/wiki/Zenker%27s_diverticulum" title="Zenker&#39;s diverticulum">Zenker's diverticulum</a></li> <li><a href="/wiki/Barrett%27s_esophagus" title="Barrett&#39;s esophagus">Barrett's esophagus</a></li> <li><a href="/wiki/Esophageal_motility_disorder" title="Esophageal motility disorder">Esophageal motility disorder</a> <ul><li><a href="/wiki/Nutcracker_esophagus" title="Nutcracker esophagus">Nutcracker esophagus</a></li> <li><a href="/wiki/Achalasia" class="mw-redirect" title="Achalasia">Achalasia</a></li> <li><a href="/wiki/Esophagogastric_junction_outflow_obstruction" title="Esophagogastric junction outflow obstruction">Esophagogastric junction outflow obstruction</a></li> <li><a href="/wiki/Diffuse_esophageal_spasm" title="Diffuse esophageal spasm">Diffuse esophageal spasm</a></li> <li><a href="/wiki/Gastroesophageal_reflux_disease" title="Gastroesophageal reflux disease">Gastroesophageal reflux disease</a> (GERD)</li></ul></li> <li><a href="/wiki/Laryngopharyngeal_reflux" title="Laryngopharyngeal reflux">Laryngopharyngeal reflux</a> (LPR)</li> <li><a href="/wiki/Esophageal_stricture" title="Esophageal stricture">Esophageal stricture</a></li> <li><a href="/wiki/Esophageal_inlet_patch" title="Esophageal inlet patch">Inlet patch</a></li> <li><a href="/wiki/Megaesophagus" title="Megaesophagus">Megaesophagus</a></li> <li><a href="/wiki/Esophageal_intramural_pseudodiverticulosis" title="Esophageal intramural pseudodiverticulosis">Esophageal intramural pseudodiverticulosis</a></li> <li><a href="/wiki/Acute_esophageal_necrosis" title="Acute esophageal necrosis">Acute esophageal necrosis</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Stomach_disease" title="Stomach disease">Stomach</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Gastritis" title="Gastritis">Gastritis</a> <ul><li><a href="/wiki/Atrophic_gastritis" title="Atrophic gastritis">Atrophic</a></li> <li><a href="/wiki/M%C3%A9n%C3%A9trier%27s_disease" title="Ménétrier&#39;s disease">Ménétrier's disease</a></li> <li><a href="/wiki/Gastroenteritis" title="Gastroenteritis">Gastroenteritis</a></li></ul></li> <li><a href="/wiki/Peptic_ulcer" class="mw-redirect" title="Peptic ulcer">Peptic (gastric) ulcer</a> <ul><li><a href="/wiki/Cushing_ulcer" title="Cushing ulcer">Cushing ulcer</a></li> <li><a href="/wiki/Dieulafoy%27s_lesion" title="Dieulafoy&#39;s lesion">Dieulafoy's lesion</a></li></ul></li> <li><a href="/wiki/Dyspepsia" class="mw-redirect" title="Dyspepsia">Dyspepsia</a> <ul><li><a href="/wiki/Functional_dyspepsia" title="Functional dyspepsia">Functional dyspepsia</a></li></ul></li> <li><a href="/wiki/Pyloric_stenosis" title="Pyloric stenosis">Pyloric stenosis</a></li> <li><a href="/wiki/Achlorhydria" title="Achlorhydria">Achlorhydria</a></li> <li><a href="/wiki/Gastroparesis" title="Gastroparesis">Gastroparesis</a></li> <li><a href="/wiki/Gastroptosis" title="Gastroptosis">Gastroptosis</a></li> <li><a href="/wiki/Portal_hypertensive_gastropathy" title="Portal hypertensive gastropathy">Portal hypertensive gastropathy</a></li> <li><a href="/wiki/Gastric_antral_vascular_ectasia" title="Gastric antral vascular ectasia">Gastric antral vascular ectasia</a></li> <li><a href="/wiki/Gastric_dumping_syndrome" class="mw-redirect" title="Gastric dumping syndrome">Gastric dumping syndrome</a></li> <li><a href="/wiki/Gastric_volvulus" title="Gastric volvulus">Gastric volvulus</a></li> <li><a href="/wiki/Buried_bumper_syndrome" title="Buried bumper syndrome">Buried bumper syndrome</a></li> <li><a href="/wiki/Gastrinoma" title="Gastrinoma">Gastrinoma</a> <ul><li><a href="/wiki/Zollinger%E2%80%93Ellison_syndrome" title="Zollinger–Ellison syndrome">Zollinger–Ellison syndrome</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Gastrointestinal_tract#Lower_gastrointestinal_tract" title="Gastrointestinal tract">Lower GI tract</a> <br /> <a href="/wiki/Enteropathy" title="Enteropathy">Enteropathy</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Small_intestine" title="Small intestine">Small intestine</a> <br /> (<a href="/wiki/Duodenum" title="Duodenum">Duodenum</a>/<a href="/wiki/Jejunum" title="Jejunum">Jejunum</a>/<a href="/wiki/Ileum" title="Ileum">Ileum</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Enteritis" title="Enteritis">Enteritis</a> <ul><li><a href="/wiki/Duodenitis" title="Duodenitis">Duodenitis</a></li> <li><a href="/wiki/Jejunitis" title="Jejunitis">Jejunitis</a></li> <li><a href="/wiki/Ileitis" title="Ileitis">Ileitis</a></li></ul></li> <li><a href="/wiki/Peptic_ulcer" class="mw-redirect" title="Peptic ulcer">Peptic (duodenal) ulcer</a> <ul><li><a href="/wiki/Curling%27s_ulcer" title="Curling&#39;s ulcer">Curling's ulcer</a></li></ul></li> <li><a href="/wiki/Malabsorption" title="Malabsorption">Malabsorption</a>: <a href="/wiki/Coeliac_disease" title="Coeliac disease">Coeliac</a></li> <li><a href="/wiki/Tropical_sprue" title="Tropical sprue">Tropical sprue</a></li> <li><a href="/wiki/Blind_loop_syndrome" title="Blind loop syndrome">Blind loop syndrome</a></li> <li><a href="/wiki/Small_intestinal_bacterial_overgrowth" title="Small intestinal bacterial overgrowth">Small intestinal bacterial overgrowth</a></li> <li><a href="/wiki/Whipple%27s_disease" title="Whipple&#39;s disease">Whipple's</a></li> <li><a href="/wiki/Short_bowel_syndrome" title="Short bowel syndrome">Short bowel syndrome</a></li> <li><a href="/wiki/Steatorrhea" title="Steatorrhea">Steatorrhea</a></li> <li><a href="/wiki/Milroy_disease" class="mw-redirect" title="Milroy disease">Milroy disease</a></li> <li><a href="/wiki/Bile_acid_malabsorption" title="Bile acid malabsorption">Bile acid malabsorption</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Large_intestine" title="Large intestine">Large intestine</a> <br /> (<a href="/wiki/Vermiform_appendix" class="mw-redirect" title="Vermiform appendix">Appendix</a>/<a href="/wiki/Colon_(anatomy)" class="mw-redirect" title="Colon (anatomy)">Colon</a>)</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Appendicitis" title="Appendicitis">Appendicitis</a></li> <li><a href="/wiki/Colitis" title="Colitis">Colitis</a> <ul><li><a href="/wiki/Pseudomembranous_colitis" class="mw-redirect" title="Pseudomembranous colitis">Pseudomembranous</a></li> <li><a href="/wiki/Ulcerative_colitis" title="Ulcerative colitis">Ulcerative</a></li> <li><a href="/wiki/Ischemic_colitis" title="Ischemic colitis">Ischemic</a></li> <li><a href="/wiki/Microscopic_colitis" title="Microscopic colitis">Microscopic</a></li> <li><a href="/wiki/Collagenous_colitis" title="Collagenous colitis">Collagenous</a></li> <li><a href="/wiki/Lymphocytic_colitis" title="Lymphocytic colitis">Lymphocytic</a></li></ul></li> <li><a href="/wiki/Dysentery" title="Dysentery">Dysentery</a></li> <li><a href="/wiki/Functional_colonic_disease" class="mw-redirect" title="Functional colonic disease">Functional colonic disease</a> <ul><li><a href="/wiki/Irritable_bowel_syndrome" title="Irritable bowel syndrome">IBS</a></li> <li><a href="/wiki/Intestinal_pseudoobstruction" class="mw-redirect" title="Intestinal pseudoobstruction">Intestinal pseudoobstruction</a>&#160;/ <a href="/wiki/Ogilvie_syndrome" title="Ogilvie syndrome">Ogilvie syndrome</a></li></ul></li> <li><a href="/wiki/Megacolon" title="Megacolon">Megacolon</a>&#160;/ <a href="/wiki/Toxic_megacolon" title="Toxic megacolon">Toxic megacolon</a></li> <li><a href="/wiki/Diverticulitis" title="Diverticulitis">Diverticulitis</a>/<a href="/wiki/Diverticulosis" title="Diverticulosis">Diverticulosis</a>/<a href="/wiki/Segmental_colitis_associated_with_diverticulosis" title="Segmental colitis associated with diverticulosis">SCAD</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Large and/or small</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Enterocolitis" title="Enterocolitis">Enterocolitis</a> <ul><li><a href="/wiki/Necrotizing_enterocolitis" title="Necrotizing enterocolitis">Necrotizing</a></li></ul></li> <li><a href="/wiki/Gastroenterocolitis" title="Gastroenterocolitis">Gastroenterocolitis</a></li> <li><a href="/wiki/Inflammatory_bowel_disease" title="Inflammatory bowel disease">IBD</a> <ul><li><a href="/wiki/Crohn%27s_disease" title="Crohn&#39;s disease">Crohn's disease</a></li></ul></li> <li><i><a href="/wiki/Vascular_disease" title="Vascular disease">Vascular</a></i>: <a href="/wiki/Abdominal_angina" title="Abdominal angina">Abdominal angina</a></li> <li><a href="/wiki/Mesenteric_ischemia" class="mw-redirect" title="Mesenteric ischemia">Mesenteric ischemia</a></li> <li><a href="/wiki/Angiodysplasia" title="Angiodysplasia">Angiodysplasia</a></li> <li><a href="/wiki/Bowel_obstruction" title="Bowel obstruction">Bowel obstruction</a>: <a href="/wiki/Ileus" title="Ileus">Ileus</a></li> <li><a href="/wiki/Intussusception_(medical_disorder)" title="Intussusception (medical disorder)">Intussusception</a></li> <li><a href="/wiki/Volvulus" title="Volvulus">Volvulus</a></li> <li><a href="/wiki/Fecal_impaction" title="Fecal impaction">Fecal impaction</a></li> <li><a href="/wiki/Constipation" title="Constipation">Constipation</a> <ul><li><a href="/wiki/Functional_constipation" title="Functional constipation">Functional</a></li></ul></li> <li><a href="/wiki/Diarrhea" title="Diarrhea">Diarrhea</a> <ul><li><a href="/wiki/Infectious_diarrhea" class="mw-redirect" title="Infectious diarrhea">Infectious</a></li></ul></li> <li><a href="/wiki/Adhesion_(medicine)" title="Adhesion (medicine)">Intestinal adhesions</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Rectum" title="Rectum">Rectum</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Proctitis" title="Proctitis">Proctitis</a> <ul><li><a href="/wiki/Radiation_proctitis" title="Radiation proctitis">Radiation proctitis</a></li></ul></li> <li><a href="/wiki/Proctalgia_fugax" title="Proctalgia fugax">Proctalgia fugax</a></li> <li><a href="/wiki/Rectal_prolapse" title="Rectal prolapse">Rectal prolapse</a></li> <li><a href="/wiki/Anismus" title="Anismus">Anismus</a></li> <li><a href="/wiki/Solitary_rectal_ulcer_syndrome" title="Solitary rectal ulcer syndrome">Solitary rectal ulcer syndrome</a></li> <li><a href="/wiki/Rectal_stricture" title="Rectal stricture">Rectal stricture</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Anal_canal" title="Anal canal">Anal canal</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Anal_fissure" title="Anal fissure">Anal fissure</a>/<a href="/wiki/Anal_fistula" title="Anal fistula">Anal fistula</a></li> <li><a href="/wiki/Anal_abscess" class="mw-redirect" title="Anal abscess">Anal abscess</a></li> <li><a href="/wiki/Hemorrhoid" title="Hemorrhoid">Hemorrhoid</a></li> <li><a href="/wiki/Anal_dysplasia" title="Anal dysplasia">Anal dysplasia</a></li> <li><a href="/wiki/Pruritus_ani" title="Pruritus ani">Pruritus ani</a></li> <li><a href="/wiki/Anal_stricture" title="Anal stricture">Anal stricture</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Gastrointestinal_bleeding" title="Gastrointestinal bleeding">GI bleeding</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Blood_in_stool" title="Blood in stool">Blood in stool</a></li> <li><a href="/wiki/Upper_gastrointestinal_bleeding" title="Upper gastrointestinal bleeding">Upper</a> <ul><li><a href="/wiki/Hematemesis" title="Hematemesis">Hematemesis</a></li> <li><a href="/wiki/Melena" title="Melena">Melena</a></li></ul></li> <li><a href="/wiki/Lower_gastrointestinal_bleeding" title="Lower gastrointestinal bleeding">Lower</a> <ul><li><a href="/wiki/Hematochezia" title="Hematochezia">Hematochezia</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Accessory_digestive_gland" class="mw-redirect" title="Accessory digestive gland">Accessory</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Liver_disease" title="Liver disease">Liver</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Hepatitis" title="Hepatitis">Hepatitis</a> <ul><li><a href="/wiki/Viral_hepatitis" title="Viral hepatitis">Viral hepatitis</a></li> <li><a href="/wiki/Autoimmune_hepatitis" title="Autoimmune hepatitis">Autoimmune hepatitis</a></li> <li><a href="/wiki/Alcoholic_hepatitis" title="Alcoholic hepatitis">Alcoholic hepatitis</a></li></ul></li> <li><a href="/wiki/Cirrhosis" title="Cirrhosis">Cirrhosis</a> <ul><li><a href="/wiki/Primary_biliary_cirrhosis" class="mw-redirect" title="Primary biliary cirrhosis">PBC</a></li></ul></li> <li><a href="/wiki/Fatty_liver" class="mw-redirect" title="Fatty liver">Fatty liver</a> <ul><li><a href="/wiki/Metabolic_dysfunction%E2%80%93associated_steatotic_liver_disease" title="Metabolic dysfunction–associated steatotic liver disease">MASLD</a></li></ul></li> <li><i><a href="/wiki/Vascular_disease" title="Vascular disease">Vascular</a></i> <ul><li><a href="/wiki/Budd%E2%80%93Chiari_syndrome" title="Budd–Chiari syndrome">Budd–Chiari syndrome</a></li> <li><a href="/wiki/Hepatic_veno-occlusive_disease" title="Hepatic veno-occlusive disease">Hepatic veno-occlusive disease</a></li> <li><a href="/wiki/Portal_hypertension" title="Portal hypertension">Portal hypertension</a></li> <li><a href="/wiki/Nutmeg_liver" class="mw-redirect" title="Nutmeg liver">Nutmeg liver</a></li></ul></li> <li><a href="/wiki/Alcoholic_liver_disease" title="Alcoholic liver disease">Alcoholic liver disease</a></li> <li><a href="/wiki/Liver_failure" title="Liver failure">Liver failure</a> <ul><li><a href="/wiki/Hepatic_encephalopathy" title="Hepatic encephalopathy">Hepatic encephalopathy</a></li> <li><a href="/wiki/Acute_liver_failure" title="Acute liver failure">Acute liver failure</a></li></ul></li> <li><a href="/wiki/Liver_abscess" title="Liver abscess">Liver abscess</a> <ul><li><a href="/wiki/Pyogenic_liver_abscess" title="Pyogenic liver abscess">Pyogenic</a></li> <li><a href="/wiki/Amoebic_liver_abscess" title="Amoebic liver abscess">Amoebic</a></li></ul></li> <li><a href="/wiki/Hepatorenal_syndrome" title="Hepatorenal syndrome">Hepatorenal syndrome</a></li> <li><a href="/wiki/Peliosis_hepatis" title="Peliosis hepatis">Peliosis hepatis</a></li> <li><a href="/wiki/Metabolic_disorder" title="Metabolic disorder">Metabolic disorders</a> <ul><li><a href="/wiki/Wilson%27s_disease" title="Wilson&#39;s disease">Wilson's disease</a></li> <li><a href="/wiki/Hemochromatosis" class="mw-redirect" title="Hemochromatosis">Hemochromatosis</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Gallbladder_disease" title="Gallbladder disease">Gallbladder</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cholecystitis" title="Cholecystitis">Cholecystitis</a></li> <li><a href="/wiki/Gallstone" title="Gallstone">Gallstone / Cholelithiasis</a></li> <li><a href="/wiki/Cholesterolosis_of_gallbladder" title="Cholesterolosis of gallbladder">Cholesterolosis</a></li> <li><a href="/wiki/Adenomyomatosis" title="Adenomyomatosis">Adenomyomatosis</a></li> <li><a href="/wiki/Postcholecystectomy_syndrome" title="Postcholecystectomy syndrome">Postcholecystectomy syndrome</a></li> <li><a href="/wiki/Porcelain_gallbladder" title="Porcelain gallbladder">Porcelain gallbladder</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Bile_duct" title="Bile duct">Bile duct</a>/ <br /> Other <a href="/wiki/Biliary_tree" class="mw-redirect" title="Biliary tree">biliary tree</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cholangitis" class="mw-redirect" title="Cholangitis">Cholangitis</a> <ul><li><a href="/wiki/Primary_sclerosing_cholangitis" title="Primary sclerosing cholangitis">Primary sclerosing cholangitis</a></li> <li><a href="/wiki/Secondary_sclerosing_cholangitis" title="Secondary sclerosing cholangitis">Secondary sclerosing cholangitis</a></li> <li><a href="/wiki/Ascending_cholangitis" title="Ascending cholangitis">Ascending</a></li></ul></li> <li><a href="/wiki/Cholestasis" title="Cholestasis">Cholestasis</a>/<a href="/wiki/Mirizzi%27s_syndrome" title="Mirizzi&#39;s syndrome">Mirizzi's syndrome</a></li> <li><a href="/wiki/Biliary_fistula" title="Biliary fistula">Biliary fistula</a></li> <li><a href="/wiki/Haemobilia" title="Haemobilia">Haemobilia</a></li></ul> <ul><li><i><a href="/wiki/Common_bile_duct" title="Common bile duct">Common bile duct</a></i> <ul><li><a href="/wiki/Choledocholithiasis" class="mw-redirect" title="Choledocholithiasis">Choledocholithiasis</a></li> <li><a href="/wiki/Biliary_dyskinesia" title="Biliary dyskinesia">Biliary dyskinesia</a></li></ul></li> <li><a href="/wiki/Sphincter_of_Oddi_dysfunction" title="Sphincter of Oddi dysfunction">Sphincter of Oddi dysfunction</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Pancreatic_disease" title="Pancreatic disease">Pancreatic</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Pancreatitis" title="Pancreatitis">Pancreatitis</a> <ul><li><a href="/wiki/Acute_pancreatitis" title="Acute pancreatitis">Acute</a></li> <li><a href="/wiki/Chronic_pancreatitis" title="Chronic pancreatitis">Chronic</a></li> <li><a href="/wiki/Hereditary_pancreatitis" title="Hereditary pancreatitis">Hereditary</a></li> <li><a href="/wiki/Pancreatic_abscess" title="Pancreatic abscess">Pancreatic abscess</a></li></ul></li> <li><a href="/wiki/Pancreatic_pseudocyst" title="Pancreatic pseudocyst">Pancreatic pseudocyst</a></li> <li><a href="/wiki/Exocrine_pancreatic_insufficiency" title="Exocrine pancreatic insufficiency">Exocrine pancreatic insufficiency</a></li> <li><a href="/wiki/Pancreatic_fistula" title="Pancreatic fistula">Pancreatic fistula</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th id="Hernia" scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Hernia" title="Hernia">Hernia</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Diaphragmatic_hernia" title="Diaphragmatic hernia">Diaphragmatic</a> <ul><li><a href="/wiki/Congenital_diaphragmatic_hernia" title="Congenital diaphragmatic hernia">Congenital</a></li></ul></li> <li><a href="/wiki/Hiatus_hernia" class="mw-redirect" title="Hiatus hernia">Hiatus</a></li></ul> <ul><li><a href="/wiki/Inguinal_hernia" title="Inguinal hernia">Inguinal</a> <ul><li><a href="/wiki/Indirect_inguinal_hernia" class="mw-redirect" title="Indirect inguinal hernia">Indirect</a></li> <li><a href="/wiki/Direct_inguinal_hernia" class="mw-redirect" title="Direct inguinal hernia">Direct</a></li></ul></li> <li><a href="/wiki/Umbilical_hernia" title="Umbilical hernia">Umbilical</a></li> <li><a href="/wiki/Femoral_hernia" title="Femoral hernia">Femoral</a></li> <li><a href="/wiki/Obturator_hernia" title="Obturator hernia">Obturator</a></li> <li><a href="/wiki/Spigelian_hernia" title="Spigelian hernia">Spigelian</a></li></ul> <ul><li><i><a href="/wiki/Lumbar_hernia" class="mw-redirect" title="Lumbar hernia">Lumbar</a></i> <ul><li><a href="/wiki/Petit%27s_hernia" title="Petit&#39;s hernia">Petit's</a></li> <li><a href="/wiki/Grynfeltt%E2%80%93Lesshaft_hernia" title="Grynfeltt–Lesshaft hernia">Grynfeltt–Lesshaft</a></li></ul></li></ul> <ul><li><i>Undefined location</i> <ul><li><a href="/wiki/Incisional_hernia" title="Incisional hernia">Incisional</a></li> <li><a href="/wiki/Internal_hernia" title="Internal hernia">Internal hernia</a></li> <li><a href="/wiki/Richter%27s_hernia" title="Richter&#39;s hernia">Richter's</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Peritoneal_disease" class="mw-redirect" title="Peritoneal disease">Peritoneal</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Peritonitis" title="Peritonitis">Peritonitis</a> <ul><li><a href="/wiki/Spontaneous_bacterial_peritonitis" title="Spontaneous bacterial peritonitis">Spontaneous bacterial peritonitis</a></li></ul></li> <li><a href="/wiki/Hemoperitoneum" title="Hemoperitoneum">Hemoperitoneum</a></li> <li><a href="/wiki/Pneumoperitoneum" title="Pneumoperitoneum">Pneumoperitoneum</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"><style data-mw-deduplicate="TemplateStyles:r1038841319">.mw-parser-output .tooltip-dotted{border-bottom:1px dotted;cursor:help}</style><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1038841319"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1038841319"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1038841319"></div><div role="navigation" class="navbox authority-control" aria-label="Navbox" style="padding:3px"><table class="nowraplinks hlist navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Help:Authority_control" title="Help:Authority control">Authority control databases</a>: National <span class="mw-valign-text-top noprint" typeof="mw:File/Frameless"><a href="https://www.wikidata.org/wiki/Q154869#identifiers" title="Edit this at Wikidata"><img alt="Edit this at Wikidata" src="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/10px-OOjs_UI_icon_edit-ltr-progressive.svg.png" decoding="async" width="10" height="10" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/15px-OOjs_UI_icon_edit-ltr-progressive.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/20px-OOjs_UI_icon_edit-ltr-progressive.svg.png 2x" data-file-width="20" data-file-height="20" /></a></span></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><ul><li><span class="uid"><a rel="nofollow" class="external text" href="https://d-nb.info/gnd/4262007-7">Germany</a></span></li><li><span class="uid"><span class="rt-commentedText tooltip tooltip-dotted" title="Hepatitis C"><a rel="nofollow" class="external text" href="https://id.loc.gov/authorities/sh85060290">United States</a></span></span></li><li><span class="uid"><span class="rt-commentedText tooltip tooltip-dotted" title="Hépatite C"><a rel="nofollow" class="external text" href="https://catalogue.bnf.fr/ark:/12148/cb12175477z">France</a></span></span></li><li><span class="uid"><span class="rt-commentedText tooltip tooltip-dotted" title="Hépatite C"><a rel="nofollow" class="external text" href="https://data.bnf.fr/ark:/12148/cb12175477z">BnF data</a></span></span></li><li><span class="uid"><a rel="nofollow" class="external text" href="https://id.ndl.go.jp/auth/ndlna/00986947">Japan</a></span></li><li><span class="uid"><span class="rt-commentedText tooltip tooltip-dotted" title="hepatitida C"><a rel="nofollow" class="external text" href="https://aleph.nkp.cz/F/?func=find-c&amp;local_base=aut&amp;ccl_term=ica=ph120673&amp;CON_LNG=ENG">Czech Republic</a></span></span></li><li><span class="uid"><a rel="nofollow" class="external text" href="http://olduli.nli.org.il/F/?func=find-b&amp;local_base=NLX10&amp;find_code=UID&amp;request=987007558059905171">Israel</a></span></li></ul></div></td></tr></tbody></table></div> <!-- NewPP limit report Parsed by mw‐web.codfw.main‐f69cdc8f6‐rpq2w Cached time: 20241122140607 Cache expiry: 2592000 Reduced expiry: false Complications: [vary‐revision‐sha1, show‐toc] CPU time usage: 2.334 seconds Real time usage: 2.666 seconds Preprocessor visited node count: 13868/1000000 Post‐expand include size: 524218/2097152 bytes Template argument size: 10144/2097152 bytes Highest expansion depth: 17/100 Expensive parser function count: 15/500 Unstrip recursion depth: 1/20 Unstrip post‐expand size: 719647/5000000 bytes Lua time usage: 1.415/10.000 seconds Lua memory usage: 8973987/52428800 bytes Lua Profile: ? 260 ms 16.9% MediaWiki\Extension\Scribunto\Engines\LuaSandbox\LuaSandboxCallback::callParserFunction 260 ms 16.9% dataWrapper <mw.lua:672> 180 ms 11.7% 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