Hepatitis C

Unique identifier / Notation

BI0213

Synonyms

Acute hepatitis C Chronic hepatitis C Hepatitis C-related cirrhosis and liver cancer

Hepatitis C is a blood-borne liver disease caused by the hepatitis C virus: the virus can cause both acute and chronic hepatitis, ranging in severity from a mild illness lasting a few weeks to a serious, lifelong illness including liver cirrhosis and liver cancer. Hepatitis C is endemic and epidemic worldwide (WHO, 2024a).

Primary reference(s)

WHO, 2024a. Hepatitis C. World Health Organization (WHO). www.who.int/news-room/fact-sheets/detail/hepatitis-c Accessed 26 May 2025.

Annotations

Additional scientific description

Hepatitis C is a viral infection that affects the liver. It can cause both acute (short-term) and chronic (long-term) illness. It can be life-threatening (WHO, 2024a).

The most common modes of infection of hepatitis C are through exposure to small quantities of blood. This may happen through injecting drug use, unsafe injection practices, unsafe health care, and transfusion of unscreened blood and blood products. Hepatitis C can also be passed from an infected mother to her baby, and via sexual practices that lead to exposure to blood; however, these modes are less common. The incubation period for hepatitis C ranges from two weeks to six months (WHO, 2024a).

Symptoms can include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine and yellowing of the skin or eyes (jaundice) (WHO, 2024a).

There is no vaccine for hepatitis C, but it can be treated with antiviral medications. (WHO, 2024a).

Early detection and treatment can prevent serious liver damage and improve long-term health. Acute HCV infections are usually asymptomatic and most do not lead to a life-threatening disease. Around 30% (15-45%) of infected persons spontaneously clear the virus within 6 months of infection without any treatment, and the remaining 70% (55-85%) of persons will develop chronic HCV infection. Of those with chronic HCV infection, the risk of cirrhosis ranges from 15% to 30% within 20 years. (WHO, 2024a).

Hepatitis C infection is diagnosed in two steps: testing for anti-HCV antibodies with a serological test to identify people who have been infected with the virus; and, if the test is positive for anti-HCV antibodies, a nucleic acid test for HCV ribonucleic acid (RNA) to confirm chronic infection and the need for treatment. The nucleic acid test is important because about 30% of people infected with HCV spontaneously clear the infection without the need for treatment, but they will still test positive for anti-HCV antibodies (WHO, 2024a).

There are effective treatments for hepatitis C. The goal of treatment is to cure the disease and prevent long-term liver damage. Antiviral medications, including sofosbuvir and daclatasvir, are used to treat hepatitis C. WHO recommends therapy with pan-genotypic direct-acting antivirals (DAAs) for all adults, adolescents and children down to 3 years of age with chronic hepatitis C infection. People with hepatitis C may also benefit from lifestyle changes, such as avoiding alcohol and maintaining a healthy weight (WHO, 2024a).

There is no effective vaccine against hepatitis C. Prevention of hepatitis C infection depends upon reducing the risk of exposure to the hepatitis C virus (HCV) in health-care settings and in higher-risk populations, such as people who inject drugs and men who have sex with men, particularly those living with human immunodeficiency virus (HIV) infection or those who are taking pre-exposure prophylaxis against HIV (WHO, 2024a).

Metrics and numeric limits

Globally, an estimated 50 million people are living with chronic hepatitis C virus infection, with about 1.0 million new infections occurring per year (WHO, 2024a). However, this number may be affected by underreporting, as many new infections are asymptomatic and go undiagnosed.

The WHO estimated that in 2022, approximately 242,000 people died from hepatitis C, mostly from cirrhosis and hepatocellular carcinoma (primary liver cancer) (WHO, 2024a).

The most affected regions by hepatitis C are the WHO Eastern Mediterranean Region and the WHO European Region, with an estimated prevalence of chronic HCV infection in 2022 of 1.8% and 0.9% respectively. Prevalence of chronic hepatitis C infection in other WHO regions varies from 0.4% to 0.7% (WHO, 2024b).

Key relevant UN convention / multilateral treaty

International Health Regulations (2005), 3rd ed. (WHO, 2016b).

Drivers

Depending on the country, HCV infection can be concentrated in certain populations. These populations include people who inject drugs, people in prisons, men who have sex with men, and HIV-infected persons. For example, an estimated 23–39% of new HCV infections occur among people who inject drugs. Globally, 1 in 3 HCV deaths are attributable to injecting drug use (WHO, no date). Yet, people who inject drugs and people in prisons are rarely included in national responses. In countries where infection control practices are or were historically insufficient, HCV infection is often more widely distributed in the general population (WHO, 2024a).

Impacts

New hepatitis C infections (approximately 80%) are usually asymptomatic. Those persons who are acutely symptomatic may exhibit fever, fatigue, decreased appetite, nausea, vomiting, abdominal pain, dark urine, grey-coloured faeces, joint pain, and jaundice (yellowing of the skin and the whites of the eyes). Around 30% (15–45%) of infected persons spontaneously clear the virus within six months of infection without any treatment. The remaining 70% (55–85%) of persons will develop chronic hepatitis C infection. Of those with chronic hepatitis C infection, a significant number will go on to develop cirrhosis (liver scarring) or liver cancer (WHO, 2024a).

WHO (2024b) reported that including Hepatitis C, about 1.3 million people died of viral hepatitis in 2022, similar to the number of deaths caused by tuberculosis. Viral hepatitis and tuberculosis were the second leading causes of death among communicable diseases in 2022, after COVID-19 (WHO, 2024b).

Multi-hazard context

CDC in 2025 summarised the populations as being at an increased risk for hepatitis C – they include those who inject drugs or did so in the past; people with human immunodeficiency virus (HIV) infection; those with certain medical conditions, including those who have ever received maintenance haemodialysis and those with persistently abnormal alanine aminotransferase (ALT) (a liver enzyme) levels; and those who have received transfusions or organ transplants (CDC, 2025). Health-care and public safety personnel who have been exposed to the blood of someone who has hepatitis C (through needle sticks, sharps, or mucosal exposures) may be at risk of developing Hepatitis C (CDC, 2025). Infants born to people with known hepatitis C are also potentially at risk (CDC, 2025).

Risk Management

Early diagnosis can prevent health problems that may result from infection and can prevent transmission of the virus. The WHO recommends testing people who may be at increased risk of infection. Ways to prevent hepatitis C include safe handling and disposal of needles and medical waste, harm-reduction services for people who inject drugs, testing of donated blood for HCV, training of health personnel, and practicing safe sex by using barrier methods such as condoms (WHO, 2024a).

Direct-acting antiviral medicines (DAAs) can cure more than 95% of persons with hepatitis C infection, but access to diagnosis and treatment is low (WHO, 2024a).

In 2018, the WHO updated its guidelines for the care and treatment of persons diagnosed with chronic HCV infection. These guidelines are intended for government officials to use as the basis for developing national hepatitis policies, plans and treatment guidelines (WHO, 2018).

The Global Health Sector Strategies (GHSS) on, respectively, HIV, viral hepatitis, and sexually transmitted infections for the period 2022–2030 guide the health sector in implementing strategically focused responses to achieve the goals of ending AIDS, viral hepatitis (especially chronic hepatitis B and C) and sexually transmitted infections by 2030 (WHO, 2022).

Monitoring

The WHO has published surveillance standards for hepatitis C (WHO, 2016b). Surveillance can help to detect outbreaks, monitor trends in incidence and identify risk factors for new infections. Many countries have laws, statutes or other regulations that mandate the reporting of cases of acute viral hepatitis C (WHO, 2016b).

The Global Health Sector Strategies (GHSS) recommend investing in strengthening information systems for viral hepatitis and integrating them more fully into broader health information systems (WHO, 2022).

WHO supports countries to conduct all-hazards strategic risk assessments in the contexts of health emergencies and disasters, which results in the development of a country risk profile. Empowered with the country risk profile, inclusive of a seasonal risk calendar, countries can anticipate potential emergencies before they occur to trigger early alerts and inform early actions (WHO, 2021).

WHO's Early Warning, Alert and Response System (EWARS) has been designed to improve disease outbreak detection in emergency settings, such as in countries in conflict or following a natural disaster. It is a simple and cost-effective way to rapidly set up a disease surveillance system. EWARS is deployed during an emergency as an adjunct to the national disease surveillance system. WHO works with Ministries of Health and health sector partners to train local health workers to use the system. After the emergency, EWARS should re-integrate back into the national system (WHO, no date).