The Infection You Haven’t Tested For (But Probably Should)

American health authorities made a pretty big announcement in early March: All adults between 18 and 79 should be tested for Hepatitis C at least once in their lives. It didn’t make many headlines, which have been dominated by coronavirus coverage, but this new recommendation is important news. 

Hepatitis C is a viral infection of the liver, which usually has few or no symptoms but can cause serious damage over the years, and even death, if it goes untreated. And it’s on the rise — rates of acute Hepatitis C tripled between 2009 and 2018. Who is at risk? Should you be tested? We’ll explain.

How Does Hepatitis C Spread?

It is most often spread through sharing needles to inject drugs, but in some cases can be spread through sexual contact or sharing items like toothbrushes and razors. More rarely you can contract it when receiving a tattoo or body piercing with needles that aren’t properly sanitized. Some people who received a blood transfusion or organ transplant before 1992 contracted Hepatitis C from that, because blood and organ donors were not routinely screened for the virus until that year. 

How Dangerous is Hepatitis C?

Although you don’t hear about it much, Hepatitis C is the most common blood-borne virus in the United States, and an estimated 4.1 million Americans have either a current or past Hepatitis C infection. It often has no symptoms, but if left undetected and untreated it can lead to cirrhosis, liver cancer, and even death. It causes more deaths in the US than all other reportable infectious diseases combined.

What Are the Symptoms of Hepatitis C?

People who are newly infected, which is called acute infection, usually show no symptoms. If they do have symptoms they can include dark urine, fever, fatigue, nausea, and abdominal pain, among other symptoms, which show up between 2 and 12 weeks after infection. 

Chronic Hepatitis C, which develops over many years if the infection isn’t treated, may cause chronic fatigue or depression, loss of appetite, nausea and vomiting and abdominal pain, yellowing of skin and eyes and itching skin, but may also have no symptoms unless it leads to advanced liver disease. Symptoms of advanced liver disease include yellowing of the skin and eyes (jaundice) which may be constant or may come and go, easy bruising or bleeding, intensely itchy skin, nausea and loss of appetite, swelling in the midsection and legs, and cognitive problems like poor concentration and memory. 

Who Should Be Tested for Hepatitis C?

Because Hepatitis C has so few symptoms, and can result in such serious illness and even death, the US Preventive Services Task Force now recommends that every American adult be tested at least once. To be on the safe side, you might want to include Hepatitis C testing the next time you get a check for sexually transmitted infections.

People who have a history of injecting drugs are at the greatest risk, and in general Hepatitis C affects both the young and old. The two age groups where acute Hep C is highest among Americans 20-39 and 50-69 years old. People with HIV are also more likely to be infected with Hepatitis C. 

How Can You Get Tested?

Talk to your doctor about Hepatitis C testing and whether it makes sense for you. If you are due for a regular STI check, you can get tested using the Full Control STI Home Test Kit from Nurx. This kit contains tests for common sexually transmitted infections including chlamydia, gonorrhea, and HIV, as well as a test for Hepatitis C. You collect your samples at home in just 15 minutes and return them to our partner lab in a prepaid envelope. Once your results are in a member of our medical team will be in touch to go over the results and help you get treatment if necessary. You can learn more about home testing for STIs here.

About the Author

Dr. Emily Rymland, Clinical Development Manager at Nurx, has been a nurse practitioner working in HIV care in Northern California since the early 90s. She was originally drawn to medicine because of the HIV epidemic when many of her friends became ill. She has spent time working in Women’s Health at Planned Parenthood and runs the Buseesa Community Development Centre, a small bush clinic in western Uganda. Emily enjoys working in telemedicine because it increases access for patients, especially those who suffer from the stigma surrounding HIV.

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