How do I recognise (acute) hepatitis C?

If you have just been infected with hepatitis C, it is called acute hepatitis C. During acute hepatitis C infection, people do not usually get sick. But approximately 10% of patients do experience symptoms, such as:

• nausea and vomiting
• tiredness
• lack of appetite
• muscle and joint pain
• fever
• flu-like symptoms
• jaundice (yellowing of the skin and the whites of the eyes, and discolouration of stools and urine)
• pain in the upper right abdomen

Acute hepatitis C rarely causes life-threatening symptoms.

What is chronic hepatitis C?

In approximately 80% of patients, acute hepatitis C develops into chronic hepatitis. This means the infection has lasted longer than six months. In chronic hepatitis C, the virus remains in the patient's blood without causing illness at that time. This patient's blood remains contagious to others.

After many years, the liver of people with chronic hepatitis C can become severely damaged. That is called cirrhosis of the liver. This happens in approximately 20% of patients. Patients may also eventually develop liver cancer. These late consequences of chronic hepatitis C can cause death. That is why it is important that patients with chronic hepatitis C are monitored regularly by a doctor

Who can get (very) ill from hepatitis C? 

Anyone can get hepatitis C and become ill. Some people are more likely to get hepatitis C:

• people who were born in a country where hepatitis C is common
• people who inject drugs with used needles
• people who received a blood transfusion before 1992
• men who have sex with men and have HIV or have many different sex partners.

Is hepatitis C dangerous during pregnancy?

Hepatitis C is usually not dangerous during the course of the pregnancy. However, there is a small chance that the pregnant person will pass the virus on to the baby. This happens in about 4% to 14% of pregnant persons who carry the virus in their blood. This is in part determined by the quantity of the virus in the blood (the viral load). The virus is usually passed to the baby during pregnancy or at birth. This almost never happens after childbirth. The virus cannot be passed on to the baby through breastfeeding.

If you used to inject drugs or have frequently come into contact with blood, there is a bigger risk that you have hepatitis C. It is a good idea to get tested before you become pregnant.

How do I get hepatitis C?

Hepatitis C is mainly passed on through blood. This can happen in several ways:

• By using the same injection needle as someone else.
• By accidentally pricking yourself with used needles.
• By using someone else's objects that may have blood on them. For example, a razor or toothbrush.
• When giving or receiving blood (a blood transfusion), for example, after an operation. In the Netherlands, donor blood is tested for hepatitis C.
• By getting a tattoo or piercing where dirty needles are used.
• Through unsafe sex (without a condom). This occurs especially during anal sex. In some cases, (rough or forced) sex can cause some bleeding. The chance of getting hepatitis C this way is very small, but if your blood comes into contact with your sex partner's blood during rough sex, it is more likely to occur. You also have a higher risk of getting hepatitis C in this way if you already have another sexually transmitted disease (STD).
• During pregnancy or at birth (see above).

People can carry the virus and pass it on to others without showing any symptoms. Someone remains contagious until the virus has disappeared from the body.

If you have had hepatitis C before, this does not mean you are protected against a new infection. You can be infected by the virus again.

How do I prevent hepatitis C?

You can do several things to prevent hepatitis C:

• Only use your toothbrush or razor for yourself.
• Be careful when bandaging wounds, use waterproof sticking plasters.
• Practice safe sex, so use a condom.
• Make sure someone else's blood cannot get into any wounds you have.
• Make sure someone else's blood does not get into your eye, mouth or nose.
• Do not use injection needles that were used by others.
• When getting a tattoo or piercing, make sure that this is done with clean needles.

If you have a small wound and blood from someone with hepatitis C went into the wound, you must let the wound bleed thoroughly and rinse it under the tap with lukewarm water. Then put iodine on it and call the GP. If you have had unsafe sex with someone who has hepatitis C, visit your GP or make an appointment with the local health authority GGD.

Can hepatitis C be treated?

There are several medication treatments for Hepatitis C. For treatment, you will need to see a specialist in the hospital. The medicines for chronic hepatitis C have become much better lately. As a result, hepatitis C almost always disappears and there are fewer side effects. Unfortunately, when your liver is damaged by chronic hepatitis C, this damage is often irreversible.

If you have hepatitis C, it is better not to drink alcohol. Alcohol can damage the liver even more.

How common is Hepatitis C in the Netherlands?

In 2023, around 25,000 people in the Netherlands had chronic hepatitis C. On average, the disease is more common in people from other parts of the world, such as Asia, Africa, the Mediterranean region, South America or Eastern Europe.