Hepatitis C Virus (HCV) is the most common chronic blood borne infection in the United States (CDC, 2004). Approximately 1.8 percent of the United States' population has been infected with HCV, according to NHANES III (1988-94). This amounts to 3.9 million people, 2.7 million of whom are chronically infected. The actual numbers may be higher as the estimates do not include homeless, institutionalized, or incarcerated populations. Such populations may not be as likely to seek out or receive medical care and hence, may not be diagnosed.

Hepatitis C is a blood borne pathogen; the most prevalent mode of transmission is sharing needles or syringes to inject illicit drugs. Blood transfusions pose an extremely limited risk today, but for those patients who received a blood transfusion prior to July 1992, the risk was approximately 1 in 200 transfused units. Sexual transmission of hepatitis C does occur, but does not appear to be an efficient mode of transmission. Other potential risks for transmission include long-term hemodialysis, sharing straws for intranasal cocaine use, vertical (mother to infant) transmission, occupational blood exposure, and tattooing or body piercing with non-sterilized equipment. Hepatitis C is not spread via casual contact, kissing, sneezing, hugging, breast milk, and sharing glasses or utensils.

The state of Iowa has an estimated 52,943 cases of HCV infection, based on 2001 projected census information. Between January 1999 and March 2004, a total of 7,183 HCV cases were identified in the state. This accounts for 13.5 percent of projected cases.

Unfortunately, the majority of those infected with HCV do not know they are infected. About 80 percent of people have no signs or symptoms when the infection first develops. Infected individuals may have HCV for up to 10 to 20 years before they are aware or symptoms are recognized. In 75 to 85 percent of those infected, the virus persists in the body and the person develops chronic infection. Chronic HCV develops into chronic liver disease in 70 percent of those infected. Twenty percent of those chronically infected develop liver cirrhosis. Approximately three to five percent of HCV patients develop liver cancer. According to the Centers for Disease Control and Prevention (CDC), approximately 8,000-10,000 deaths each year in the United States are attributed to HCV. Such deaths attributed to HCV-related chronic liver disease could increase substantially in the near future. In support of this prediction, John Wong, MD, of Tufts-New England Medical Center estimates that future HCV-related mortality may double during the next 10 to 20 years (Wong, 2004).

HCV was first identified in 1989 as a distinctive organism that causes hepatitis. Prior to this time it was known only as hepatitis that differed from hepatitis A and hepatitis B and was called "non-A, non-B hepatitis." A laboratory detection test became available for use in July 1992. People most at risk of having and/or for acquiring HCV infection include:

• Persons who have ever injected drugs, even once in their lifetime
• Injecting drug users who share needles or other equipment
• Persons who received blood transfusions or organ transplants prior to July 1992
• Persons who received clotting factor from plasma produced before 1987
• Persons who have ever been on long-term kidney dialysis
• Persons with undiagnosed liver problems
• Health care or emergency workers after known exposure to HCV positive blood
• Children born to HCV positive women

Unfortunately, there is no vaccine currently available for hepatitis C.

Iowa Department of Public Health is not a treatment facility. If you are looking for information about treatment for hepatitis C virus read the following: