Hepatitis C is considered a bloodborn disease, and it is thought that many people with hepatitis C contracted it either through a blood transfusion or by receiving blood products that were contaminated with hepatitis C, or by sharing needles with intravenous drug users that were infected with hepatitis C. Thanks to HCV testing after 1990 the risk of acquiring hepatitis C from blood transfusion has been reduced tremendously. The disease is generally milder and most people are asymptomatic or have vague or no symptoms. Nevertheless, 10-15 years from the infection, the complications of cirrhosis appear in about one third of patients, sometimes unexpectedly. The percentage of patients who develop cirrhosis is much greater than in chronic hepatitis B, while primary liver cancer appears to be much less common. A characteristic feature of chronic hepatitis C is the fluctuation in aminotrasferase values seen in half of cases.
Fluctuations seem to represent effects of mutations in the virus or episodic immune reactions.
Transaminase values don't correlate well with histological features of disease. About one fifth of patients with positive diagnostic tests for HCV have persistently normal liver enzymes. Some of them progress to more advanced disease, in others infection appears to remain quiescent. Diagnosis of Hepatitis C Hepatitis C can be detected with a simple blood test. Hepatitis C has been called the silent epidemic.