Hepatitis C (or non-A, non-B hepatitis):

Hepatitis C (or non-A, non-B hepatitis): 

Hepatitis C is a liver infection that can lead to serious liver damage. It’s caused by the hepatitis C virus. About 2.4 million people in the U.S. have the disease. But it causes few symptoms, so most of them don't know. The virus spreads through an infected person’s blood or body fluids.

There are many forms of the hepatitis C virus, or HCV. The most common in the U.S. is type 1. 

Stages of Hepatitis C

The hepatitis C virus affects people in different ways and has several stages:

• Incubation period: This is the time between first exposure to the start of the disease. It can last anywhere from 14 to 80 days, but the average is 45
• Acute hepatitis C: This is a short-term illness that lasts for the first 6 months after the virus enters your body. After that, some people who have it will get rid of, or clear, the virus on their own.
• Chronic hepatitis C: For most people who get hepatitis C -- up to 85% -- the illness moves into a long-lasting stage (longer than 6 months). This is called a chronic hepatitis C infection and can lead to serious health problems like liver cancer or cirrhosis.
• Cirrhosis: This disease leads to inflammation that, over time, replaces your healthy liver cells with scar tissue. It usually takes about 20 to 30 years for this to happen, though it can be faster if you drink alcohol or have HIV.
• Liver cancer: Cirrhosis makes liver cancer more likely. Your doctor will make sure you get regular tests because there are usually no symptoms in the early stages.

Transmission

The hepatitis C virus is a bloodborne virus. It is most commonly transmitted through:

• the reuse or inadequate sterilization of medical equipment, especially syringes and needles in healthcare settings;
• the transfusion of unscreened blood and blood products; and
• injecting drug use through the sharing of injection equipment.
• HCV can be passed from an infected mother to her baby and via sexual practices that lead to exposure to blood (for example, people with multiple sexual partners and among men who have sex with men); however, these modes of transmission are less common.
• Hepatitis C is not spread through breast milk, food, water or casual contact such as hugging, kissing, and sharing food or drinks with an infected person.

Symptoms 

Acute symptoms of hepatitis C infection may resemble flu symptoms, such as:

• Fever.
• Fatigue.
• Body aches.
• Loss of appetite.

They may also resemble the symptoms of acute liver failure, such as:

• Jaundice (yellowing of lighter skin and the whites of the eyes).
• Abdominal pain (especially in the upper right quadrant).
• Nausea and vomiting.
• Dark-colored pee and light-colored poop.

Diagnosis

Screening for hepatitis C

The U.S. Preventive Services Task Force recommends that all adults ages 18 to 79 years be screened for hepatitis C, even those without symptoms or known liver disease. Screening for HCV is especially important if you're at high risk of exposure, including:

• Anyone who has ever injected or inhaled illicit drugs
• Anyone who has abnormal liver function test results with no identified cause
• Babies born to mothers with hepatitis C
• Health care and emergency workers who have been exposed to blood or accidental needle sticks
• People with hemophilia who were treated with clotting factors before 1987
• People who have undergone long-term hemodialysis treatments
• People who received blood transfusions or organ transplants before 1992
• Sexual partners of anyone diagnosed with hepatitis C infection
• People with HIV infection
• Anyone born from 1945 to 1965
• Anyone who has been in prison

Other blood tests

If an initial blood test shows that you have hepatitis C, additional blood tests will:

• Measure the quantity of the hepatitis C virus in your blood (viral load)
• Identify the genotype of the virus
• Tests for liver damage

Doctors typically use one or more of the following tests to assess liver damage in chronic hepatitis C.

• Magnetic resonance elastography (MRE): A noninvasive alternative to a liver biopsy (see below), MRE combines magnetic resonance imaging technology with patterns formed by sound waves bouncing off the liver to create a visual map showing gradients of stiffness throughout the liver. Stiff liver tissue indicates the presence of scarring of the liver (fibrosis) as a result of chronic hepatitis C.
• Transient elastography: Another noninvasive test, transient elastography is a type of ultrasound that transmits vibrations into the liver and measures the speed of their dispersal through liver tissue to estimate its stiffness.
• Liver biopsy: Typically done using ultrasound guidance, this test involves inserting a thin needle through the abdominal wall to remove a small sample of liver tissue for laboratory testing.
• Blood tests: A series of blood tests can indicate the extent of fibrosis in your liver.

Note (1): Evaluate sequelae, such as cirrhosis or malignancy of the liver, under an appropriate diagnostic code, but do not use the same signs and symptoms as the basis for evaluation under DC 7354 and under a diagnostic code for sequelae. (See §4.14.).

Note (2): For purposes of evaluating conditions under diagnostic code 7354, “incapacitating episode” means a period of acute signs and symptoms severe enough to require bed rest and treatment by a physician.