Hepatitis C is a disease of the liver caused by infection with the hepatitis C virus (HCV). HCV can cause both acute and chronic hepatitis infection, which can last either as a mild disease lasting only a few weeks or as a serious lifelong disease ending in cirrhosis or cancer.

Hepatitis C occurs worldwide, with the highest burden of disease in the eastern Mediterranean and Europe, where 12 million people are chronically infected in each region, according to WHO.

Humans are the pathogen reservoir

The virus is mainly transmitted through contact with blood of an infected person. In Europe, HCV transmission occurs in most cases through intravenous drug use, when contaminated needles are shared. Medical procedures with insufficiently sterilized instruments, transfusion of blood or blood products that have not been tested, as well as the pricking of tattoos and application of piercings with non-sterile instruments also play an important role.

Other modes of transmission include: risky sexual behavior or sexual practices that lead to blood contact (e.g., persons with multiple sexual partners; men who have sex with men), inadequate protection in health care settings (gloves, disposal of used needles...), and transmission from an infected mother to her child during childbirth (perinatal).

Most people with acute hepatitis C virus infection have no symptoms. If symptoms do occur, they manifest as fatigue, fever and jaundice (yellowing of the skin and eyeballs), among other symptoms.

Also, in many chronic hepatitis C virus infections, symptoms never occur or only after years. Symptomatic infected persons suffer from general complaints such as fatigue, nausea and abdominal discomfort. Approximately 30% of patients with chronic hepatitis C virus infection develop cirrhosis (end-stage liver damage). In a few cases, this cirrhosis develops further into liver cancer.

Detected in time, hepatitis C virus infection can be cured with appropriate antiviral drug combinations. With antiviral treatment, over 90% of diagnosed HCV-infected individuals in Europe can be cured today. In individuals who develop severe liver disease, liver transplantation may be necessary.

There is currently no effective vaccine against hepatitis C. A passed infection does not leave immunity against the hepatitis C virus. Therefore, reinfection can occur despite successful therapy.

One of the most important preventive measures to reduce the risk of HCV infection is education of vulnerable populations (people who inject drugs intravenously and men who have sex with men).

Since most new HCV infections are asymptomatic, few individuals are diagnosed at this stage. Therefore, the number of people actually infected is likely to be higher.

The following table lists the newly or first-time diagnosed cases of HCV infection. These numbers also include those cases whose HCV antibody test was positive, but no detection of viral RNA was performed. Thus, not all of these cases can be guaranteed to be "new or first-time diagnosed"; chronic hepatitis C disease could also be included. There were 219 HCV infections diagnosed in the first quarter of 2023.

The introduction of DAA drugs (pan-genomic direct-acting antivirals) in 2014 for curative therapy of hepatitis C infections achieved a breakthrough in the elimination of the virus in Austria as well.

WHO recommends pan-genomic direct-acting antiviral agents (DAAs) for the treatment of chronic hepatitis C for all adults, adolescents, and children aged three years and older.

WHO recommends the following primary prevention methods:

• Safe and appropriate use of injections in health care settings.
• Safe handling when disposing of sharps
• Providing understandable harm reduction information to people who inject drugs.
• Testing donated blood for HBV and HCV.
• Training of health care workers
• Prevention of blood contact during sexual intercourse.