The term “hepatitis” revers to any inflammation of the liver, but in most contexts, it refers to inflammation resulting from one of a handful of viral infections. Hepatitis A, hepatitis B, and hepatitis C are the three most common viral infections affecting the liver, though there are tow other liver-specific viral infections and a handful of other infections can cause inflammation. Hepatitis A is caused by fecal contamination and B usually through sexual contact. Hepatitis C, the most dangerous type—it’s one of the leading causes for liver transplantation in the United States—is transmitted by blood contact, meaning it is occasionally also transmitted in intimate circumstances.
Hepatitis C is, in fact, the most common type of viral hepatitis in the United States, indeed, the most common blood-borne illness overall. It is particularly among baby boomers. In part because blood supplies and other medical means of transmission were not routinely screened for hepatitis C until relatively recently, and in part because infection rates peaked in the 1970s and 1980s, 75 percent of adults with hepatitis C were born between 1945 and 1965. Because hepatitis C, which is often asymptomatic, and related illnesses cause 15,000 deaths in the United States each year, public health officials recommend that everyone, but particularly boomers, get tested for the disease.
Testing, in fact, is extremely effective at finding hepatitis C so treatment can be started. Blood tests find the presence of hepatitis C virus and measure the viral load. If there is some sign of infection, a liver biopsy will be performed to determine the severity of illness. Blood testing can also determine which specific type of hepatitis C virus a patient has and help predict what type of treatment will work best.
Two of those subtypes, called genotype 2 and genotype 3, together account for one in four hepatitis C cases, and a drug called sofosbuvir has a very high cure rate—93 percent for genotype 2—with relatively few side effects. Other antiviral medications, primarily interferon, are used for other subtypes. In severe cases, a liver transplant may be needed, though the disease can recur in the transplanted liver.