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5 Minutes Read

How Do You Know If Hepatitis C Has Come Back?

While a person with hepatitis C can be cured completely using modern medications, recurrence of symptoms is still possible even after properly completing the treatment.

Hepatitis C recurrence is possible in all cases, whether spontaneously resolved or cured with medication. While the probability is very low, approximately 1%, a person can get re-infected with hepatitis C following a successful cure. This means that successful treatment of an acute hepatitis C attack does not grant a person immunity for the rest of their life. Regular blood tests that detect multiple parameters of hepatitis C can be used to screen a person’s blood following a recent infection to eliminate the possibility of a re-infection. Antibody testing or RNA detection can tell if a re-infection has taken place.

It is important to understand that while re-infection with hepatitis C is possible, it is only problematic when a person has extensive liver damage or a lowered immune state. Otherwise, a re-infection with hepatitis C is not more troublesome than an initial hepatitis C infection and is just as easily treatable. 


Recurrence of hepatitis C symptoms can occur in 2 different scenarios: you can either have a re-infection with hepatitis C virus following the successful treatment of a previous hepatitis C infection, or you can develop the symptoms again after they had previously faded away. However, the second scenario would not be called a re-infection because the initial infection was never resolved to begin with.

Before we talk about the recurrence of symptoms through re-infection, it is best to differentiate between a re-infection with hepatitis C and a chronic infection of hepatitis C. 

A chronic hepatitis C infection is when the initial infection lasts longer than six months and lasts for a far longer period than an acute episode would. Unlike a re-infection, chronic infection is simply the prolongation of the initial episode of illness and not a completely new episode. 

On the other hand, re-infection is a completely new episode of illness following the successful resolution of a previous similar episode. As mentioned before, re-infection with hepatitis C is rare but not at all impossible. According to the estimates, approximately 1% of people who have been treated for hepatitis C will develop another episode of hepatitis C following complete recovery. Detecting a re-infection is of key importance because prompt diagnosis and effective, early treatment can help a person prevent the occurrence of any lasting liver damage.

Often the first sign of re-infection is the return of signs and symptoms following a recovery period. Familiar signs and symptoms often point towards the diagnosis of a re-infection. These signs and symptoms are often supplemented with positive physical findings that suggest the same thing.

A definitive diagnosis of a re-infection with hepatitis C is made through specialized blood tests. Anti-HCV antibody testing and HCV RNA testing are used to determine if a person has developed a new infection with hepatitis C. these tests are often repeated to eliminate the possibility of a false-positive result. 

A diagnosis of re-infection is made when a person shows increased viral loads following negative test results and a period of sustained virological response, or SVR. A sustained virological response is when a person’s viral loads diminish to the point where they become undetectable through blood tests. 


While a sustained virological response, or SVR, indicates successful treatment of hepatitis C, it does not guarantee lifelong immunity to the hepatitis C virus. While rare, re-infection with hepatitis C can occur in people who have achieved SVR before. Certain risk factors put some people at a higher risk of acquiring a re-infection than others. These risk factors include:

  • Using IV injecting needles
  • Getting frequent tattoos and piercings
  • Acquiring HIV or other STDs
  • Working in a healthcare setting
  • Having a history of imprisonment

These risk factors are responsible for a large fraction of the total cases of re-infection with hepatitis C. Controlling or eliminating these risk factors can effectively eliminate a person’s chances of developing a re-infection with hepatitis C.


Yes, re-infection with a different hepatitis virus following an initial hepatitis C infection is not uncommon. Just as getting infected with hepatitis C once does not confer a person with lifelong immunity against the hepatitis C virus, initial infection with any hepatitis virus does not make a person immune to all the other types of hepatitis viruses. 

However, unlike hepatitis C, hepatitis A and B infections are preventable thanks to a simple vaccination. While there is no vaccination for hepatitis C, vaccination against hepatitis A and B definitely protects a person from getting re-infected with any of these viruses. 


While the prospect of a re-infection with hepatitis C sounds scary, it is only dangerous under certain conditions. For example, an older immunocompromised person is at a much greater risk of developing long-term complications following a re-infection than a person who is younger and much healthier.

Usually, a re-infection with hepatitis C is treated in the same way an initial episode of hepatitis C is treated. Direct Acting Antivirals are highly effective in eliminating the virus and curing an individual. A successful cure is reached using DAAs without any long-term complications in otherwise healthy individuals.


Prevention of a re-infection with hepatitis C is very simple and extremely effective in virtually eliminating the possibility if done right. Prevention of hepatitis C is done best when all the risk factors for hepatitis C are eliminated from your daily life. Here are some measures that you can take to prevent a re-infection with hepatitis C:

If you use IV injecting needles to inject illicit drugs, make sure to find help and eliminate this high-risk behavior from your life. At the very least, make sure not to share any IV injecting needles with anyone else.

If you want to get tattoos or piercings, ensure that you only get them from licensed places with sterilized equipment. You can ask the establishment to show you their practice license and how they sterilize their equipment.

If you are a healthcare provider, wear a double layer of gloves when administering an IV injection. Also, take appropriate measures when disposing of IV needles to protect yourself from accidental pricks.


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