Hepatitis, or inflammation of the liver, can be caused by many things, which is one reason why it is takes so long to become a doctor: You have to at least know the most common causes and most facts about these causes, which, along with anatomy, burns a lot of time.

Hepatitis C (thank God not named after some obscure European dude with a horribly long, difficult to spell last name) afflicts many Americans. It is caused by a nasty virus, which can be transmitted through sex, blood and blood products, and sharing of needles. It is one of the leading causes of liver failure requiring liver transplantation.

Unfortunately, by some estimates, almost 50% of people with Hepatitis C have no idea that they are infected. One would think that in this day, when you could theoretically tweet an  Amazon rain forest Indian,  infected people would  at least know that they have the disease.

However, the early stages are truly asymptomatic and routine tests for Hepatitis C, according to the experts are not a good idea: the cost would be huge and there would be a lot of false positives, or positive tests in people who really don’t have the disease. Furthermore, infection could have occurred decades earlier-who remembers each and every crazy thing he or she did twenty years ago?

The problem is that the virus relentlessly attacks the liver. The liver regenerates pretty well, until  a certain threshold is reached. After this, the liver scars and cirrhosis develops. The cirrhosis in turn causes a whole slew of horrible side effects. Eventually, a liver transplant is needed or the sufferer will die.

Recent statistics show that the death rate from Hepatitis C has actually become higher than the death rate for HIV. To make matters worse, if you happen to have Hepatitis B or HIV and Hepatitis C, then the death rate skyrockets. Also, if you are middle aged you will have a higher mortality risk.

Recently, new treatments have been developed.  Unfortunately, unlike Hepatitis B, there are no effective vaccines for Hepatitis C.

Still, there is hope that one day such a vaccine will be developed. Until then, use your head: If you shoot up, don’t share needles and practice safe sex at all times.