Hepatitis C is one of six viruses known to cause liver disease (Buggs 2001; NIDA 2002, Strickland 2002). Hepatitis C is very difficult for the immune system to overcome and often becomes chronic, leading to serious and permanent liver damage. Typically hepatitis C infection is mild in the early stages and rarely recognized until it has caused significant damage to the liver. From infection to noticeable or significant liver damage can take 20 years or more. The symptoms of hepatitis C are also very mild in the early stages. Fatigue, the most common symptom, may not appear for many years. Other symptoms are mild fever, muscle and joint aches, nausea and vomiting, poor appetite, and vague abdominal pains. Hepatitis C often goes undiagnosed because the symptoms come and go and are so suggestive of a flu-like illness. Its presence is usually identified during a routine blood test or because the hepatitis C antibody is positive at the time of a blood donation.