Hepatitis C is a viral infection that causes inflammation of the liver. Over time, the hepatitis C virus (HCV) can cause permanent liver damage.
People usually contract HCV after coming into contact with blood that is infected with the virus. Acute HCV develops within the first 6 months of exposure to the virus.
Many people with HCV do not have any symptoms. As a result, a person may live with HCV for many years without knowing that they have it.
In most cases, HCV is curable. However, untreated HCV can have adverse effects on several organs and systems within the body. Keep reading to learn more about the different ways that HCV can affect a person's body.
Because it does not always cause symptoms, a person may not know that they have HCV for several months, years, or even decades.
They may not realize their liver is inflamed until they start to experience symptoms related to liver damage or complications elsewhere in the body.
In the following sections, we describe the potential effects of untreated HCV on some of the body's systems.
The liver is the largest internal organ of the human body. As such, it is responsible for several vital functions, including:
- helping remove waste and toxins from the blood
- producing a fluid called bile, which aids digestion
- producing proteins important for blood clotting
- storing nutrients such as vitamins and glucose
HCV can cause the liver to become swollen and inflamed. Over time, this can cause scarring, or fibrosis.
Fibrosis may develop into severe permanent scarring, or cirrhosis, in which large sections of the liver are unable to function. Left untreated, this may lead to liver failure. Cirrhosis also increases the risk of liver cancer.
As HCV progresses, a person may experience symptoms such as jaundice (or yellowing of the skin or eyes), weight loss, abdominal swelling, and abdominal pain. A person should speak to their healthcare provider if they experience any of these symptoms.
Central nervous system
A damaged liver is less effective at filtering toxins from the blood.
Over time, the toxins — particularly ammonia — can build up in the blood, causing confusion and alterations in consciousness. Some other symptoms of the toxins' effects on the central nervous system (CNS) and brain include:
- sleep disturbances
- sweet, musty breath
- difficulty performing fine motor skills, such as writing or blinking
- dry mouth or eyes
- changes in personality
- difficulty concentrating
As the condition advances untreated, a person may experience more severe CNS symptoms, including:
- slurred speech-abnormal shaking
The liver produces bile, which plays an important role in the digestive process. Bile breaks down fats and helps the intestines absorb nutrients.
As HCV progresses, the liver may not produce enough bile to support digestion. As a result, a person may have difficulty digesting fatty foods.
Poor liver function may also result in the following gastrointestinal symptoms:
- abdominal pain or discomfort
- weight loss
- pale stools
- loss of appetite
People with liver damage may also experience ascites, which is a buildup of fluid in the abdomen. Ascites may cause the abdomen to appear bloated or distended.
The endocrine system is a network of glands that produce hormones.
The thyroid, for example, is an important gland within the endocrine system. It releases hormones that regulate vital functions throughout the body.
In some cases, HCV may cause the immune system to attack the thyroid gland. If this occurs, a person may experience:
- hypothyroidism, or an underactive thyroid: This can lead to weight gain and fatigue.
- hyperthyroidism, or an overactive thyroid: This can lead to weight loss and sleep disorders.
The liver also helps control blood sugar levels. Therefore, a person with a damaged liver has a higher risk of developing type 2 diabetes.
The integumentary system refers to the skin, hair, and nails. It also includes exocrine glands such as the sweat glands and salivary glands.
A damaged liver is less able to absorb nutrients from a person's diet. This may lead to a noticeable decline in the growth and overall health of a person's hair and nails.
A damaged liver is also less effective at removing waste from the blood. This may result in a noticeable yellowing of the skin or eyes.
People may also experience the following skin symptoms:
- easy bruising
- loss of pigmentation
Muscle and joint pain
According to one 2017 review, up to 66% of people with HCV experience rheumatic conditions. These are conditions characterized by pain and inflammation in the joints, muscles, or other fibrous body tissues. Examples include:
- joint pain, or arthralgia
- muscular pain, or myalgia
Fibromyalgia is particularly common in people with HCV. It is a chronic condition characterized by muscle pains and aches throughout the body.
A healthy liver stores iron in its cells. Whenever there is increased demand for iron in the body, the liver releases some of its iron into the bloodstream.
A damaged liver is less able to store and release iron. This increases a person's risk of anemia.
Liver damage may also impair blood flow within its blood vessels. This increases blood pressure within the large vein that supplies blood to the liver. As blood pressure increases, it forces blood through smaller veins in other areas of the body, such as the stomach and esophagus.
These smaller veins do not have the capacity to handle such a large volume of blood, and they may burst. This could cause severe internal bleeding.
Women with liver damage associated with HCV are at increased risk of the following pregnancy complications:
HCV also poses an increased risk to the fetus. Potential risks include:
- preterm delivery
- low birth weight
- transmission of the virus during pregnancy or delivery
- neonatal death
Women who develop HCV as a result of a substance use disorder might experience additional pregnancy complications. However, these are likely due to the substance use itself.
Many people with HCV are unaware that they have the virus. They may only develop symptoms after experiencing significant liver damage.
For this reason, people at increased risk of developing HCV should undergo screening to check for the virus.
The CDC recommend HCV screening for:
- everyone born between 1945 and 1965
- people who use or have used intravenous drugs
- people who received blood transfusions or organ transplants before 1992
- anyone who received clotting factor concentrates before 1987
- people undergoing long term dialysis
- people with HIV
- children born to mothers with hepatitis C
- healthcare workers or public safety workers who have come into contact with blood from someone who has HCV
HCV is usually curable if a person receives treatment early enough. The exact treatment will depend on a variety of factors, such as:
- viral load, or the amount of virus present in the person's blood
- the strain (or genotype) of hepatitis C the person has
- whether or not the person has any other health conditions
- whether or not liver damage is present
- the person's response to any previous treatments
In the sections below, we describe the different treatment options available for acute hepatitis C and chronic hepatitis C.
Acute hepatitis C
Often, a person will not know that they have hepatitis C. This means that many cases of HCV go untreated.
In some cases, HCV goes away on its own. However, it may develop into a chronic condition.
People who suspect that they have had contact with HCV can have blood tests to check for the virus. If the blood test shows that the person has hepatitis C, a doctor may recommend antiviral medications. These aim to clear the virus from the body.
People will receive follow-up blood work to monitor their viral load. Healthcare professionals consider HCV "cured" if the virus is no longer detectable in the blood 3 months after the person completes treatment.
Chronic hepatitis C
Doctors consider HCV to be chronic if it persists for 6 months or longer.
They tend to prescribe one or more antiviral medication. These can take 12–24 weeks to have an effect. People will continue to receive regular blood tests to monitor their viral load. This helps determine if the current treatment is effective.
In many cases, the doctor will also check the liver for any signs of damage or scarring. They may prescribe medications to prevent or slow down liver damage.
Many people with HCV do not experience any symptoms until they have a significant amount of liver damage. In fact, many people with HCV only become aware that they have the virus after undergoing routine blood screening.
Certain people are at increased risk of developing HCV. These people can request a screening to check if they have the virus. With prompt treatment, HCV is usually curable.
People can discuss their treatment options with their doctor. The doctor will usually prescribe antiviral medications to help eliminate the virus or keep it under control. A person may also receive medications to treat any symptoms related to liver damage.