Hepatitis C is a virus or infection that causes liver disease. It is spread through the blood and can cause life-long health problems, including some as severe as cirrhosis and liver cancer.
Unfortunately, many people do not experience any symptoms of hepatitis C until long after the disease has progressed. Even without symptoms, liver damage can and often does occur.
Generally, here is how hepatitis C progresses:
Acute hepatitis C
The acute phase of hepatitis C is the first six months after contracting the disease. But, as noted, most people infected with hepatitis C have no symptoms and do not know they have it for many years--often not until liver disease is apparent. Some people do experience mild symptoms, anywhere from two weeks to six months after contracting the infection. Those symptoms include:
- Loss of appetite
- Nausea and vomiting
- Abdominal pain
- Dark urine
- Joint pain
- Mild jaundice--yellowing of skin and eyes
The symptoms usually clear up within a few months. Having these symptoms does not mean that liver damage will occur. In fact, between 15 and 25 percent of those who become infected with hepatitis C fight off the infection and do not have long-term health problems.
It is not understood why some people are able to beat the infection while in others it becomes a chronic condition. However, some factors seem to play a role:
- Women clear the virus more often than men
- Younger people are more apt to clear the virus
- Those who develop symptoms during the acute phase are more likely to clear the virus
In addition, the amount and type of virus can make a difference. Those who contracted hepatitis C through a transfusion are more likely to develop a chronic condition because they received a larger amount of the virus than someone who was exposed to a small amount of another person's blood.
Chronic hepatitis C
Anyone not able to fight off the infection within the first six months is considered to have chronic hepatitis C. With that comes the increased risk of liver damage, which usually follows this pattern:
- Inflammation: The liver becomes inflamed, tender and enlarged.
- Fibrosis: The damaged liver develops scars and, as the scars replace healthy liver tissue, liver function decreases.
- Cirrhosis: The liver is so damaged and scarred that it can no longer heal itself and create new, healthy tissue.
- Liver cancer: The level of organ damage increases the risk of developing liver cancer.
- Liver failure: As the disease progresses, the liver becomes unable to function and is considered to be in failure.
This progression often occurs very slowly, sometimes taking up to 30 years. Some people can have the virus for many years and experience only minimal liver damage, while in others, it can progress much more quickly. On average:
- Chronic hepatitis C is evident on a liver biopsy between 10 and 14 years after contracting the disease
- Cirrhosis develops about 20 years after contracting the disease; between 10 and 25 percent of those with hepatitis C develop cirrhosis within 15 years of contracting the disease
- Cancer develops about 28 years after contracting the disease.
When the liver is damaged to the point where it can no longer function, it is called end-stage hepatitis C. Then the only treatment is a liver transplant.
Continued and excessive use of alcohol can accelerate the progression of the disease. Also, if you have HIV or a second hepatitis virus, the disease may progress more quickly. Men tend to develop cirrhosis sooner than women. If you are diagnosed with hepatitis C, avoid alcohol to help protect the liver tissue that's still healthy.
In recent years, scientists have discovered that hepatitis C may actually affect more than the liver. Research has found that it can also infect parts of the immune system, some blood cells and probably the brain. This suggests hepatitis C may be a systemic condition, rather than a just a liver disease.
"Hepatitis C FAQs for the Public," Updated 2014, Feb 10, U.S. Centers for Disease Control and Prevention
"Hepatitis C Info," Date Unknown, Staff Writer, Hepatitis C Trust
"What I Need to Know About Hepatitis C," Updated 2012, Dec. Staff Writer, National Digestive Diseases Information Clearinghouse