illustration of liver

Hepatitis C is an infection that leads to liver inflammation. Symptoms can be mild for many years, even while liver damage is taking place. The majority of people who are infected end up with chronic hepatitis that can last a lifetime. The consequences of long-term infection include liver damage, liver cancer, and even death.

Read on to learn how the infection is spread and how it progresses.

How Hepatitis C Spreads

You can become infected with hepatitis C through contact with the blood of an infected person. You’re at risk of contracting the virus if you:

  • share infected needles
  • come into regular contact with blood
  • have had long-term kidney dialysis
  • engage in unprotected sex with an infected person

Infected mothers also can pass the virus on to their children during childbirth, but not during breast-feeding.

Early Warning Signs

In most cases, there are no early warning signs. Most people are symptom-free and remain unaware of the infection for a long time. Others experience mild symptoms, such as fatigue and loss of appetite, which clear up on their own. About 15 to 20 percent of people infected with hepatitis C fight it off without treatment and suffer no long-term damage to their health.

Acute Phase

The first six months following infection is the acute phase of the disease. Early symptoms may include fatigue, loss of appetite, or mild yellowing of the skin and eyes (jaundice). In most cases, symptoms clear up within a few weeks. If your immune system doesn’t resolve the problem on its own, it enters the chronic phase. Because of the lack of symptoms, chronic hepatitis C can go unnoticed for years. It’s often discovered during a blood test that’s being done for other reasons.

Chronic Phase

Most people who’ve been infected will progress to the chronic phase. However, even in the chronic phase, it may take years for symptoms to show. Progression begins with inflammation of the liver, followed by the death of liver cells. This causes scarring and hardening (cirrhosis) of liver tissue.

About 20 percent of people with chronic hepatitis C will experience gradual damage to the liver over a period of years, and go on to develop cirrhosis of the liver in 15 to 20 years.

Cirrhosis of the Liver

When permanent scar tissue replaces healthy liver cells, it’s called cirrhosis. The liver becomes so scarred that it can no longer heal itself. This can cause a variety of health concerns, including a buildup of fluid in the abdomen and bleeding from veins in the esophagus. When the liver fails to filter toxins, they can build up in the bloodstream and damage brain function. Some people with cirrhosis of the liver will go on to develop liver cancer. This risk is greater in people who drink excessive amounts of alcohol.

End Stage

Chronic hepatitis C can cause serious long-term health consequences, including liver failure, liver cancer, and death. End-stage hepatitis C occurs when the liver is severely damaged and can no longer function properly.

Symptoms may include fatigue, jaundice, nausea, loss of appetite, abdominal swelling, and muddled thinking. People with cirrhosis may also experience bleeding in the esophagus, as well as brain and nervous system damage.

A liver transplant is the only treatment for end-stage liver disease. Most transplant patients live at last five years, but unfortunately hepatitis C almost always returns in these patients.

Factors That Affect Progression

Because alcohol is processed in the liver, excessive alcohol consumption can hasten liver damage. Damage progresses faster in people who are also HIV-positive.

In people who also have hepatitis B, the risk of developing liver cancer is increased. When it comes to cirrhosis, men tend to progress faster than women. Additionally, people over 40 with cirrhosis progress at a faster rate than younger people.