Chronic hepatitis C refers to ongoing liver inflammation due to HCV infection. However, it can lead to symptoms throughout your body, including digestive problems, thyroid tissue damage, and other ongoing effects.

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), up to 3.9 million people in the United States may have the chronic form of hepatitis C, which is caused by the hepatitis C virus (HCV).

According to the World Health Organization (WHO), an estimated 58 million people worldwide have chronic hepatitis C.

Over time, an HCV infection can lead to cirrhosis, which can cause liver failure. Cirrhosis gradually causes scar tissue to gradually replace liver cells. It can then progress to a point where there aren’t enough cells for typical liver function.

Cirrhosis can create a buildup of toxins in the brain that make you confused or forgetful. It can also cause blood flow problems and skin issues like easy bruising or jaundice.

Research suggests that about 15–30% of people with chronic hepatitis C will develop liver failure.

HCV is transmitted through contact with the blood. It’s rarely transmitted through sexual contact with someone who has the virus.

The infection has two stages: acute and chronic.

The acute stage is the first 6 months after presumed exposure to the virus. For some, this is a short-term illness.

According to the Centers for Disease Control and Prevention (CDC), more than 50% of people who contract HCV go on to develop chronic hepatitis C. Most people don’t realize they’ve contracted the virus until other symptoms within their body start developing.

A blood test can measure HCV antibodies in your bloodstream. If you have antibodies, you’ve been exposed to the virus. In most cases, your healthcare professional will request a second blood test to confirm an HCV infection.

Although the hepatitis A, B, and C viruses all cause hepatitis, they’re three different and distinct viruses.

A healthy liver is crucial to your health as it supports many other body systems.

The liver’s job is to process blood and filter toxins from your body. It produces proteins, important blood components, and bile, which helps you digest food. It also stores glucose and vitamins.

HCV infection causes inflammation that interrupts the liver’s ability to perform these vital functions.

Early symptoms may be mild and easily dismissed, but early treatment is critical to preventing long-term complications.

As hepatitis C progresses, symptoms like skin conditions, blood disorders, and unexplained weight loss may appear. Significantly adverse health outcomes like severe liver damage, liver cancer, and liver failure can also occur.

One liver function is producing bile, which breaks down dietary fats. Your body stores bile in the gallbladder and then sends it to the beginning section of the small intestine when needed.

Bile is combined with stomach acids and digestive fluids from the pancreas, which helps the intestines absorb nutrients into the bloodstream.

HCV infection can severely hinder the liver’s ability to produce bile. Poor bile production can make it difficult and uncomfortable to digest fatty foods.

You also might feel pain throughout the abdomen from a buildup of fluid in the peritoneal space, which is the space between the organs and the abdominal wall. This is known as ascites, and it develops with cirrhosis.

Ascites occur when the damaged liver doesn’t produce enough albumin, a substance that regulates the amount of fluid in cells.

Other digestive symptoms include:

  • nausea
  • vomiting
  • loss of appetite
  • weight loss
  • pale or clay-colored stools

Severe pain can occur if your gallbladder becomes inflamed. Hepatitis C is an extremely rare cause of gallbladder inflammation.

Liver dysfunction can damage the CNS, which includes the brain and spinal cord. When hepatitis C leads to cirrhosis, CNS damage occurs because of a buildup of toxins in the brain.

This can lead to:

  • insomnia
  • confusion
  • forgetfulness
  • poor concentration
  • personality changes

Severe cases of liver failure may cause coma.

In addition to filtering toxins, the liver also produces proteins that help with blood clotting.

A poorly functioning liver can also create blood flow problems and increase pressure in the portal (main) vein that leads to the liver. This can result in portal hypertension, which may force blood to find alternate veins.

If the vein is located in the esophagus or stomach, it can burst, causing variceal bleeding. This is severe internal bleeding. A poorly functioning liver cannot absorb, transport properly, and store iron. This can result in anemia.

Hepatitis C is associated with various skin symptoms, including easy bruising, loss of skin pigment, rashes, and itching.

Bilirubin is an important substance that comes from the breakdown of hemoglobin. When the liver is cirrhotic, bilirubin can build up and cause jaundice, or the yellowing of your skin and the whites of your eyes.

Poor liver function can also lead to poor nutrition. This leads to inadequate growth of hair and nails as well.

Skin conditions that may occur include:

  • porphyria cutanea tarda, which is a kind of photosensitivity leading to skin blistering
  • lichen planus, which are purple, itchy papules that can appear on the skin and in the mouth
  • leukocytic vasculitis, which is inflammation of the small blood vessels

The endocrine system regulates hormones. As part of the endocrine system, the thyroid gland delivers hormones into the bloodstream.

Sometimes, HCV can cause the immune system to attack or damage thyroid tissue mistakenly.

This may increase the risk of either:

  • hyperthyroidism (overactive thyroid), which can cause sleep disorders and weight loss
  • hypothyroidism (underactive thyroid), which can cause fatigue and weight gain

A healthy liver also helps manage how the body uses sugar. The body’s inability to control sugar levels can lead to type 2 diabetes.

HCV can also lead to autoimmune thyroiditis and thyroid cancer.

Many people with hepatitis C have no symptoms, especially in the acute stage. Some report general fatigue, fever, or nonspecific aches and pains. Most signs and symptoms are more noticeable if the disease becomes chronic.

Prompt diagnosis and treatment can help prevent permanent liver damage and other potentially life threatening complications.