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.

What exactly is chronic hepatitis C? In a nutshell, it refers to the ongoing inflammation of your liver due to chronic HCV infection.

But it can lead to symptoms throughout your body. These symptoms throughout the body can include digestive problems, thyroid tissue damage, and other ongoing impacts.

Over time, an HCV infection can lead to cirrhosis, which can cause liver failure. Cirrhosis gradually causes liver cells to be replaced by scar tissue. It can then progress to a point where there isn’t enough normal 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.

About 15 to 30 percent of people with HCV infection 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.

Ultimately, if the virus becomes chronic, this infection leads to liver inflammation and many other issues that can severely damage your health.

The infection has two stages: acute and chronic.

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

But according to the Centers for Disease Control and Prevention (CDC), more than 50 percent of people with HCV will develop a chronic HCV infection. This means it can be lifelong. Most people don’t realize they have the virus until other symptoms within their body start.

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

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Illustration by Wenzdai Figueroa

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 serious damage. When a chronic infection occurs, it can cause cirrhosis, or scarring of the liver, over time.

As hepatitis C progresses, symptoms like skin problems, blood disorders, and weight loss may appear. Dangerous outcomes like severe liver damage, liver cancer, and liver failure can also occur.

A blood test can measure HCV antibodies in your bloodstream. If you have antibodies, it means that you’ve been exposed to the virus. In most cases, you’ll need to take a second blood test for your doctor to confirm an HCV infection.

A healthy liver is crucial to your health as it supports many other body systems. One function of the liver is to produce bile, a substance needed to break down fats.

Your body stores bile in the gallbladder and then sends it to the beginning section of the small intestine when needed. Bile is then combined with stomach acids and digestive fluids from the pancreas, which helps the intestines absorb nutrients into the bloodstream.

HCV 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 some pain throughout the abdomen from a buildup of fluid in the peritoneal space, which is the space in the abdomen between the organs and the abdominal wall. This is known as ascites, and it develops with cirrhosis. It occurs 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 from HCV. This is an extremely rare cause of gallbladder inflammation.

Liver dysfunction can damage the central nervous system. In cases of a hepatitis C that leads to cirrhosis, this occurs because of a buildup of toxins in the brain.

This can lead to:

  • confusion
  • forgetfulness
  • poor concentration
  • personality changes

In addition to filtering toxins, the liver also produces proteins needed for healthy blood and helps to regulate blood clotting.

A poorly functioning liver can 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.

These veins can burst, causing variceal bleeding. This is severe internal bleeding. A poorly functioning liver is also unable to properly absorb, transport, and store iron. This can result in anemia.

Advanced symptoms include:

  • abnormal shaking
  • agitation
  • disorientation
  • slurred speech

Severe cases of liver failure may cause coma. About 47 percent of people with cirrhosis survive for 10 years from diagnosis.

Hepatitis C is associated with a wide variety of skin problems. Some common conditions include easy bruising, loss of skin pigment, rashes, and itching.

Bilirubin is an important substance that comes from the breakdown of hemoglobin. When the liver can’t do its job, 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 than 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 mistakenly attack or damage thyroid tissue. This may lead to 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 sugar is used in the body. The body’s inability to control sugar levels can lead to type 2 diabetes.

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.

In its chronic state, you’ll likely benefit from treatment in order to prevent permanent liver damage and other potentially life threatening complications.