Advancing Liver Disease and Cirrhosis

It’s far better for the public health to test broadly for HCV, and to treat it early. Advanced HCV liver disease is costly, painful, and preventable! Left undiagnosed and/or untreated, hepatitis C advances – often silently – until suddenly it is too late.

Overview of HCV Disease Progression
If acute hepatitis C infection (HCV) becomes a chronic infection it can eventually progress to a more serious disease. Over time it can produce fibrosis (light, moderate and severe scarring), cirrhosis (extensive scarring), decompensated cirrhosis (potentially life-threatening scarring), encephalopathy, liver cancer, the need for a new liver (liver transplant) and for some it could lead to coma or death.  To educate yourself further about these important issues, see:

• Understanding Cirrhosis of the Liver: First steps for the newly diagnosed – a particularly easy to understand introduction to cirrhosis, but has all the most important facts for families and patients to know and discuss further with health care providers. Written by hepatology nurses with lots of practical experience! Two more helpful links about Cirrhosis: You Tube medical animation about cirrhosis and A great introduction to cirrhosis written in simple language
• Encephalopathy and Coma – seek most recent information on this topic; excellent new treatments are becoming available.
• Liver Cancer (hepato-cellular carcinoma or HCC) – seek most recent information on this topic; prevention, diagnosis and treatment of liver cancer is constantly changing.
• Transplant

Possible Symptoms of Hepatitis C-related Cirrhosis – View images of “Stage 4” in Stages of Liver Disease.

• People vary from one or two symptoms to several symptoms to even NO SYMPTOMS AT ALL. Cirrhosis is sometimes a “Silent” disease, until suddenly the person is diagnosed with highly advanced liver damage. Symptoms of chronic hepatitis C from Stages 1 – 3 may increase in severity and can include the following :
  • progressively more severe fatigue
  • increased loss of appetite and loss of weight
  • easy bruisability
  • jaundice (yellow skin)
  • icterus (yellow eyes)
  • dark urine (the color of cola)
  • ascites or abdominal fluid accumulation and swelling (one symptom of this is sudden weight gain)
  • bleeding into the stomach, bloody stool and variceal rectal bleeding (caused by portal hypertension)
  • bleeding into the esophagus and variceal oral bleeding, coughing up/vomiting blood (caused by portal hypertension)
  • muscle wasting
  • swelling of spleen
  • severe itching (caused by bilirubin buildup under skin)
  • mild encephalopathy resulting in forgetfulness, disorientation and/or confusion

Possible Symptoms of Hepatitis C-related Liver De-compensation and Failure (end-stage liver disease)

• all above possible symptoms of hepatitis C-related Cirrhosis may increase in severity
• risk of the following increases:
  • liver cancer (HCC or hepatocellular carcinoma)
  • kidney failure
  • life-threatening variceal bleeding – oral or rectal
  • severe ascites or swelling of abdomen
  • severe encephalopathy resulting in debilitating disorientation, dementia, and/or hepatic coma