Last Updated on June 4, 2020 by Shuvani Sanyal, MD
Most people do not know they have hep-C. In fact, the virus was around for years before scientists even identified it. So, lots of people were infected before anyone knew the virus existed. Now there are ways to find out if you were exposed to and/or infected with hepatitis C.
Hep C is a small virus spread through blood-to-blood contact. Hep-C travels through the bloodstream to the liver. It enters the liver cells and interferes with normal liver cell activity. It forces the liver cells to make billions of virus copies a day. This stresses the liver, causing it to become inflamed. Hep-C makes your liver work even harder at the many jobs it must do to keep your body healthy. Later on, hep-C can damage your liver and prevent it from working properly. That is what makes you sick.
Incubation Period
If you are infected with the hep-C virus, there is an incubation period. During this period, the virus tries to enter the liver cells. About 15-20% of people infected with hep-C clear the virus on their own; the rest (about 80-85%) go on to have chronic (long-term) hep-C.
There is no ‘typical’ hep-C experience. Only 10-25% of people with chronic hep-C have symptoms when first infected. About 25% never have any symptoms, even though some will have mild liver scarring. Many people only discover they are infected years later when they develop symptoms and/or testing confirms they have the virus.
In its early stages, hep-C is difficult to recognize from just the symptoms, because many of them are similar to symptoms you get from other diseases, like the flu or HIV.
Some Symptoms
- Headaches
- Loss of appetite
- Nausea
- Stiff/aching joints
- Brain fog/cloudy head
- Depression
The following are symptoms that are more likely to show up at an advanced stage of the disease, when the liver has become damaged:
- Pain in the right side, over the liver area
- Dark urine
- Pale stools
- Constant tiredness and lack of energy
- Jaundice (yellowing of the skin and eyes)
- Severe itching on the skin – usually the arms and legs
- Water retention with bloating in the lower stomach area and legs
- Easy bruising/bleeding, including in your esophagus
- Severe mental confusion
The only way to know for sure if you have hep-C is to have a blood test. If you are at risk, especially if you have symptoms, consider getting tested.
Hepatitis & the Liver
The liver is a strong vital organ that keeps your body functioning smoothly. Your liver processes almost everything you take into your body. It performs over 500 necessary jobs everyday. Some of the most important are:
- Helping the body digest food
- Removing toxins from your system, such as alcohol, drugs and medications
- Regulating the chemicals produced by your others organs, such as the kidney and the spleen
- Storing and releasing nutrients for the body, such as vitamins, minerals and sugar
- Making platelets, which help your blood to clot
The liver can withstand lots of damage because it is capable of repairing itself. Like a sore on your skin, the liver will scab as it heals, but it will also scar. A scar on your liver is different from a scar on your skin. The scar on your liver makes it harder for your liver to work the way it’s supposed to. The more your liver scars, the less it can do.
In about 3% of hep-C infected people, the liver becomes so severely damaged that it can no longer work properly. At this stage, called liver failure, the only medical option is a liver transplant. Liver transplants are difficult, expensive, and hard to get. Injection drug users and people living with HIV may not be able to get liver transplants at all. Even worse, if you do get a transplant, hep-C almost always re-appears in the new liver. That is why it’s so important to prevent hep-C and to find out early if you are infected.
Disease Progression
Of all people infected with hep-C:
- 15-20% clear the virus within 2-6 months of being infected.
- 80-85% remain chronically infected. Nearly all will show characteristics on examination.
Of all people chronically infected with hep-C:
- 20% will never suffer significant liver damage or symptoms (17% of all infected).
- 80% will get some long term symptoms or liver damage over a period of 10-40 years (68% of all).
Of all people who develop some liver disease:
- About 20% will develop cirrhosis after an average of 20-30 years (13-15% of all infected). Risk factors to get there include: males over 50, big alcohol drinkers and certain genotypes.
Of all people with cirrhosis:
- 25% will have liver failure or cancer over 5-10 years (3-4% of all).
- 75% will remain stable over 5-10 years (10-12% of all).
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Did the information above help you? Are you living with hep-C and would like to share your perspective? Share your thoughts in the comments section below!