Healthcare provider discussing untreated hepatitis C risk with patient

Untreated Hepatitis C: Who Is Most at Risk and What to Do

Medically reviewed on November 16, 2023 by Jordan Stachel, MS, RDN, CPT. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

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Managing your physical health can be challenging, at times. Many people do not know where to turn or who to consult to help manage ailments that may arise. Hepatitis C is an infection that is caused by the hepatitis C virus, also known as HCV. It is estimated that 2.7 million people in the United States are living with a chronic hepatitis C infection, making this a common condition that warrants more awareness, as untreatable hepatitis C can have many health repercussions.[1]

In this guide, we’ll explore what happens if a hepatitis C infection is left untreated, how to reduce your risk of getting hepatitis C, and how to detect and treat HCV to protect your overall health.

Understanding Hepatitis C

Hepatitis refers to general inflammation of the liver. The liver can become inflamed due to heavy use of alcohol, some medications, and/or toxin exposure. The different types of hepatitis (A, B, and C) are caused by different viruses and present with unique sets of symptoms. While vaccines can help prevent the development and spread of hepatitis A and B, there is no vaccine for hepatitis C.[2]

There are two main types of hepatitis C: acute and chronic [2]:

  • Acute hepatitis C: This condition typically occurs within six months after exposure to the HCV and can either be a short or long-term infection.
  • Chronic hepatitis C: This condition can be lifelong and can cause other health complications to arise, especially if left untreated [2].

Symptoms of Hepatitis C

Part of the challenge with diagnosing and treating hepatitis C is that the acute phase may not present with symptoms. If symptoms do present during the acute phase, they may include tiredness, jaundice, nausea, fever, and/or muscle aches.

Even chronic hepatitis C may not present with symptoms for several years. Symptoms typically begin to emerge once the liver has experienced a significant level of damage. Symptoms of long-term hepatitis C can include [3]:

  • Easier bleeding and/or bruising
  • Fatigue
  • Loss of appetite
  • Jaundice
  • Darker colored urine
  • Itchy skin
  • Ascites: fluid buildup around the stomach
  • Swelling of the legs
  • Hepatic encephalopathy: confusion and/or slurred speech
  • Spider angiomas

Hepatitis C is typically treated with medicine known as direct-acting antivirals (DAA) which are most effective for treating the strain of the virus contracted.[4] While taking medication to treat hepatitis C, regular laboratory work is advised to make sure that the medicine is effective. The health of the liver will also be evaluated using a fibroscan, and after the course of treatment is completed, blood tests will be taken to see if the virus has been cleared. It is thought that treatment with DAAs can cure around 90% of people with a hepatitis C infection.[4]

Effects of Untreated Hepatitis C

If hepatitis C goes untreated, there are risks to your general health and well-being. A few of the most common risks and/or complications of untreated hepatitis C include [5-9]:

  • Cirrhosis: Because hepatitis C affects the liver, if left untreated, the liver can become scarred, and the scar tissue can overpower the healthy tissue of the liver, leading to cirrhosis. This scarring is problematic due to the reduction in blood flow that coincides with an increase in scar tissue. In addition, cirrhosis can cause other complications, including jaundice, gallstones, and bone disease.
  • Liver cancer: If cirrhosis occurs, the body begins to make new cells to fight off the process of the scarring, increasing the risk for developing cancerous cells as well.
  • Liver disease: If hepatitis C goes untreated, it is possible to develop liver disease, which can lead to liver failure. Liver failure is something that can be detected via a blood test, a CT scan, and/or a liver biopsy.
  • Mental health complications: HCV infection can affect the neurological system, as it can cause neuropathies, cognitive decline, and/or other psychological disorders like depression.
  • Cardiovascular risk: If people have hepatitis C in addition to other conditions, such as human immunodeficiency virus (HV), they are at a much greater risk of suffering heart-related complications. It can be common for hepatitis C and HIV to coinfect people because the transmission route (blood-to-blood contact) is the same.
  • Arthritis: Because a chronic HCV infection can travel to other sites in the body, arthritis can be common. It is thought that this is because the HCV infection triggers an inflammatory response in the body, which can then cause tissue damage.
  • Diabetes: There is some research to indicate that untreated hepatitis C can be related to poor glucose control and an increased risk of developing diabetes. This may be because cirrhosis is linked to poor glucose tolerance. Having the HCV infection, in general, can also lead to defects in the pathways responsible for regulating insulin, increasing your risk of developing type II diabetes.

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How to Reduce Your Risk of Getting Hepatitis C

While there is no vaccine for hepatitis C, you can help prevent the spread of the virus. Some of the best ways to reduce your risk of contracting the virus include [10]:

  • Using clean and safe injection methods under the supervision of qualified healthcare professionals
  • Safely disposing of needles
  • Increased services and educational opportunities for harm-reducing tactics for those who inject drugs
  • Testing donated blood to ensure that the virus is not passed on via blood
  • Educating healthcare professionals on the signs of hepatitis C and how to use safer practices
  • Practicing safe sex by using condoms and/or other protection

How to Treat Hepatitis C

As mentioned above, antiviral medicines can treat hepatitis C. If the virus has done too much damage, you may be eligible for a liver transplant. However, a liver transplant won’t completely cure someone of hepatitis C.[11] Even people who have received a transplant are still susceptible to reinfection from the virus. In this case, antiviral medications are still warranted.

It is important to be aware of potential side effects of medications to treat hepatitis C.[12] Some of the most common side effects of DAAs include:

  • Insomnia
  • Nausea
  • Diarrhea
  • Headaches
  • Fatigue

As with any immunocompromised condition and treatment plan, getting adequate sleep, eating a well-rounded diet, and trying to manage stressors will all help to improve the HCV treatment. That said, start small by evaluating your sleep hygiene and tweaking any little details to improve the quality of your sleep (the temperature of your room, the fabric of your sheets). Add in a few anti-inflammatory foods like berries and/or grounding root vegetables. Manage your stress by engaging in stress-reducing techniques more regularly that work well for you.

Support Your Physical Health with Everlywell

At Everlywell, we combine the best in modernized, rigorous lab testing with easy access to at-home medicine. We provide a range of blood tests, including the hepatitis C test, that you can take from the comfort of your home. Your results will be analyzed in CLIA-certified labs, and an experienced healthcare provider will deliver your results that you can trust every time. Protect your physical health with Everlywell.

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  1. Hepatitis C (HCV): Symptoms, causes & treatments. American Liver Foundation. Published May 23, 2022. Accessed November 1, 2023.
  2. What is Hepatitis C: FAQ. Centers for Disease Control and Prevention. Published October 27, 2020. Accessed November 1, 2023.
  3. Hepatitis C: symptoms and causes. Mayo Clinic. Published 2023. Accessed November 1, 2023.
  4. NHS. Hepatitis C: treatment. National Health Service. Published February 5, 2018. Accessed November 1, 2023.
  5. Long-term effects of untreated hepatitis C. Healthline. Published June 2, 2020. Accessed November 1, 2023.
  6. Faccioli J, Nardelli S, Gioia S, Riggio O, Ridola L. Neurological and psychiatric effects of hepatitis C virus infection. World Journal of Gastroenterology. 2021;27(29):4846-4861. doi:
  7. Heart attack risk increased among people with HIV and hepatitis C as they aged. American Heart Association. Accessed November 1, 2023.
  8. Kemmer NM, Sherman KE. Hepatitis C-related arthropathy: diagnostic and treatment considerations. The Journal of musculoskeletal medicine. 2010;27(9):351-354.
  9. Hammerstad SS, Grock SF, Lee HJ, Hasham A, Sundaram N, Tomer Y. Diabetes and hepatitis C: a two-way association. Frontiers in Endocrinology. 2015;6. doi:
  10. Hepatitis C. World Health Organization. . Published July 18, 2023. Accessed November 1, 2023.
  11. Hepatitis C: diagnosis and treatment. Mayo Clinic. Published 2019. Accessed November 1, 2023.
  12. Hepatitis C self-care and home remedy tips and recommendations. Healthline. Published July 28, 2015. Accessed November 1, 2023.
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