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

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].

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]

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

• Cirrhosis: If left untreated, scar tissue can overpower healthy liver tissue, leading to cirrhosis. This scarring reduces blood flow through the liver and can cause additional complications including jaundice, gallstones, and bone disease.
• Liver cancer: When cirrhosis occurs, the body produces new cells to combat the scarring — a process that also increases the risk of cancerous cell development.
• Liver disease: Untreated hepatitis C can progress to liver disease and ultimately liver failure, which can be detected via blood tests, CT scans, and/or liver biopsy.
• Mental health complications: HCV infection can affect the neurological system, potentially causing neuropathies, cognitive decline, and psychological conditions such as depression.
• Cardiovascular risk: People living with hepatitis C alongside other conditions such as human immunodeficiency virus (HIV) are at greater risk of heart-related complications. Co-infection with HIV is not uncommon, as both viruses share the same blood-to-blood transmission route.
• Arthritis: Chronic HCV infection can spread to other sites in the body. The inflammatory response triggered by the virus may cause tissue damage, contributing to arthritis.
• Diabetes: Some research suggests untreated hepatitis C may contribute to poor glucose control and increased diabetes risk — potentially because cirrhosis impairs glucose tolerance and the infection can disrupt insulin-regulating pathways, raising the risk of type 2 diabetes.

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

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.

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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