The connection between cirrhosis and hepatitis C
Both conditions are individually harmful and together may make it more likely that a person will develop liver failure and liver cancer, potentially resulting in death, according to the Centers for Disease Control and Prevention (CDC).
The link between hepatitis C and cirrhosis
A person with hepatitis C can develop scarring of the liver, known as cirrhosis.
Hepatitis C can cause cirrhosis, but cirrhosis cannot cause hepatitis C. This is because a person must have exposure to the virus to get hepatitis C.
Hepatitis C is a virus that people contract when they come into contact with the blood of someone who has hepatitis C.
Transmission can occur through:
- sharing needles
- needlestick injury among healthcare workers
- sexual intercourse
- being born to a parent with hepatitis C
It is also possible to have hepatitis C for many years and be unaware of it.
When a person first contracts the virus, they usually experience mild illness, and the body may clear the virus completely. This is true in about 15 to 25 percent of people who contract the hepatitis C virus, according to the CDC. The remainder may experience a chronic infection.
Cirrhosis is scarring of the liver, and the condition can be a side effect of chronic hepatitis C.
The following may also cause cirrhosis:
- alcohol abuse or alcoholic liver disease
- autoimmune hepatitis where the immune system attacks the liver
- chronic heart failure
- chronic hepatitis B, another type of viral hepatitis
- inherited liver diseases
- type 2 diabetes
The liver is vital to the body and is responsible for filtering and processing toxins and creating essential proteins. The liver cannot work as well if cirrhosis causes severe scarring, and it may eventually fail, which can be fatal.
Prognosis of hepatitis C and cirrhosis
If a person with hepatitis C has a history of taking immunosuppressive drugs, they may have a higher risk of developing cirrhosis.
Not every person with hepatitis C will experience cirrhosis. Again, according to the CDC, for every 100 people with hepatitis C, an estimated 10 to 20 will develop cirrhosis over the following 20 to 30 years.
A person is more likely to develop cirrhosis when they have hepatitis C if they have other risk factors, including:
- non-alcoholic fatty liver disease
- HIV or hepatitis B coinfection
- a history of taking immunosuppressive drugs
These severe complications make liver cirrhosis one of the most advanced forms of liver disease.
Doctors will look at a variety of factors and symptoms when determining a person's outlook if they have hepatitis C and cirrhosis.
For example, according to a 2014 study in the World Journal of Gastroenterology, the outlook is worse for those who have the following:
- low serum albumin levels
- low platelet counts
- elevated serum alpha-fetoprotein levels
What happens if someone has both?
Cirrhosis due to the hepatitis C virus usually takes decades to develop. If a person knows they have had hepatitis C, they should seek medical care to prevent their condition from causing to cirrhosis.
As a result, doctors recommend that a person with the following risk factors receive testing for hepatitis C:
- born from 1945 to 1965
- born to mothers who have hepatitis C
- current or former intravenous drug users
- receiving long-term hemodialysis
- a history of exposure to the hepatitis C virus, such as healthcare workers
- had a blood transfusion before July 1992, when screening became widespread
- has tattoos that were done by an unlicensed artist
- was or is currently in jail or prison
- has the HIV infection
If doctors detect hepatitis C before it causes significant liver damage, they can usually prescribe medications that may help to cure a large majority of people.
But if a person already has liver cirrhosis, then curing their hepatitis C will not reverse the damage that is already there.
When a person with hepatitis C already has cirrhosis, the treatment goal is to minimize further damage to the liver. There are several ways to accomplish this that we discuss next.
What are the treatment options?
Avoiding alcohol can help prevent liver damage.
People with hepatitis C and cirrhosis should talk to their doctor about strategies that can prevent further damage.
A person should avoid drinking alcohol, for example, as doing so may lead to liver damage.
The liver filters many medications, so people must also talk to their doctor if they are taking any of the following that could potentially harm the liver:
- prescription pills
- other medications
Doctors may prescribe medications that help reduce the likelihood of someone experiencing bleeding and developing excess fluid in the abdomen.
A doctor may also recommend routine testing for liver cancer, such as an ultrasound.
Cirrhosis can ultimately lead to liver failure where the liver stops working. When this occurs, a person may require a liver transplant to survive. However, not all people are candidates for a liver transplant, and there are fewer organs available than the many people waiting for transplants.
Hepatitis C can cause liver cirrhosis, or severe scarring, and damage to the liver. Liver cirrhosis can lead to liver cancer and liver failure.
A doctor will ideally be able to prescribe medications, such as antivirals, that cure hepatitis C and prevent cirrhosis from developing.
There is no cure for cirrhosis once it has begun. Treatment options are more likely to offer support while aiming to prevent further damage when a person experiences hepatitis C-related cirrhosis.