In a 2006 article published in the "Annals of Internal Medicine," researchers noted that 3.9 million people living in the United States had positive blood tests for hepatitis C. Approximately 2.7 million of those people were sick with chronic infection; the others had not yet developed symptoms. The HCAdvocate website notes that 8,000 to 10,000 people die annually from complications related to Hepatitis C. The advanced stages of Hepatitis C can be debilitating.
Hepatic Encephalopathy
Hepatic encephalopathy is another serious complication of Hepatitis C. According to the National Institutes of Health, the exact cause of hepatic encephalopathy is not known. Encephalopathy occurs when the liver is damaged and unable to remove toxins from the blood. Ammonia is a substance that is produced from the intake of proteins. Normally, the liver makes ammonia harmless. But if the liver cannot process ammonia, it builds up and causes brain damage. Symptoms begin slowly and progress over time. Family members may notice a sweet smell on the patient's breath, changes in personality, confusion, forgetfulness and difficultly sleeping. More severe symptoms include disorientation, tremors, agitation, drowsiness, slurred speech or sluggish movements. Patients with hepatic encephalopathy can become unresponsive and go into a coma. Hepatic encephalopathy is a medical emergency.
Variceal Bleed
When cirrhosis caused by Hepatitis C occurs, it destroys hepatocytes, and movement of blood through the liver is impaired. This causes a back-up of blood and an increase in pressure in the portal vein that leads to the liver. An increase in pressure if not relieved can cause further back-up of blood in the circulatory system. Increased pressure within the circulatory system causes swollen veins, particularly in the esophagus and stomach. As these veins remain under pressure, they become thin and weak. Eventually, they rupture and patients may find themselves vomiting blood. The Merck Manual notes that patients with advanced cirrhosis have greater than 50 percent mortality with variceal bleeding.
Liver Cancer
Liver cancer, known as hepatocellular carcinoma, is caused by Hepatitis C in the late stages. According to the Merck Manual, hepatocellular cancer causes 14,000 deaths a year. Patients present with weight loss, abdominal pain and loss of appetite. In some patients, the first symptoms of cancer of the liver are bloody ascites or bloody fluid that has leaked into the abdomen, infection of the wall of the abdomen or shock caused by hemorrhage of the tumor. Hepatocellular carcinoma is staged to determine treatment. Stage IV liver cancer carries a five-year survival rate of less than 5 percent.
References
- Annals of Internal Medicine: The Prevalence of Hepatitis C Virus Infection in the United States, 1999 through 2002: May 16, 2006
- HCAdvocate: Hepatitis C
- National Institutes of Health: Hepatic Encephalopathy
- The Merck Manual Online Library: Varices: GI Bleeding
- The Merck Manual Online Library: Liver Cancer
