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Most hepatitis C episodes are acute. These episodes have one or two major symptoms and last for about a month before spontaneously resolving independently.
While most cases of hepatitis C are active, meaning that the patient knows that they have some kind of illness due to the presence of symptoms, sometimes the disease can linger on without the patient even knowing about it. The inactive form of hepatitis C is most common with chronic hepatitis. The signs and symptoms of the disease are suppressed to the point where the patient actually starts to feel much better. The virus is said to have gone into a dormant stage during the period of inactivity. However, the virus can reactivate at any time without prior warning.
The period of inactivity of the virus is variable and is dependent on multiple factors. A person's immunity, the number of comorbid diseases, and overall health state determine how long a chronic hepatitis C infection would remain.
CAN HEPATITIS C BE INACTIVE?
As mentioned above, hepatitis C comes in both an acute and a chronic form. Not all acute-phase infections with hepatitis C progress to the chronic stage. However, most of the cases progress to the chronic stage when the infection is left untreated.
While the acute stage of the disease is fairly active, sometimes a person can get infected with viral hepatitis C without even knowing it. This is called a subacute form of infection, and it usually presents with little to no symptoms. However, this is different from an inactive stage of hepatitis. o
An inactive stage of hepatitis is when the patient first develops symptoms of hepatitis but recovers soon after without any evidence of the virus being eliminated from the body. The inactive stage of hepatitis C is most commonly associated with chronic hepatitis C infection. The patient appears to have been cured during the inactive stage as there are no symptoms whatsoever. However, the virus merely goes into a dormant stage and can reactivate to cause symptoms again.
Hepatitis C can become inactive due to multiple reasons. Often, the virus becomes dormant in a chronic infection for no obvious reason. Sometimes, during chronic hepatitis C, a person's immunity may take over and force the virus into a dormant or inactive stage. Incomplete or ineffective treatment of the virus during the acute attack can also cause the hepatitis C virus, or the HCV, to become inactive inside the patient’s body.
Whatever the cause may be, the virus can return to its active form at any stage without any warning. The trigger for the reactivation of the virus is often stress. Systemic diseases, such as diabetes, and hypertension, can also cause the virus to reactivate and cause symptoms again.
CAN I HAVE MORE THAN ONE RELAPSE OF HEPATITIS C?
When the hepatitis C virus reactivates to cause symptoms following a period of inactivity, it is called a relapse. Relapse is different from re-infection as the original infection was never cured to begin with – it was just prolonged, and the virus simply became inactive for the time being.
It is certainly possible for the hepatitis C virus to go inactive more than once in the same individual. This means that you can have more than one relapse of hepatitis C symptoms. However, this possibility is very unlikely as the natural course of the virus either allows for a complete cure or extensive liver damage following a period of inactivity.
Moreover, treatment with modern antiviral drugs allows for a complete cure of hepatitis C in most cases. Even when the disease is not completely cured in one course of treatment, multiple relapses are still highly unlikely as the viral load decreases greatly.
I HAVE CHRONIC HEPATITIS C; WHAT NOW?
Having chronic hepatitis C can be bothersome simply because living with any chronic condition can be tough as it can have a massive physical and emotional toll on an individual. However, chronic hepatitis C can have more detrimental effects than just an emotional toll on a person's mental health.
Chronic hepatitis C is associated with extensive liver damage. Even when a person does not have any symptoms, the virus can continue to affect their liver. Continuous liver inflammation can lead to fibrosis, where the patient's liver tissue is replaced with scar tissue. The scar tissue cannot perform the normal functions of a healthy liver, and, thus, all the normal functions of a healthy liver are lost. This is called cirrhosis of the liver.
Liver cirrhosis is an extremely dangerous situation. The liver shrinks in size and becomes hard. Oftentimes, the liver gets filled with fluid and causes complications like ascites, variceal bleeding, and generalized edema in the patient.
If you have chronic hepatitis C, it is best to check your disease progression by visiting your doctor frequently. Taking the antiviral medication is the best way to eliminate the possibility of cirrhosis and effectively eliminate the virus from your body. Activities that worsen your liver, such as drinking, are best avoided. Any medications you need to take for anything other than your liver disease should first be checked by your doctor.
CAN CHRONIC HEPATITIS C CAUSE LIVER CANCER?
As mentioned before, chronic hepatitis C can cause cirrhosis of the liver. A cirrhotic liver is abnormal both in function and cellular architecture. Whenever the cellular architecture of an organ is disturbed, the chance for cancer to develop increases proportionally.
Liver cirrhosis can lead to the development of liver cancer, which is known as hepatocellular carcinoma. Not all cirrhotic livers will progress to liver cancer. However, a major chunk of cirrhotic livers develop hepatocellular carcinoma and cause a completely new set of symptoms.
Hepatocellular carcinoma can cause both local and systemic effects. The growing mass on the liver can cause pressure symptoms which present as abdominal pain, localized in the right upper quadrant of the abdomen. The mass can pressure large local vessels and cause fluid buildup in the abdomen, known as ascites. Esophageal varices can also develop, which lead to bloody vomiting and dark stools. Most patients develop hemorrhoids, generalized edema, and muscle wasting. Petechial hemorrhages start occurring in every part of the body due to an acquired deficiency of coagulation factors.
