Hepatitis C has now become one of the most manageable conditions, thanks to modern medicine. However, even after so much medical advancement, HCV infection still prevails as most people never find out that they have it.
One of the reasons why the prevalence of hepatitis C is so high around the world is because people don't realize they have hepatitis C until it's too late. The acute phase of hepatitis C seldom presents with any symptoms. Most people have already progressed to the chronic stage when they start to get the first signs and symptoms of the infection. The chronic phase can linger on inside individuals for months and even years before serious liver damage makes the infection apparent. So, yes, it is possible for hepatitis C to damage someone’s liver without showing any signs or symptoms.
While all chronic infections stem from an acute episode of hepatitis C, not all acute episodes of hepatitis C progress to the chronic stage. On average, approximately 70-80% of acute cases go on to develop chronic infections without proper treatment. The rest of the cases simply resolve on their own without any intervention.
CAN HEPATITIS C DAMAGE MY LIVER WITHOUT ANY SYMPTOMS?
Hepatitis C is an inflammation of the liver. This inflammation can present in both acute and chronic stages. The acute stage of the disease lasts for about a month, while the chronic stage of the disease can linger on for months and even years.
A person can have an acute or a chronic stage of hepatitis C and not know about it simply because the infection does not always present with definite symptoms.
Acute hepatitis C is a form of mild infection that often starts without any obvious signs and symptoms. Most people don’t even know that they have hepatitis C until the infection has turned chronic and has brought about drastic changes in their bodies.
Moreover, often the symptoms associated with the acute phase of hepatitis C are very nonspecific. This means that nausea, vomiting, and abdominal pain that is sometimes associated with hepatitis C are not even specific to hepatitis and can be caused by other diseases as well. This is one reason why many people do not bother getting tested for hepatitis C and why some physicians overlook the possibility of hepatitis C.
Chronic hepatitis C often becomes depressed, and the virus goes into a dormant stage only to relapse later. A person's immunity also plays a role in chronic hepatitis C not having any symptoms. Most of the time, with an acute infection, a person's immunity takes an immediate hit, and the infection prevails, taking over various body systems.
With a chronic infection like chronic hepatitis C, a person's immune system gets much more time to recover and suppress the virus. This immunity buildup may keep the hepatitis C virus at bay for longer, symptom-free periods.
Even when there is no symptom, viral hepatitis C can continue to cause liver damage. Liver damage can progress greatly without the patient knowing, and often the first signs of infection appear when the liver has already undergone cirrhosis.
WHAT IS A CIRRHOTIC LIVER?
Cirrhosis of the liver simply means fibrosis of the liver. Whenever a tissue in the body gets damaged, it gets replaced by scar tissue. When hepatitis C causes extensive liver damage, the body attempts to repair the damaged liver by pushing in more fibroblast cells.
These fibroblast cells cause extensive fibrosis of the liver. Extensive fibrosis disrupts the liver's normal architecture and alters its functions. The normal lining of a human liver is then replaced with scar tissue, which cannot perform the functions of a normal healthy liver. The scarred liver, thus, becomes hard, shrinks in size, and appears to cause local and distant problems through vascular obstruction and mass effect.
A cirrhotic liver may cause ascites, which is fluid buildup in the abdomen. Normally, the blood from the gut is passed back to the heart through the liver. When the liver becomes cirrhotic, peripheral blood finds it way more difficult to pass it and return to the heart. This is called increased vascular resistance, and it causes the blood to pool in the large vessels of the gut.
Eventually, this fluid leaks out from the vessels and is collected in the peritoneal cavity of the abdomen. The abdomen becomes distended, and ascites is formed.
Increased vascular resistance also causes varices to develop in the lower part of the esophagus. These varices bleed extensively when eating or coughing. Thus, a patient with liver cirrhosis may cough up blood or even have dark stools (indicating an upper GI bleed).
A cirrhotic liver also cannot produce coagulation factors and proteins. This causes fluid buildup in the entire body and also small vessel hemorrhages throughout the body. The generalized edema, along with petechial hemorrhages, cause the patient to swell up and develop bluish-purple spots on their body.
Lastly, cirrhosis of the liver disrupts the normal architecture of the liver. This altered architecture of the liver enables dysplastic changes to develop in the liver, which can lead to cancer. A common form of liver cancer called hepatocellular carcinoma might develop in a patient with liver cirrhosis.
IS HEPATITIS C FATAL?
Even though hepatitis C can quickly turn chronic without the patient knowing and cause cirrhotic changes in the liver, the infection itself is not as harmful today as it once used to be.
Modern medication allows for not just the treatment of this infection but also a complete cure. Direct Acting Antivirals, or DAAs, eliminate the hepatitis C virus from the body effectively and eliminate the possibility of a long-standing infection.
If you get tested for hepatitis regularly, eliminate all high-risk factors for hepatitis C from your daily life, and protect your liver from unsolicited damage from drugs and alcohol, you are a much safer place than you think. While cirrhotic changes in the liver can effectively subdue a person and prove to be fatal in the long run, it is possible to control and eliminate hepatitis C before it turns your liver cirrhotic.