Complications of Hepatitis C Virus Infection
the term for the accumulation of fluid in the abdomen
liver disease. It is not specific to hepatitis
but may be caused by any liver condition which results
protein metabolism and increased portal hypertension
blood pressure in the liver).
especially albumin, play a critical role in maintaining
balance of fluids in the body. Albumin, which is
in the liver, helps "hold" fluid (plasma) in the blood
the liver is unable to produce the necessary amount of
plasma leaks through the walls of blood vessels and
in the abdominal space.
tissue present in many sick livers impairs the flow of
the liver by way of the portal vein. This increased
blood flow through the liver results in higher
within the portal vein, called portal hypertension. This
"back-pressure", combined with low levels of albumin,
to be forced out of the blood vessels into the abdomen,
be "drained off" through a procedure called
A needle connected to a vacuum jar is inserted into
and the fluid is removed. Although this may provide
temporary relief for patients with advanced liver disease, the
generally builds back up in the abdomen within a few days.
Cryoglobulinemia is a condition in which certain proteins in the
together when exposed to cold temperatures. The
proteins tend to deposit in the joints and very small
vessels, causing pain. The most common symptoms are weakness,
(joint ache), and purpura (purple bruises). The extent
caused by cryoglobulinemia varies from person to person.
Any or all
organs or body systems may be affected, including the
joints, nerves, kidneys, and liver.
Cryoglobulinemia is not common. Its cause is not known, but there
association with the hepatitis C virus.
plays an important role in the production of substances
in the clotting process. Clotting is essential for the
and healing of cuts and other wounds. When the liver is
patients may notice that they bruise very easily, and minor
scrapes bleed for much longer.
have coagulopathies (bleeding disorders) have to use
caution to avoid injury or trauma. An injury that might
moderate bleeding in a healthy person might result in very
even life-threatening bleeding for a patient with liver
patients need to avoid the use of common drugs which
clotting, such as aspirin and acetaminophen. Hepatitis
have to take "blood thinners" (anticoagulants) for
conditions must use extreme caution and be prepared
medical intervention if bleeding starts.
Edema is the
accumulation of fluid in the tissues of the
(such as in arms or legs). For hepatitis patients,
caused by the same mechanisms described in the section
Ascites). Edema can be resolved, or at least relieved,
the extremity above the level of the heart. Since
downhill, gravity will assist the fluid to return to
occur in almost anyone who keeps an extremity in a
position for an extended period. If you have ever taken
a long trip
in a car or an airplane with your shoes off, you may
that you have trouble getting your shoes back on at
the end of
encephalopathy is a condition that results from the liver's
remove abnormally high levels of ammonia from the blood.
Ammonia has a
direct and serious effect on brain tissue, and is a
protein metabolism. Although medications exist that
encephalopathy, failure to adequately treat this
will result in confusion, disorientation, hallucination,
(also called Incterus) is a yellow discoloration of the
eyes. It is caused by excessive amounts of bilirubin in
When liver cells are sick or damaged, the liver cannot
bilirubin into the form necessary to allow it to be
the body. Jaundice may be transient, and can begin
blood levels of bilirubin concentrations exceed 2.5
(milligrams per deciliter). The color of urine may become
stools may become lighter-colored. In cases of viral
fever, chills, pain, loss of appetite and fatigue may
onset of jaundice.
(itching) often occurs with jaundice, and results from
being deposited in the skin. This is not common in
hepatitis C, but when it occurs, it may be very
treat. If the itching is due to bile salts, the
will not respond to creams, lotion, or other "home
Only medications which improve the flow and excretion of
decrease the symptoms.
When the body
is attacked by a virus, it creates substances called
which attack viruses, bacteria, parasites and other
invaders, collectively referred to as antigens. When
are produced as a result of a foreign invasion, they
themselves to the antigen, rendering the antigen incapable
cells. The combined antigen and antibody is referred
to as an
"antigen-antibody (AgAb) complex."
complexes are fairly large, as microscopic things go.
pass through the kidney, they can "clog" the filtering
resulting in a condition called Membranoproliferative
Glomerulonephritis. This condition allows protein to be lost in the
can eventually contribute to muscle wasting and
in rare cases, causes renal failure.
disease is common is the general population, but even more
hepatitis patients. Both hypothyroid (too little) and
(too much) can occur, and can be medically managed
In some cases, thyroid disorders can develop during
Hepatitis C Virus therapy,
and may persist after the conclusion of therapy.
veins which have been stretched and distorted by
pressure resulting from impaired blood flow through the
sites for varices are the esophagus, stomach and
Varices are thin-walled veins under high blood pressure,
is a common problem. In some instances, esophageal
rupture and massive bleeding can ensue, resulting in
ingestion of large amounts of blood. If uncontrolled,
varices can result in death.
is further complicated by the fact that hepatitis
have greater difficulty with clotting, prolonging the
plays a central role in the metabolism of protein.
the building-block of body tissues, so when protein
impaired by a sick liver, the body can begin to break
tissue to obtain the protein necessary for other
processes. Protein is also necessary for the liver to
albumin, so decreased protein synthesis can contribute
development of ascites and edema.
If you have
hepatitis, you should consume an adequate amount of
avoid muscle wasting. However, a by-product of protein
ammonia, which the liver has to metabolize in order
to excrete. A
sick liver may not be able to remove the increased
ammonia produced by a high protein diet. This can cause
high levels of ammonia to accumulate in the blood, which
severe neurological impairment, a condition called