Cirrhosis is an advanced form of liver disease that has many causes, not just chronic hepatitis C infection. Alcoholism, autoimmune diseases, hepatitis B, and other conditions can result in cirrhosis. In the case of hepatitis C, the virus attacks the liver and may gradually lead to the formation of scar tissue. Early damage is called fibrosis; severe damage is cirrhosis. About 5 to 20 percent of people infected with HCV, will develop cirrhosis over a 20-to-30-year period of HCV infection.
Although cirrhosis is usually irreversible, reversal was observed in nearly half of all cirrhotic patients whose hepatitis C was cured. Otherwise, liver transplantation is the only treatment for cirrhosis.
Cirrhosis has two phases, compensated and decompensated. Compensated cirrhosis means that the liver is still functioning relatively well. At this stage, the early symptoms may still be vague and some people may be unaware that they have cirrhosis. The symptoms of compensated cirrhosis include:
Confusion or difficulty thinking
Dark, cola-colored urine
Easy bruising and abnormal bleeding
Edema in the feet and legs (swelling from fluid build-up)
Fatigue (feeling tired)
Impotence, shrinking of the testicles, and breast swelling in men
Itchy skin (pruritus)
Jaundice (yellowing in the skin, mucous membranes, or eyes)
Pale or clay-colored stools
Redness on the palms of the hands
Spider veins (small red spidery veins on the skin)
Decompensated cirrhosis means that the liver is not functioning well. Some serious complications that occur with decompensated cirrhosis are:
Ascites, which is bloating from fluid build-up in the abdomen
Hepatic encephalopathy (HE) is a brain disorder that develops when the liver is unable to remove ammonia and other toxins from the body. HE may cause impaired concentration, sleep disturbances, confusion, or coma.
Spontaneous bacterial peritonitis (SBP) is associated with ascites, an infection of the membrane that covers the abdominal organs)
Variceal hemorrhage is severe bleeding from enlarged veins in the esophagus and upper stomach)