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What Happens When Hep C is Left Untreated

Many patients do not get treatment for hep C. Learn how an untreated hep C infection damages the liver and more.

Medically reviewed in March 2022

While there are treatments that can effectively cure a person from hepatitis C, some people infected with the hepatitis C virus (HCV) do not receive treatment. If you or a loved one has hepatitis C, it is extremely important to seek treatment from a healthcare provider. Left untreated, hep C can severely damage a person’s health and result in premature death.

Hep C and inflammation
The most well known impact of hep C is damage and scarring in the liver, the primary site of an infection with HCV (the word hepatitis actually means “inflammation of the liver”). The liver is a vital organ that helps metabolize nutrients such as fats and proteins, as well as substances like alcohol and medications. It also converts certain waste materials into forms that can be eliminated in the urine or stool.

Inflammation is a normal response by an immune system that is faced with an infection. Like other viral infections (or other pathogens or harmful substances), an HCV infection stimulates the immune system to trigger a cascade of events. This cascade includes an influx of fluids, white blood cells and antibodies that repair and remove cells that are injured or infected, and protect the area from further injury or infection. (This is a simplified explanation, as the biologic process is complicated and involves many different cells working together.)

With an infection like chronic hep C, the inflammation is also chronic—the inflammatory process is always happening, and never resolves. While the inflammation may be too low-grade to cause noticeable symptoms, it can lead to scarring and hardening of the affected tissues and organs.

Hep C and cirrhosis
Scarring and hardening of the liver is called cirrhosis. When a liver reaches the cirrhotic stage—which occurs in 10 to 20 percent of chronic hep c infections—the organ will be less able to perform its normal functions. Cirrhosis can lead to a long list of health complications. Blood vessels can become distended and damaged, overwhelmed when blood is unable to flow through the liver at a normal pace. Bleeding (including internal bleeding) and bruising can occur, as the liver is no longer able to make clotting factors for the blood. When the liver is unable to clear toxins from the blood, certain toxins can accumulate in the brain, causing cognitive impairment. The skin and eyes can become yellowed (a condition called jaundice) due to the buildup of waste products in the blood. People with cirrhosis are also at an increased risk of kidney disease, diabetes and liver cancer.

Hep C treatment
There are treatments available for hep C that can cure the disease in 90 percent or more of cases. Treating hep C can prevent further liver damage and reduce the risk of complications from liver scarring. Some patients even see slow improvement in liver scarring that was caused by hep C after being cured (though some risk of worsening liver disease and liver cancer remains for patients who have cirrhosis). It is important to understand that not every treatment is right for every patient, which is why anyone diagnosed with hep C must work closely with a healthcare provider.

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