Should I Be Screened for Cirrhosis?

Cirrhosis is a serious liver disease that impairs the liver’s ability to function and can be life-threatening. Because the two most common causes of cirrhosis are alcohol abuse and viral hepatitis, it’s important for people who have had hepatitis C to understand their increased risk for this condition.¹ Even for those who have been cured of the hepatitis C virus face this risk of developing cirrhosis – cirrhosis may occur many years after the initial infection.

In our 2018 Hepatitis C In America survey, 539 respondents answered questions about their experience with hepatitis C, including their diagnosis, symptoms, treatment, and quality of life. The survey participants included 302 people who currently have the viral infection and 237 who have been cured of the infection. Cirrhosis affects 22% of those who have not been cured and 41% of those who have been cured of hepatitis C.

Stages of cirrhosis

Cirrhosis is classified as compensated or decompensated. In compensated cirrhosis, most of the liver is still functioning. Compensated cirrhosis often does not cause symptoms, and someone may be unaware they have it. If symptoms do occur, people may notice fatigue, weight loss, or a loss of appetite.²

Decompensated cirrhosis is a more severe form of the condition, and people with decompensated cirrhosis may have symptoms including jaundice (yellow coloring to the skin or whites of the eyes), itchy skin, ascites (a build-up of fluid in the abdomen causing swelling and discomfort), and variceal hemorrhage (bleeding due to enlarged blood vessels in the esophagus or stomach).^2,3

In our survey, 59% of those with cirrhosis had compensated cirrhosis and 28% had decompensated cirrhosis.

Risk factors for cirrhosis

People who have been infected with the hepatitis C virus or the hepatitis B virus are at an increased risk of developing cirrhosis.¹ These viruses replicate within liver cells, causing damage or death to the cell. The immune system’s response to these viruses can also cause damage to the liver tissue, and the result is scar tissue (also called fibrosis).⁴

Other risk factors for cirrhosis include chronic alcohol abuse and nonalcoholic fatty liver disease. Some other conditions also increase a person’s risk of developing cirrhosis, including cystic fibrosis, Wilson’s disease, and inherited disorders of sugar metabolism, such as glycogen storage disease.²

When to seek medical care

If you are experiencing any of the symptoms of cirrhosis, you should talk to a doctor and request testing. Prepare for your doctor’s visit by considering the following:²

• What symptoms are you experiencing?
• How long have you experienced symptoms?
• How would you rate the severity of your symptoms?

Your doctor will also want to know about your medical history, including any past or current infections (like HCV), how frequently you consume alcohol, and any exposure to illegal drugs.²

Treating cirrhosis

Treating cirrhosis begins with treating any underlying causes, such as HCV infection. There are also medications and lifestyle approaches (like eating a low-sodium, healthy diet and avoiding alcohol) that can help manage the disease. However, in some advanced cases of cirrhosis when the liver fails to function, liver transplantation is necessary.²