While hepatitis C virus (HCV) is known as a condition that affects the liver, HCV can affect the whole body. The liver is an organ with several important functions: it changes nutrients from food into substances the body can use, it stores these substances and supplies the cells with them when needed, it filters out toxic substances, processes medications, and produces proteins that are used in blood clotting.1 When the liver is damaged, such as when there is a chronic HCV infection, it cannot properly do these jobs. If left untreated, HCV can cause many problems in different organs and systems of the body.
Many people with HCV report that they experience brain fog, a term that can mean any type of difficulty with thinking, focusing, or remembering. While doctors don’t know exactly why this occurs, they believe it may be an effect of the HCV virus on the brain or it may be due to an increase of toxins in the body, which can affect the brain.2 Brain fog can be worsened if the person is also experiencing fatigue, depression, or anxiety. Fortunately, brain fog does seem to improve with treatment for HCV.
If the liver develops cirrhosis, hepatic encephalopathy can occur. Hepatic encephalopathy is a brain condition that occurs when the toxins which are normally cleared by the liver collect and cause damage to the brain. Hepatic encephalopathy can range from mild to severe and may appear as difficulty with memory, shortened attention span, irritability, confusion, or changes in personality. Treatment with medication can help, although some people may need a liver transplant.3
In our 2018 Hepatitis C In America survey, over 40% of respondents said fatigue is the symptom that most impacts their daily life. Fatigue is characterized as an extreme tiredness that doesn’t get better with sleep. It may be described as sleepiness, drowsiness, exhaustion, or feeling worn out. Fatigue can also make other symptoms of chronic HCV infection worse, such as depression, anxiety, or brain fog.
When toxins build up in the body because the liver isn’t able to clear them all out, the toxins can affect the hair, causing it to become more brittle or fall out at a faster than normal rate. Some people may notice their hair becomes thinner or changes texture. Some of the treatments for HCV can also cause hair loss, although this is usually temporary and improves after treatment is finished.
Living with a chronic condition like HCV is stressful, and having HCV puts a person at higher risk for depression or anxiety. Depression is one of the most common psychiatric complications associated with HCV. Some studies found that up to a half of people with HCV experienced depression.4 Depression can show up as persistent low moods, feelings of worthlessness or hopelessness, or a lack of interest in activities that used to be enjoyable. Anxiety is also common among people with HCV.
Anxiety can cause intense feelings of worry or nervousness. Both anxiety and depression can be treated with a variety of approaches. If you are feeling symptoms of depression or anxiety, talk to your doctor and get support.
HCV may cause skin issues. Some of the skin conditions that may occur with HCV include:
Jaundice, a yellowing of the skin or the whites of the eyes
Lichen planus, purple and flat bumps that are itchy
Porphyria cutanea tarda, blisters or bubbles on the skin with a darkened patch around them
Urticaria, itchy red rashes or splotches
Many people with HCV experience nausea, which can range from a mild upset stomach or queasy feeling to an overwhelming urge to vomit. Other stomach issues associated with HCV include stomach pain, ulcers, and gallstones.5
Muscle and joint pain
HCV can also cause muscle and joint pain, which may be described as aches or soreness. Part of the soreness in the muscles and joints is due to the virus itself, and part is due to the immune system fighting it. The muscle and joint pain can be improved with treatment for HCV, although some people experience long-term effects from having a chronic HCV infection.
Neuropathy is caused by damage to the nerves, which can cause feelings of numbness, pain, weakness, or tingling. Neuropathy often affects the hands and feet, although it can occur in other parts of the body as well.
Treatment can help
HCV can affect the body in many ways, but treatment can help. In addition to the treatment for the HCV infection itself, other treatments are available that can help ease symptoms and complications caused by the virus. It’s important to talk to your doctor about all symptoms you may be experiencing to get the help you need.
Informed Health Online [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. How does the liver work? 2009 Sep 17 [Updated 2016 Aug 22]. Available at https://www.ncbi.nlm.nih.gov/books/NBK279393/. Accessed 11/16/18.
Senzolo M, Schiff S, D'Aloiso CM, et al. Neuropsychological alterations in hepatitis C infection: the role of inflammation. World J Gastroenterol. 2011;17(29):3369-74.
Hepatic encephalopathy. National Organization for Rare Disorders. Available at https://rarediseases.org/rare-diseases/hepatic-encephalopathy/. Accessed 11/16/18.
Saunders JC. Neuropsychiatric symptoms of hepatitis C. Issues Ment Health Nurs 2008;29:209-20.
Symptoms of infection with hepatitis C. The Hepatitis C Trust. Available at http://www.hepctrust.org.uk/information/symptoms-hepatitis-c. Accessed 11/16/18.