Hepatitis C is known to be associated with two skin conditions, lichen planus and porphyria cutanea tarda.
- Diabetes, heart disease, and arterial blockage are more common among patients with chronic hepatitis C infection than in the general population. It may be that liver damage and chronic inflammation caused by hepatitis C may affect the levels of blood fats (lipids) and blood sugar.
- Low platelet counts may occur as a result of the destruction of platelets by antibodies.
- Hepatitis C also is associated with B-cell lymphoma, a cancer of the blood.
End-stage liver disease
Over several years or decades, chronic inflammation may cause death of liver cells and cirrhosis (scaring, fibrosis). When the liver becomes cirrhotic, it becomes stiff, and it cannot perform its normal functions of clearing waste products from the blood. As fibrosis worsens, symptoms of liver failure begin to appear. This is called "decompensated cirrhosis" or "end-stage liver disease." Symptoms of end-stage liver disease include:
- Small spider veins begin to appear on the skin as the stiff, scarred liver obstructs the forward flow of blood.
- Body fluids back up and accumulate in the abdomen (ascites).
- The spleen enlarges because of back-pressure.
- Yellowing of eyes and skin (jaundice) occur because the liver is not clearing bilirubin (a yellow pigment from breakdown of red blood cells) from the blood.
- A serious complication is severe bleeding from varicose veins that develop in the swallowing tube or esophagus (esophageal varices).
Cirrhosis-associated immune dysfunction syndrome
The liver and spleen have an important function of clearing bacteria from the blood stream. Cirrhosis affects many areas of immune function, including attraction of white blood cells to bacteria, reduced killing of bacteria, reduced production of proteins involved in immune defenses, and decreased life span of white blood cells involved in immune defenses. This may be referred to as having cirrhosis-associated immune dysfunction syndrome or CAIDS.
Fluid in the abdomen often becomes infected (spontaneous bacterial peritonitis), and preventive antibiotics may be given for this type of infection.
Bacteria also may enter the bloodstream easily (bacterial translocation), referred to as sepsis, especially when esophageal varices bleed.
Individuals may succumb to many types of bacterial infections more easily than normal, but some are specific to cirrhosis.
- Vibrio species of bacteria are a serious risk from eating raw oysters or exposure to sea water.
- Listeria species may cause sepsis and meningitis, and are a risk from unpasteurized dairy products and salty processed meats.
- Yersinia species may be picked up from raw or undercooked pork, especially intestines (chitterlings).
- People with chronic hepatitis C and fibrosis should avoid being exposed to these bacteria.