End stage hepatitis C occurs when the infection has progressed to such a degree that it has damaged the liver irreversibly. Symptoms at this stage may include jaundice and abdominal swelling.
Hepatitis C is a viral infection of the liver that typically progresses slowly. It is curable if doctors diagnose and treat it early. If people do not receive treatment, hepatitis C can lead to severe complications, such as cirrhosis and liver failure.
Doctors may not be able to treat end stage hepatitis C with antiviral medications or a liver transplant. In this case, the liver may eventually fail and lead to death.
This article discusses the signs that a person with end stage hepatitis C and liver failure is nearing death. It also provides links to support for caregivers.
Information for caregivers
As a person’s condition progresses, they may need help reading or understanding information regarding their circumstances. This article contains details that may help caregivers identify and monitor symptom progression, side effects of drugs, or other factors relating to the person’s condition.
Symptoms of end stage hepatitis C can include:
- jaundice, a yellowing of the skin and eyes
- abdominal swelling
- fluid retention
- edema or swelling in the legs
- internal bleeding
- hepatic encephalopathy — a decline in brain function due to a buildup of toxins in the blood
- fever
- bruising
- abdominal pain
- loss of appetite
- nausea and vomiting
- coma
If a person develops liver failure as a result of end stage hepatitis C, a doctor may treat them with medication for several years.
However, a liver transplant is the only potential cure. This involves removing the person’s liver and replacing it with a donor’s liver.
Some people with end stage hepatitis C may be unable to receive a liver transplant, or their transplant may be unsuccessful. In these cases, the illness leads to death.
Learn about eligibility for a liver transplant.
People with liver failure
A person may experience various symptoms in the final days of liver failure, including nausea, itching, ascites, and hepatic encephalopathy.
Ascites is a buildup of fluid in the abdomen. It occurs when the blood pressure of the portal vein increases, which reduces liver and kidney function. In some cases, ascites
People with hepatitis C who experience hepatic encephalopathy may experience confusion, disorientation, forgetfulness, and personality changes.
Palliative care may help relieve physical, mental, and emotional symptoms during the final days of liver failure. Research from 2021 suggests that palliative care can
Learn about the signs that someone is close to death.
In end stage hepatitis C, the infection has progressed far enough to cause severe, irreversible liver damage.
Hepatitis C causes damage over time by triggering a persistent inflammatory response in the liver. The inflammatory response prompts repair cells to continuously deposit a protein called collagen, which stiffens around the liver tissue.
Usually, liver inflammation resolves and the body can discard excess collagen. However, in hepatitis C, the inflammation does not subside, and cells continue depositing collagen.
The collagen deposits harden, forming scars or “fibrosis” in the liver. A buildup of scar tissue can prevent blood flow in the liver, leading to cell death.
Over time, the fibrosis can replace healthy liver cells, leading to severe scarring called cirrhosis. Scar tissue from cirrhosis affects the liver’s ability to function. Around 1 in 3 people with hepatitis C develop cirrhosis.
In end stage hepatitis C, cirrhosis and chronic liver failure occur. At this stage, treatment cannot reverse liver damage, and the organ can no longer function effectively. Each year, about 1 in 20 people with hepatitis-associated cirrhosis experience liver failure.
Support is available
Caring for someone with an advanced illness is difficult, and it can feel isolating. The following organizations offer information and support to those affected:
- CaringBridge: A free platform that allows caregivers to update friends and family about a loved one’s health, connect with other caregivers, and simplify care coordination.
- CaringInfo: Provided by the National Hospice and Palliative Care Organization, CaringInfo provides practical advice, guides, and resources for those affected by serious illness.
- Get Palliative Care: This organization provides information and advice about palliative care. It also has a search tool for finding a palliative care provider.
How long can you live with hepatitis C without treatment?
Hepatitis C usually progresses slowly. Severe complications such as cirrhosis may develop up to 20 years or more after a person acquires the infection.
How do you know when your liver is shutting down?
A person will develop symptoms during liver failure that can indicate their liver has stopped functioning. These include:
- ascites — a buildup of fluid in the abdomen
- jaundice
- edema — swelling caused by trapped fluid in tissues
- dark urine
- vomiting blood
How painful is liver failure?
Liver failure can cause various unpleasant symptoms.
People with advanced liver disease may experience disabling pain, which can affect sleep and mood.
Doctors can help people manage their pain and other symptoms with medication.
Hepatitis C is a viral infection that affects the liver. Without treatment, it can cause progressive liver damage that can lead to severe complications, such as cirrhosis, liver failure, and death.
Doctors cannot cure these conditions with medication or reverse the damage to the liver at this stage. A liver transplant is the only potential cure for late-stage hepatitis C.
If a liver transplant is not possible, doctors can prescribe medications to ease symptoms and make a person more comfortable. Palliative care can help support a person and their loved ones in the final days of liver failure.
