- With Mayo Clinic internist
James M. Steckelberg, M.D.
read biographyclose windowBiography of
James M. Steckelberg, M.D.
James Steckelberg, M.D.
Dr. James Steckelberg is chairman of the Division of Infectious Diseases at Mayo Clinic, a consultant and a professor of medicine at Mayo Medical School.
A native of Fremont, Neb., Dr. Steckelberg was a Rhodes Scholar and graduated from the Mayo Graduate School of Medicine as a resident in internal medicine and a fellow in infectious diseases, and is board certified in both. He is the former director of the Infectious Diseases Research Laboratory at Mayo Clinic.
Dr. Steckelberg belongs to numerous professional organizations. He is a founding member of the Musculoskeletal Infection Society of America and a fellow with the American College of Physicians and the Infectious Diseases Society of America. He has served on many Mayo Clinic committees and is a member of the Department of Medicine Leadership Committee and the executive committee of the Division of Infectious Diseases. He also served on the editorial boards of "Mayo Clinic Proceedings" and "Antimicrobial Agents & Chemotherapy" and has been an editorial reviewer for more than a dozen publications.
Dr. Steckelberg's research interests include experimental models of infection, epidemiology of infection, and antimicrobial resistance and therapy of bacterial infections.
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- Hepatitis C: How common is sexual transmission?
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Question
Hepatitis C: What happens in end-stage liver disease?
My brother has been told he has end-stage hepatitis C. What does this mean? What can we expect?
Answer
from James M. Steckelberg, M.D.
The hepatitis C virus slowly damages the liver — often over the course of several decades. As a result, end-stage complications of hepatitis C include liver failure and liver cancer. These conditions primarily occur in people who develop permanent scarring of the liver (cirrhosis) due to inflammation caused by the hepatitis.
About 20 percent of people with hepatitis C develop cirrhosis, usually within 10 to 30 years after infection. Of those who have cirrhosis, about half progress to either liver failure or liver cancer.
Signs and symptoms of end-stage liver disease or liver cancer may include:
- Fatigue
- Persistent or recurring yellowing of your skin and eyes (jaundice)
- Loss of appetite
- Nausea and vomiting
- Fever
- Abdominal pain
- Abdominal swelling due to fluid accumulation (ascites)
In addition to liver failure or cancer, people with cirrhosis may also develop:
- Gastrointestinal bleeding due to enlarged veins (varices) in the esophagus
- Brain and nervous system damage due to the accumulation of toxins in the bloodstream (hepatic encephalopathy)
Once these complications occur, the disease tends to progress at a faster rate.
The best treatment for people with end-stage liver disease is liver transplantation. Though the number of people awaiting liver transplants far exceeds the number of donated organs, new developments in transplantation — including the donation of liver segments from living relatives and splitting one donated liver between two people — may make it possible for more people to receive transplants.
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