If left untreated, hepatitis C can sometimes cause scarring of the liver (cirrhosis). This can develop up to 20 years or more after you first become infected.
A number of things can increase your risk of getting cirrhosis, including:
having type 2 diabetes
getting hepatitis C at an older age
having another type of hepatitis, such as hepatitis B
Overall, up to 1 in every 3 people infected with hepatitis C will develop cirrhosis within 20 to 30 years. Some of these will then go on to develop liver failure or liver cancer.
If you have cirrhosis, the scarred tissue in your liver gradually replaces healthy tissue and prevents the liver from working properly.
There are usually few symptoms in the early stages. But as your liver loses its ability to function properly, you may experience:
tiredness and weakness
loss of appetite
very itchy skin
tenderness or pain in your tummy
tiny red lines (blood capillaries) on the skin
yellowing of the skin or whites of the eyes (jaundice)
There's no cure for cirrhosis. However, lifestyle measures and hepatitis C medications can help stop the condition getting worse.
Read more about treating cirrhosis.
In severe cases of cirrhosis, the liver loses most or all of its functions. This is known as liver failure or end-stage liver disease.
Each year, around 1 in every 20 people with hepatitis-associated cirrhosis will develop liver failure.
Symptoms of liver failure include:
build-up of fluid in the legs, ankles and feet (oedema)
build-up of fluid in your tummy (ascites)
black, tarry poo or very pale poo
frequent nosebleeds and bleeding gums
the whites of your eyes turning yellow, or your skin turning yellow, although this may be less noticeable on black or brown skin
It's usually possible to live with liver failure for several years by taking medication. However, a liver transplant is currently the only way to cure the condition.
Having hepatitis-associated cirrhosis increases your risk of developing liver cancer.
Symptoms of liver cancer can include:
loss of appetite
unintentional weight loss
feeling and being sick
pain or swelling in your tummy