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.
Some things can increase your risk of getting cirrhosis, including:
- drinking alcohol
- having overweight or obesity
- having type 2 diabetes
- getting hepatitis C at an older age
- living with HIV
- having another type of hepatitis
Up to 1 in 3 people infected with hepatitis C develop cirrhosis in 20 to 30 years if they do not have treatment. Some of these can go on to develop liver failure or liver cancer.
If you have cirrhosis, the scarred tissue in your liver gradually replaces healthy tissue. This stops the liver from working properly.
You may not have any symptoms in the early stages. But you will have regular appointments with a specialist because of the risk of liver cancer and further damage to your liver.
As your liver becomes damaged, you may:
- feel very tired and weak
- feel sick (nausea)
- lose your appetite
- lose weight and muscle mass
- get red patches on your palms and small, spider-like blood vessels on your skin (spider angiomas) above waist level
- tenderness or pain in your tummy
If cirrhosis gets worse, you can develop symptoms of liver failure.
There's no cure for cirrhosis. But lifestyle changes and hepatitis C medicines can help stop the condition from getting worse.
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.
About 1 in 20 people with cirrhosis from hepatitis C develop liver failure each year.
Symptoms of liver failure include:
- hair loss
- build-up of fluid in the legs, ankles and feet (oedema)
- build-up of fluid in your tummy (ascites)
- dark pee
- black, tarry poo or very pale poo
- nosebleeds and bleeding gums
- bruising easily
- vomiting blood
- itchy skin
- problems with memory and thinking ('brain fog')
It's usually possible to live with liver failure some years by taking medicines. But a liver transplant is currently the only way to cure liver failure.
Having cirrhosis increases your risk of developing liver cancer.
If you have cirrhosis, you will have:
- regular appointments with a liver specialist
- ultrasounds for liver cancer screening every 6 months
It is important to go to these appointments because most people with early stages of liver cancer have no symptoms. But liver cancer can be cured if it is diagnosed at an early stage.
Symptoms of liver cancer
When liver cancer progresses, symptoms can include:
- loss of appetite
- unintentional weight loss
- feeling and being sick
- pain or swelling in your tummy
It's not usually possible to cure liver cancer after symptoms start to show. But treatment can help manage your symptoms and slow the spread of the cancer.
Content supplied by the NHS and adapted for Ireland by the HSE