If it is not treated, chronic hepatitis C can sometimes cause scarring of the liver (cirrhosis). This can develop up to 20 years after you first become infected.

A number of factors can increase your risk of getting cirrhosis, such as:

• drinking alcohol
• having type 2 diabetes
• contracting hepatitis C at an older age
• having HIV or other types of hepatitis, such as hepatitis B

Depending on these factors, the risk of cirrhosis can range from 10% to 40%.

Symptoms of cirrhosis include:

• tiredness and weakness
• loss of appetite
• weight loss
• feeling sick
• very itchy skin
• tenderness or pain around the liver
• tiny red lines (blood capillaries) on the skin above waist level
• jaundice 

Other than a liver transplant, there is no cure for cirrhosis. However, treatments can help relieve some of the symptoms of cirrhosis and prevent the condition from worsening.

Read more about the treatment of cirrhosis.

Liver failure

In severe cases of cirrhosis, the liver loses most or all of its functions. The liver has a wide range of functions, such as filtering toxins from the blood and producing a number of important hormones.

This is known as liver failure or end stage liver disease. Liver failure occurs in around one in five people with hepatitis-associated cirrhosis.

Symptoms of liver failure include:

• hair loss
• build-up of fluid in the legs, ankles and feet (oedema)
• build-up of fluid in your abdomen that can make you look heavily pregnant (ascites)
• dark urine
• black, tarry stools or very pale stools
• frequent nosebleeds and bleeding gums
• a tendency to bruise easily
• vomiting blood

Once liver failure has occurred, it is usually possible to sustain life for several years using medication. However, a liver transplant is currently the only way to cure liver failure.

Liver cancer

It is estimated that around one in 20 people with hepatitis-associated cirrhosis will develop liver cancer.

Symptoms of liver cancer include:

• unexplained weight loss
• feeling sick
• vomiting
• tiredness
• jaundice

It is usually not possible to cure liver cancer, especially in people with cirrhosis, though chemotherapy can be used to slow the spread of the cancer.

Read more about the treatment of liver cancer.

Other complications

Other rarer complications of chronic hepatitis C include:

• dryness of the mouth and eyes (caused by the destruction of sweat, saliva and tear glands)
• patches of itchy skin (lichen planus)
• swelling inside the kidneys (glomerulonephritis)
• sensitivity to light, leading to blisters and ulcers on the skin
• underactive thyroid gland
• overactive thyroid gland
• cryoglobulinemia (a disorder in which abnormal proteins may damage the skin, nervous system and kidneys)
• non-Hodgkin's lymphoma (a type of cancer that affects the body's lymphatic system)
• insulin resistance and diabetes
• gallbladder disease