Hepatitis C is an infection that can cause inflammation or swelling of the liver.

The liver is one of the largest organs of the body. It’s located in the upper right portion of the abdomen, below the lungs.

The liver helps your body digest food, stores vitamins and nutrients, makes and stores sugar for energy use, and removes harmful chemicals from your body.

Most hepatitis C complications stem from the liver, so keeping your liver healthy is especially important if you have hepatitis C.

Hepatitis C and Your Liver

Some people with chronic hepatitis C will suffer from liver damage. Liver damage from hepatitis C doesn’t happen immediately. It may occur over many years, even decades. Many people don’t know they have hepatitis C until they start to show signs of liver damage.

According to the Centers for Disease Control and Prevention (CDC), for every 100 people infected with the hepatitis C virus (HCV) 75 to 85 people will develop chronic hepatitis C, of those:

  • 60 to 70 people will develop chronic liver disease
  • 5 to 20 people will develop cirrhosis over a period of 20 to 30 years
  • 1 to 5 people will die from cirrhosis or liver cancer

Cirrhosis

Cirrhosis is scarring of the liver. Over time, hard scar tissue replaces healthy liver tissue. The scar tissue blocks blood flow through the liver. A liver with too much scar tissue won’t work properly. If cirrhosis isn’t treated, it can lead to liver failure.

Cirrhosis can be caused by:

  • heavy alcohol use
  • chronic hepatitis
  • nonalcoholic fatty liver disease (often caused by obesity)
  • some drugs, medicines, or harmful chemicals
  • some inherited diseases

It can take many years for liver damage from hepatitis C to lead to cirrhosis. According to the American College of Gastroenterology, almost 20 percent of those with chronic hepatitis C will go on to develop cirrhosis. But once cirrhosis has developed, the chance of developing a life-threatening complication over the next five to 10 years is about 50 percent.

People with cirrhosis may have no symptoms for many years. Symptoms of cirrhosis may include:

  • extreme weakness or tiredness
  • loss of appetite
  • feeling nauseous or sick to your stomach
  • unexplained weight loss
  • severe itching
  • red, spider-shaped blood vessels under your skin

While nothing can make all the scar tissue go away, there are things you can do to keep cirrhosis from worsening:

  • Take medicines to rid the body of HCV.
  • Do not drink alcohol.
  • Do not eat raw shellfish. Raw oysters and other shellfish can have bacteria that cause serious infections in people with cirrhosis.
  • Talk with your doctor before taking any medicines, including over-the-counter drugs and herbal supplements. Cirrhosis may make your liver sensitive to certain medicines and supplements.

Liver Failure and Liver Transplant

Liver failure happens when the liver stops working properly. Liver damage that progresses over years, or even decades, is called chronic liver failure or end-stage liver disease.

Cirrhosis caused by hepatitis C is the most common reason for liver transplants in the United States, according to the CDC.

Symptoms of liver failure include:

  • jaundice (yellow discoloration of the skin and white part of the eyes)
  • extreme fatigue or weakness
  • loss of appetite
  • nausea or upset stomach
  • unexplained weight loss
  • muscle loss
  • itching
  • bleeding or bruising easily
  • bleeding in the stomach
  • vomiting blood
  • passing black stools
  • ascites (tightness or bloating of the abdomen due to fluid build up)
  • forgetfulness or confusion

During a liver transplant, doctors will remove your liver and replace it with a healthy one from a donor.

Liver Cancer

A small number of people with cirrhosis develop liver cancer.

Since hepatitis C increases your risk of liver cancer, your doctor may recommend an ultrasound test of your liver every six to 12 months. These tests will show your doctor if any tumors are starting to form. Liver cancer is more treatable the earlier it is found.

Talk to your doctor if you notice any liver complications related to your hepatitis C. Being aware of your symptoms and how you’re feeling is important for your treatment and your health.