Hepatitis C is a bloodborne virus that causes inflammation of the liver. More than 3 million people are living with hepatitis C in the United States.

Since many people may not have symptoms or don’t know if they have hepatitis C, their status is often not diagnosed or reported.

Today, hepatitis C is usually transmitted by sharing needles or other equipment to inject drugs.

These are just a few of the serious long-term effects of untreated hepatitis C:

The area of the body most affected by hepatitis C is the liver. Cirrhosis is a chronic liver disease that results when scar tissue begins taking over healthy tissue inside the liver itself.

This scarring slows blood flow and stops the liver from processing nutrients and toxins.

Cirrhosis can do a lot of damage to the liver without ever being detected, and it can cause conditions such as:

  • yellowing of the skin and the whites of the eyes (jaundice)
  • chronic bruising and bleeding
  • gallstones
  • fluid buildup in the abdomen (ascites)
  • painful swelling of legs and feet (edema)
  • enlargement of the spleen (splenomegaly)
  • an increase of blood pressure in the portal venous system of the body (portal hypertension)
  • poisoning of the brain through the inability to process ammonia in the liver (hepatic encephalopathy)
  • chronic weakening of bone density (bone disease)

Many people with cirrhosis eventually develop liver cancer.

When the liver begins producing cells to fight off cirrhosis, some of these new cells can mutate into cancer cells and cause tumors to develop.

The problem is that often the cancer goes undetected until severe symptoms start to make themselves known.

Some symptoms to look out for include:

  • pain or lumps on the right side of the abdomen
  • pain in the back or right shoulder
  • feeling extremely full after barely eating
  • tea-colored urine
  • pale stools
  • enlargement of the breasts or testicles

Treatments for liver cancer range from ablation (destroying the cancerous tissue) to chemotherapy to a liver transplant.

Many people with chronic hepatitis C eventually develop chronic liver disease. If left untreated, this will lead to complete liver failure.

The good news is that liver failure can be detected through a blood test, CT scan, or liver biopsy. But the only current treatment for total hepatitis C–related liver failure is a liver transplant.

Scientists are quickly working to develop new treatments for liver failure, such as:

  • Artificial liver support devices that can do the work a failing liver can no longer do. This gives the liver time to regenerate itself and heal. One example is the extracorporeal liver support device (ELSD), which has seen success in trials.
  • Hepatocyte transplantation involves the transplantation of a small portion of the liver’s cells. This option leaves the liver intact, allowing cells to help it regenerate.
  • Xenotransplantation, which replaces the human liver with an animal liver or cells and tissues, can be used to speed up the process of receiving a human liver transplant.

Some of the most common mental health issues associated with hepatitis C are fatigue, depression, and impaired cognition (especially memory), says Jesse P. Houghton, MD, senior medical director of gastroenterology at Southern Ohio Medical Center.

Some of these conditions are directly related to the virus, such as fatigue, and some are also related to the stigma associated with having a chronic condition that is often associated with substance misuse, he says.

One problem in the body often leads to another, which is why hepatitis C can also impact the skin — the body’s largest organ.

Untreated hepatitis C can lead to various types of rashes, including palpable purpura, lichen planus, and even sores on the fingers and toes known as digital ulcerations, says Houghton.

People with advanced cirrhosis due to hepatitis C typically have low blood pressure.

This is caused by an increase in circulating nitric oxide, one of the most important molecules for blood vessel health, which is normally metabolized by a healthy liver, says Houghton.

Untreated hepatitis C can have serious health effects on the heart, including congestive heart failure.

Hepatitis C can affect the blood vessels that carry blood to and from the heart and lungs. This damage can lead to high blood pressure and, eventually, heart failure.

Those with untreated hepatitis C may experience a burning, prickling sensation, or numbness. This happens when nerves attached to more than one body part are affected.

Nerve problems brought on by hepatitis C are thought to be related to inflammation of the blood vessel walls caused by the presence of abnormal proteins in the blood, says Houghton.

Joint and muscle problems impact 40 to 80 percent of people with hepatitis C, says Houghton.

Joint problems include inflammation that is similar to rheumatoid arthritis — leading to painful hand and knee joints.

Muscles and joints in other parts of the body can become painful and swollen, as well.

There is some research to suggest that diabetes and hepatitis C are linked. Hepatitis C is a risk factor for developing type 1 and type 2 diabetes. People with diabetes may also be at a higher risk of experiencing complications from hepatitis C.

However, studies attempting to identify a connection between hepatitis C and diabetes or insulin resistance have been mixed, says Houghton.

Hepatitis C has numerous, damaging long-term effects. That’s why it’s important to get tested and get treatment.

If you think you may have hepatitis C or have been recently diagnosed, talk to your doctor so it can be treated early.