A chronic hepatitis C infection can lead to complications such as liver failure and scarring. Treating the infection and making certain diet changes may help prevent severe complications.

Hepatitis C is a viral infection that can cause inflammation of the liver.

But liver damage from hepatitis C doesn’t happen immediately. It may occur over many years. Many people don’t know they have hepatitis C until they show signs of liver damage.

According to the Centers for Disease Control and Prevention (CDC), for every 100 people with a hepatitis C virus (HCV) infection:

  • more than half will develop chronic hepatitis C
  • 5 to 25 people will develop cirrhosis, which can lead to liver failure or liver cancer, over a period of 20 to 30 years

What does the liver do?

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

Your liver has several functions, which include:

  • helping your body absorb nutrients from food
  • storing vitamins and nutrients
  • making and storing sugar for energy use
  • removing harmful chemicals from your body

People with chronic hepatitis C can experience liver damage.

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Below, we’ll explore the potential complications of hepatitis C in greater detail. We’ll also discuss ways to treat and potentially prevent them.

Cirrhosis is scarring of the liver. Over time, hard scar tissue replaces healthy liver tissue in a process called fibrosis. The scar tissue can also block blood flow through the liver.

In addition to chronic hepatitis C, cirrhosis can be caused by:

  • heavy alcohol use
  • chronic hepatitis B
  • nonalcoholic fatty liver disease
  • autoimmune hepatitis
  • some drugs, medications, or harmful chemicals
  • some inherited diseases

A liver that develops too much scar tissue won’t work properly. If cirrhosis isn’t managed, it can lead to liver failure.

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

It can take many years for liver damage from hepatitis C to lead to cirrhosis. People with cirrhosis may have no symptoms for many years. When they do develop, the symptoms of cirrhosis may include:

  • fatigue
  • loss of appetite
  • nausea
  • unexplained weight loss
  • abdominal pain
  • severe itching
  • easy bruising
  • darkening of the urine
  • a yellowing of the eyes or skin (jaundice)
  • swelling of the abdomen or legs
  • confusion or sleep disturbances
  • bleeding issues

Liver failure happens when your liver stops working properly. Often, liver failure occurs due to cirrhosis.

Liver damage that progresses over years or decades is called chronic liver failure or end-stage liver disease. People with chronic liver disease may require a liver transplant.

The early symptoms of liver failure include:

  • fatigue
  • nausea
  • diarrhea
  • loss of appetite
  • unexplained weight loss
  • abdominal pain

As liver failure progresses, its symptoms can get worse. Some symptoms of more advanced liver failure can include:

  • a yellowing of the eyes or skin (jaundice)
  • extreme tiredness
  • severe itching
  • easy bruising
  • darkening of the urine
  • black stool
  • vomiting blood
  • bloating in the abdomen due to fluid buildup (ascites)
  • swelling in your extremities (edema)
  • forgetfulness or confusion

Cancer happens when cells in your body begin to grow out of control. Cancer can develop in many areas of the body, including the liver.

According to the CDC, 36,000 people are diagnosed with liver cancer each year in the United States.

Both chronic hepatitis C and cirrhosis are risk factors for liver cancer. People with HCV-related cirrhosis have a higher risk of liver cancer than people who have cirrhosis that’s related to heavy alcohol consumption.

In its earliest stages, liver cancer may not have any symptoms. When symptoms do develop, they can be similar to those of liver failure. They may include:

  • abdominal discomfort, pain, or tenderness, especially in the upper abdomen
  • jaundice, or a yellowing of your skin and the whites of your eyes
  • pale, chalky stools
  • dark urine
  • nausea or vomiting
  • decreased appetite
  • early satiety, or feeling full unusually fast when eating
  • unexplained weight loss
  • bruising or bleeding easily
  • weakness
  • fatigue
  • fever

Most hepatitis C complications stem from the liver, so keeping your liver healthy is especially important if you have hepatitis C. There are many things that you can do to help prevent complications, including the following:

  • Take medications to cure HCV infection.
  • Avoid drinking alcohol, as it can cause further liver damage.
  • Get vaccinated against other types of viral hepatitis, such as hepatitis A and hepatitis B.
  • Eat a nutritious diet, but consider cutting back on salt intake. High salt intake can place stress on your liver and worsen swelling.
  • Talk with a doctor before taking any new medications or supplements, including those that are available over the counter, as some may stress your liver.
  • Continue making other healthy lifestyle choices like getting enough exercise, quitting smoking, if you smoke, and maintaining a moderate weight.

Treatment for the complications of hepatitis C typically focuses on addressing the condition that’s causing it. In this case, that means ridding your body of the HCV infection.

Medications are available for chronic hepatitis C. A doctor may prescribe you one or more of these medications.

According to the National Institutes of Health (NIH), these medications can cure chronic hepatitis C in 80 to 95 percent of people with this disease.

A doctor may recommend a liver transplant in cases of severe cirrhosis, liver failure, or liver cancer. During a liver transplant, doctors will remove your liver and replace it with a healthy one from a donor.

Doctors can also treat liver cancer using methods developed to destroy cancer cells. Examples include radiation therapy and chemotherapy.

Hepatitis C can cause a variety of potentially serious complications. These can include things like:

  • cirrhosis
  • liver failure
  • liver cancer

Talk with a doctor if you notice symptoms of a potential liver complication related to hepatitis C. Some examples can include:

  • fatigue
  • abdominal pain
  • jaundice

Hepatitis C can be cured in most people through the use of medications. Getting treated early can help to prevent further liver damage and complications.