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.

A number of things can increase your risk of getting cirrhosis, including:

• drinking alcohol
• smoking
• being overweight
• having type 2 diabetes
• getting hepatitis C at an older age
• having HIV
• having another type of hepatitis, such as hepatitis B

Overall, up to 1 in every 3 people infected with hepatitis C will develop cirrhosis within 20 to 30 years. Some of these will then go on to develop liver failure or liver cancer.

If you have cirrhosis, the scarred tissue in your liver gradually replaces healthy tissue and prevents the liver from working properly.

There are usually few symptoms in the early stages. But as your liver loses its ability to function properly, you may experience:

• tiredness and weakness
• loss of appetite
• weight loss
• feeling sick
• very itchy skin
• tenderness or pain in your tummy
• tiny red lines (blood capillaries) on the skin
• yellowing of the skin or whites of the eyes (jaundice)

There's no cure for cirrhosis. However, lifestyle measures and hepatitis C medications can help stop the condition getting worse.

Read more about treating cirrhosis.

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.

Each year, around 1 in every 20 people with hepatitis-associated cirrhosis will develop liver failure.

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 urine
• black, tarry poo or very pale poo
• frequent nosebleeds and bleeding gums
• bruising easily
• the whites of your eyes turning yellow, or your skin turning yellow, although this may be less noticeable on black or brown skin
• vomiting blood

It's usually possible to live with liver failure for several years by taking medication. However, a liver transplant is currently the only way to cure the condition.

Having hepatitis-associated cirrhosis increases your risk of developing liver cancer.

Symptoms of liver cancer can include:

• loss of appetite
• unintentional weight loss
• tiredness
• feeling and being sick
• pain or swelling in your tummy
• jaundice

Unfortunately, it's not usually possible to cure liver cancer, especially in people with cirrhosis, although treatment can help control your symptoms and slow the spread of the cancer.

Read more about treatment for liver cancer.