Hepatitis C: What happens in end-stage liver disease?

End-stage hepatitis C means the liver has been severely damaged by the hepatitis C virus. The hepatitis C virus slowly damages the liver over many years, often progressing from inflammation to permanent, irreversible scarring (cirrhosis). Often, people have no signs or symptoms of liver disease or have only mild symptoms for years or even decades until they develop cirrhosis.

Once you have cirrhosis, treatment focuses on keeping the condition from worsening. It may be possible to stop or slow the damage.

Symptoms of end-stage liver disease may include:

• Easy bleeding or bruising
• Persistent or recurring yellowing of your skin and eyes (jaundice)
• Intense itching
• Abdominal pain
• Loss of appetite
• Nausea
• Swelling due to fluid buildup in your abdomen and legs
• Problems with concentration and memory

Cirrhosis usually progresses to the point where the liver loses most or all of its function — liver failure. In addition, people with cirrhosis may develop:

• Bleeding of the digestive (gastrointestinal) tract due to enlarged veins in the tube that connects the throat and stomach (esophagus), a condition known as esophageal varices
• Brain and nervous system damage due to the buildup of toxins in the bloodstream (hepatic encephalopathy)

Cirrhosis also increases your risk of liver cancer.

The only effective treatment for people with end-stage liver disease is a liver transplant. Chronic hepatitis C virus is the most frequent cause of liver transplantation in the United States. Most people who receive liver transplants for hepatitis C survive for at least five years after their transplants, but almost always hepatitis C virus returns.

If you’re diagnosed with hepatitis C or end-stage liver disease, see a doctor who specializes in gastrointestinal diseases or liver diseases (hepatologist). Newer, more-effective hepatitis C treatments can eliminate the virus in many people, reducing the risk of end-stage liver disease.