End-stage complications of hepatitis C include liver failure and liver cancer. These complications primarily occur in people who develop permanent scarring of the liver (cirrhosis) due to inflammation caused by the hepatitis.

About 30 percent of people with hepatitis C develop cirrhosis, usually several decades after infection. Of those who have cirrhosis, fully half progress to either liver failure or cancer.

In addition, people with cirrhosis may develop:

• Fluid in the abdominal cavity (ascites)
• Gastrointestinal bleeding due to enlarged veins (varices) in the esophagus
• Brain and nervous system damage due to the accumulation of toxins in the bloodstream (hepatic encephalopathy)

Once these complications occur, the disease tends to progress at a faster rate. A liver transplant may be recommended.