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It's hard to say what will happen to you. Many people with hepatitis C have few problems with their health and live a normal life. But other people can get very sick because of hepatitis C.

There are treatments that can get rid of the virus that causes hepatitis C. Getting rid of the virus can lower your chance of getting damage to your liver. But the treatments can have side effects. And they don't work for everyone. So, it can be hard to decide about whether you should have treatment. For more information, see When to have treatment for hepatitis C.

If you have recently been infected with the hepatitis C virus, your body may fight off the virus naturally, without any treatment. This happens to about 2 in 10 people.¹ If it happens to you, you may feel sick for just a short time. Or you may not notice any symptoms at all. If your body gets rid of the virus naturally, you won't get liver problems and you won't need treatment.²

You have hepatitis C but you don't have any signs of inflammation or damage in your liver, your doctor may suggest that you wait and see if your body gets rid of the virus naturally.²

But most people still have the virus in their body more than six months later. This happens to between 7 in 10 and 8 in 10 people.^{3 4} It's called chronic hepatitis C.

If you have chronic hepatitis C, you will need to decide whether or not to have treatment to get rid of the virus. The usual treatment is having shots of a medication called pegylated interferon plus tablets of another medication called ribavirin. For more information, see Pegylated interferon plus ribavirin.

The chance of the treatment working for you depends on several things. The most important one is the type of hepatitis C you have. There are six types of hepatitis C virus, which all have different genes. Doctors call the types genotypes. They are numbered 1 to 6.

• If you have genotype 2 or genotype 3, you have a very good chance of getting rid of the virus if you have treatment. About 8 in 10 people with these types get rid of the virus when they have the usual treatment.⁵
• But if you have genotype 1, it's harder to get rid of the virus. About 4 in 10 to 5 in 10 people with genotype 1 get rid of the virus with usual treatment.⁵

There are other things that affect whether treatment will work for you.⁶ You are more likely to get rid of the virus by having treatment if:

• You are younger
• You're treated soon after you've been infected
• You don't have any liver damage
• You're a woman.

Lots of people live with the hepatitis C virus in their bodies for many years and don't have any health problems.⁷ But other people get liver damage, which can be serious. Unfortunately, there isn't any way of knowing what will happen to you.

Research shows people tend to fall into one of three groups.⁸

• One-third of people with hepatitis C get scarring in their liver (cirrhosis) within 20 years of being infected.
• One-third of people get cirrhosis between 20 and 50 years after being infected.
• And the remaining third get cirrhosis more than 50 years after being infected, or not at all.

The idea of getting serious liver problems some day can be frightening. But remember that some people with hepatitis C never get these problems. It's important to stay in touch with your doctors. That way, if you get any symptoms, they can be picked up early. Then you can talk about whether to have treatment, if you haven't already had it. And there are things you can do to make you more likely to stay healthy.

About 2 in 10 people who have been infected with hepatitis C for more than 10 years get scarring in their liver (cirrhosis).⁴ It tends to get worse over time. And it may stop your liver from working properly. Cirrhosis is why some people with chronic hepatitis C get serious problems with their liver.

The symptoms of cirrhosis include:⁴

• A swollen liver, which may make your abdomen feel sore and bloated
• A yellow tinge to your skin and the whites of your eyes (jaundice)
• Weak muscles
• Swollen ankles
• Bloating in your abdomen (from a build-up of fluid)
• Itchy skin.

If you get any of these symptoms, see your doctor.

Over time, cirrhosis can cause serious problems with your liver or liver cancer. These things happen in between 1 in 100 and 5 in 100 people with chronic hepatitis C after 20 years or more.^{3 4}

If these things happen to you, you may need an operation to get a new liver.³ This is called a liver transplant. It's a big operation. But it can save your life if your liver is badly damaged.

If you have hepatitis C, you can do some things to try to keep your liver as healthy as possible.

You may need to cut back on how much alcohol you drink. That's because alcohol can also harm your liver. Talk to your doctor about how much you drink and ask if you need to cut back.⁹

You don't need to eat in a special way. But try to keep a healthy weight.⁹ You should eat sensibly and stick to healthy foods. And you should get regular exercise. If you're not sure how to do these things, ask your doctor.

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment. ©BMJ Publishing Group Limited 2008. All rights reserved.