Symptoms of the hepatitis C virus


The signs and symptoms of hepatitis C virus (HCV) infection differ depending on the stage of infection. The most common symptoms include fatigue, jaundice (yellow skin and eyes), fever, and nausea . In the later stages of infection, liver failure can cause bleeding problems or encephalopathy (severe confusion). Sometimes liver cancer can develop, often manifesting as malnutrition.

Illustration from Get Meds Info

Stages of the disease

The body's exposure to HCV changes over time after the initial exposure. This is largely due to the spread of the virus, which can reproduce within the body and create numerous copies of itself. Progress is also associated with the cumulative effect of the virus on the liver.

Stages of HCV infection:

  • Incubation Period: At this stage, you may have contracted the virus, but most likely you will not have any symptoms. If you have symptoms, they can include fever, fatigue, or an upset stomach.
  • Acute hepatitis: About 2 to 12 months after the virus enters the body, HCV can cause mild to moderate illness. Symptoms of an acute infection occur in about 15 to 20 percent of people exposed to the virus. The presentations are usually flu-like with small signs of liver damage. About one in four people successfully fight the virus at this stage .
  • Chronic hepatitis: Most people infected with HCV develop chronic hepatitis. Chronic infection occurs when the hepatitis C virus (HCV) is not cleared spontaneously and remains in the body. Some people develop symptoms of chronic infection several years after contracting the virus, even without symptoms of acute hepatitis .
  • End-stage hepatitis: A more complex form of the disease is manifested by liver failure and a number of serious complications, such as kidney failure and liver cancer .

Frequent symptoms

Symptoms of liver failure include general flu symptoms, as well as more specific signs of liver damage, as the virus targets the liver. Common symptoms that occur in both the acute and chronic phases of HCV infection tend to last longer and be severe for longer during the chronic phase of infection.

The most common symptoms of HCV include symptoms that are not specific to hepatitis and occur with most infections. These symptoms are due in large part to the activity of the body's own immune system, which is fighting the virus.

The most common symptoms of acute and chronic HCV include :

  • Fatigue
  • Hot
  • Jaundice
  • Nausea and vomiting
  • Decreased appetite
  • Abdominal pain
  • Diarrhea
  • Joint pain
  • Muscle pains

Some of the symptoms of acute and chronic HCV are similar to those of any liver disease .

  • Bleeding and bruising: The liver plays a role in the production of proteins that promote blood clotting, which is part of healing injuries. Bleeding and bruising can be signs of liver dysfunction, even as a result of a viral attack on the liver. as an inflammatory response of the body to a virus.
  • Dark-colored urine: A buildup of bilirubin that occurs when the liver is infected or damaged can cause jaundice , as well as dark-colored urine (choluria) and pale or chalky stools .
  • Pale or chalky stools

In acute hepatitis, these symptoms usually resolve on their own, although the more severe cases associated with jaundice and choluria can take up to a year. In chronic hepatitis, these symptoms are usually more persistent than in acute hepatitis.

Rare symptoms

Several less common symptoms of HCV infection can occur in the acute or chronic stages. Many of these symptoms are the result of liver dysfunction or the body's inflammatory response to the virus.

  • Weight loss: This can happen due to a number of consequences of HCV infection. Nausea , vomiting, and fatigue can reduce your appetite, making you want to eat less. And, as the liver becomes damaged, it may not make several important proteins and fats to help you digest and absorb the food you eat, leading to diarrhea and mainly malnutrition even when you eat.
  • Abnormal tingling or burning sensation
  • Uncomfortable “ tingling '' sensation
  • Skin itch
  • Raised areas of the rash
  • Dry eyes with dry mouth
  • Rheumatic conditions: joint inflammation, muscle aches and pains can start before you know you've been exposed to HCV and can occur at any stage of infection . Joint and muscle pain occurs when the immune system is stimulated to continually fight the virus.
  • Vasculitis (inflammation of the blood vessels) is rare and can cause various effects, such as pain, blood clots, and even strokes or heart attacks, although this is rare .
  • Cryoglobulinemia : Cryoglobulins are proteins in the blood that harden when exposed to low temperatures, causing circulation problems .


The chronic stage of hepatitis C can persist for decades. During this time, steatosis (chronic fat accumulation) and fibrosis (progressive scarring of tissue) can damage the liver. Both conditions often develop unnoticed, and most people show little or no signs of illness .

End-stage liver disease refers to the time when the liver is severely damaged and cannot function. At this stage, symptoms are often very obvious and often affect multiple organ systems, including the brain, kidneys, and upper digestive tract.

Among people with chronic hepatitis C infection, 10 to 15 percent will develop an irreversible disease called cirrhosis , in which the damage caused by fibrosis is so extensive that blood flow to and from the liver changes .

Cirrhosis is classified according to the degree of involvement and is classified as:

  • Compensated cirrhosis
  • Decompensated cirrhosis

Compensated cirrhosis means that the liver works relatively well and therefore can cause minimal symptoms. When present, symptoms can include complications affecting the skin, muscles, and joints, as the limited blood supply causes both an increase in localized blood pressure, known as portal hypertension , and a build-up of bile and other toxins. .

Among the possible symptoms of compensated liver cirrhosis:

  • Vein spiders, mainly on the trunk and face.
  • Skin itch
  • Redness of the palms
  • Easy bruising or abnormal bleeding
  • Accumulation of fluid in ankles and feet.
  • Low concentration and memory.
  • Loss of appetite
  • Weightloss
  • Contraction of testicles
  • Erectile dysfunction or loss of libido.
  • Alcohol intolerance

Terminal complications of hepatitis C infection include:

  • Decompensated cirrhosis
  • Hepatocellular carcinoma (HCC)
  • End-stage renal disease (ESRD)

Decompensated cirrhosis is a serious condition in which progressive scarring of the liver causes severe damage and an inability to function. Symptoms are often profuse and progressive and can manifest in a variety of ways, including:

  • Persistent fatigue
  • Jaundice
  • Loose or bloody stools
  • Accumulation of fluid in the abdomen causing bloating and bloating.
  • Distinctive mouth odor, from sweet musty to rotten egg
  • Severe bleeding or bruising
  • Abnormal decrease in urine output
  • Personality changes, confusion, or tremors.
  • Increased drowsiness
  • Amyotrophy
  • White discoloration or milky spots on the nails.
  • Vomiting blood
  • Esophageal varices (dilated blood vessels in the esophagus that can bleed)

Hepatocellular carcinoma (HCC) is a type of liver cancer that develops almost exclusively in association with cirrhosis of the liver in people with hepatitis C. The symptoms of HCC are similar to those of decompensated cirrhosis and may include:

  • Persistent fatigue
  • Jaundice
  • Accumulation of fluid in the abdominal cavity.
  • Abnormal bruising and bleeding
  • Sudden involuntary weight loss
  • Loss of appetite
  • Feeling full after eating small amounts.
  • Delirium, confusion, or severe muscle spasms.
  • Abdominal discomfort, especially in the right upper quadrant below or just below the ribs

End-stage renal disease (ESRD), which is progressive kidney failure , can be caused and complicated by hepatitis C infection. The symptoms of ESRD can vary and include:

  • Persistent fatigue
  • Chronic abdominal pain
  • Abnormal decrease in urine output
  • Inability to urinate
  • Smell of urine from the mouth
  • An uneven or patchy discoloration of the skin.
  • Amyotrophy
  • Swelling of the legs and feet, or around the eyes.
  • Nausea or vomiting, especially in the morning and after meals.
  • Increased drowsiness
  • Repeated leg spasms
  • Shortness of breath or trouble breathing
  • Mental disability, confusion.

Outcomes for end-stage liver disease are often poor, with a 5-year survival rate of 50 percent in those with decompensated cirrhosis and 30 percent in those with HCC.

When to contact a healthcare provider

Because HCV symptoms may not appear in the early stages, and because they are not always terribly alarming, even in the acute and chronic stages, you may need to see your doctor even if you don't have clear symptoms of infection.

Signs of exposure

You should see your doctor if you have been exposed to the virus recently or at any time in the past. If you have experienced any of the following symptoms, you may have contracted HCV:

  • If you have had unprotected sex with someone who has or may have been infected with HCV.
  • If you shared needles with someone
  • If you have had a cut or crack in the skin caused by a needle, glass or any other object that has been or could have been infected with blood infected with the hepatitis C virus.

Hepatitis C Provider Discussion Guide

Get our printed guide to your next doctor's appointment to help you ask the right questions.

If you have symptoms of liver failure or severe infection, you should also see your doctor, as the cause could be hepatitis C or another serious medical condition that also requires medical attention. Signs and symptoms to look out for include:

  • Persistent fevers
  • Jaundice
  • Discoloration of urine
  • Nausea, vomiting, or diarrhea that is excessive or lasts for more than a week.
  • Unexplained fatigue that lasts more than a week.
  • Swelling of the abdomen

Frequently asked questions

  • Some people with hepatitis C never show symptoms, and the disease can be passed to another person without showing symptoms. In people who show symptoms, they usually appear 2 to 12 weeks after infection. Years later, symptoms of liver disease or liver failure may appear.

  • Yes, the use of antiviral medications, particularly direct-acting antiviral medications, has been shown to cure more than 95% of hepatitis C cases.

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