Hepatitis C Symptoms

Hepatitis C, a viral infection spread through blood, causes inflammation in the liver and, in some cases, serious liver disease, per the Centers for Disease Control and Prevention (CDC). About 2.4 million people in the U.S. are infected with hepatitis C, the CDC notes, although the true number is likely higher.

Unlike many other viral infections, hepatitis C can occur without symptoms, with around 50 percent of infected people being unaware that they have the virus.

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), hepatitis C is the most common blood-borne virus in the U.S., and its infection rate has been rising steadily since 2006. When you combine the widespread nature of hepatitis C with the seriousness of the illness, it becomes even more important to recognize any potential signs and symptoms of infection.

If you're at risk for contracting the hepatitis C virus (HCV) or think you might already be infected, here are the common signs and symptoms to know about.

Signs and Symptoms

Symptoms of hepatitis C vary based on the stage of infection you are in:

Acute infection. This stage includes the first two to 12 weeks after someone had been infected with HCV. This is when symptoms can develop, although the CDC reports that some people don't have any symptoms or are unaware that their symptoms may be a result of hepatitis C.

Chronic infection. This stage includes any hepatitis C infection lasting longer than 12 weeks. Many people with chronic hepatitis C infections don't have any symptoms, per the CDC, unless they have developed liver disease.

Fever and Fatigue

Your body is mounting a major immune system response to fight the hepatitis C virus, and all that effort takes a toll. The CDC notes that people who have symptoms in the first one to three months after being exposed to the virus may have a fever or feel tired.

Jaundice

Yellowing of the skin or the whites of the eyes is known as jaundice. The yellowish color comes from bilirubin, a substance your body naturally makes when it breaks down old red blood cells, per MedlinePlus.

A healthy liver breaks down bilirubin so that it can be removed through stool, reports the Icahn School of Medicine at Mount Sinai. Any illness, health condition, or medication that interferes with liver function (like HCV) can prevent this from happening. Jaundice occurs when too much bilirubin builds up in your blood.

People with jaundice also often experience intensely itchy skin, though experts aren't entirely sure why, according to a 2019 study in eLife.

Gastrointestinal Problems

Acute hepatitis C can cause a number of different GI issues, including loss of appetite, nausea, and vomiting, according to the CDC. It may also cause stomach pain and swelling.

If fluid builds up in the abdomen; this is called ascites, explains MedlinePlus. This problem is more common in people with chronic hepatitis C infections.

Changes to Urine and Stool

Both your urine and stool may undergo changes if you have HCV. Urine often appears dark, and your stool may become paler or resemble a light clay color, per NIDDK.

These changes happen for the same reason that jaundice does: an excess amount of bilirubin in your blood, according to the University of Rochester Medical Center.

Joint Pain

The American College of Rheumatology notes that joint pain and rheumatic, or arthritic, disease is a common symptom of hepatitis C, because your body's attempts to fight and clear the virus heightens your immune response.

Liver Damage

Acute hepatitis C infections cause inflammation in the liver, but damage only occurs if the infection persists or is left untreated over a long period of time, reports The Hepatitis C Trust. Typically, scarring of the liver can be found between 10 and 20 years post-infection, and that scarring often causes cirrhosis of the liver.

Cirrhosis means your liver is permanently scarred and damaged, no longer functioning like it should, notes NIDDK. This can lead to liver failure.

Liver cancer is also more common among people with hepatitis C—in fact, it's the most common cause of liver cancer, according to The University of Texas MD Anderson Center.

When to See a Health Care Provider

If you have symptoms of hepatitis C, especially if you are at risk for contracting the infection, it's important to see a healthcare provider so you can be diagnosed and receive prompt treatment.

Diagnosis of hepatitis C usually involves a physical exam and blood work, and may also include imaging tests such as ultrasound or even a liver biopsy, per NYU Langone Health.

If you have already been diagnosed with hepatitis C, the U.S. Department of Veterans Affairs says you should speak to a healthcare provider if you have any of the following symptoms:

• Dizziness
• Shortness of breath or chest pain
• Vision changes
• Severe fatigue
• Edema, or swelling of the limbs
• Signs of illness, like fever or diarrhea, lasting more than two days

Summary

A hepatitis C infection can cause liver inflammation and, ultimately, liver damage if left untreated. Symptoms such as unusual fever or fatigue, yellowing of the skin or eyes, GI issues, dark urine, pale stool, or joint pain may signal the presence of HCV.

But people who are newly infected often have no symptoms or feel only mildly ill. Likewise, chronic infections can persist for years without signs or symptoms until complications arise. That's why healthcare providers recommend testing for anyone at high risk of hepatitis C infection.

The sooner the infection is detected, the better. Per the CDC, treatment can cure the infection. It can even help prevent further liver damage and liver cancer in people who have had the infection for years.¹⁵