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Signs and Symptoms of Hepatitis C

By Dr. Tina M. St. John ; Updated August 14, 2017

Some illnesses hit like a thunderclap, with sudden symptoms that sideline you in a hurry. Then there are more stealthy diseases like hepatitis C. This serious viral infection usually flies under the radar and remains undetected for many years because people with the disease often experience few, if any, symptoms until the disease has substantially damaged the liver. When symptoms do occur, they are often ignored because they aren’t severe enough to disrupt daily life. Hepatitis C symptoms are also highly variable and often involve not only the liver, but also other body systems.

Initial Infection

Unlike when you catch a cold or the flu, contracting hepatitis C usually doesn’t make you sick — initially. The Centers for Disease Control and Prevention reports that 60 to 70 percent of people don’t experience symptoms during the initial phase of the illness, known as acute hepatitis C. People who do get sick typically experience symptoms similar to the flu, including tiredness, body aches, low-grade fever, upper-abdomen pain, nausea, vomiting and decreased appetite. These symptoms usually develop within six to seven weeks, but they can appear any time from two weeks to three months after infection.

Acute hepatitis C can also trigger liver-related symptoms because the infection irritates the liver and might disrupt its function. Intensely yellow urine, light-color bowel movements and yellowing of the skin and whites of the eyes may signal hepatitis C-related liver problems.

Chronic Infection

Chronic hepatitis C refers to a hepatitis C virus infection lasting longer than six months. Although most people continue to feel well, the flu-like symptoms that sometimes occur with acute hepatitis C may develop. Because these relatively mild symptoms typically come and go, many people attribute them to overwork, the stomach flu or another minor ailment.

However, these “mild” symptoms sometimes make daily life difficult. The absence of symptoms in many and the vague nature of symptoms when they do occur often lead to a long delay in diagnosing hepatitis C. In fact, results of a national U.S. survey reported in the June 2012 issue of Hepatology indicate that less than half of people with chronic hepatitis C are aware they have the illness.

Liver Failure

Many people with hepatitis C don’t develop clear symptoms until their liver has been severely scarred and distorted and begins to fail. Because the liver performs numerous jobs, many possible symptoms of liver failure can occur, including:

  • yellowing of the skin and whites of the eyes - bloating of the belly - muscle loss in the arms and legs - tiny, spider-like red marks on the face, neck and chest - confusion, incoordination or bizarre behavior - bruising or small purple spots on the skin

Other Symptoms

While hepatitis C primarily affects the liver, long-term infection often causes problems outside the liver with additional symptoms. “Brain fog” — forgetfulness, mental slowness and difficulty concentrating — occurs in roughly one-third of people with chronic hepatitis C, according to a February 2015 World Journal of Gastroenterology article.

Anxiety and depression also frequently occur in people with hepatitis C. Autoimmune disorders, in which the immune system mistakenly attacks the body’s own tissues, are common with hepatitis C. For example, people with hepatitis C often develop an underactive thyroid gland, with weight gain, weakness, constipation, irritability and lack of energy. Joint pain, dry mouth and dry eyes are other possible autoimmune complications of hepatitis C.

Next Steps

It’s impossible to diagnose hepatitis C based on symptoms alone, especially because they are so variable. But it’s important not to ignore symptoms that may signal hepatitis C. Talk with your doctor about your symptoms and whether hepatitis C testing is appropriate for you.

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