Chronic hepatitis C is referred to as a "silent epidemic," as many times those affected are asymptomatic or may present with very nonspecific symptoms such as fatigue. Some patients may be discovered to have hepatitis C when they are found to have abnormalities of routine liver laboratory tests (AST/ALT). However, others may have chronic hepatitis C with normal liver enzymes. It is important to be screened for hepatitis C if you have any risk factors, regardless of the liver enzymes.

People experience hepatitis C in different ways. They may not have any symptoms at all. In fact, symptoms of chronic hepatitis C may not appear until advanced liver disease is already present. This is why tests of your liver's health such as enzyme levels in your blood, other blood tests, a liver ultrasound, liver biopsy are important.

Symptoms develop in only 25 to 35 percent of the patients who acquire acute hepatitis C and are often very nonspecific. Therefore, the disease is only rarely diagnosed at this phase. Seventy-five to 85 percent of patients infected with acute hepatitis C will develop a persistent infection called chronic hepatitis C.

Remember: How you are feeling does not always match up with the severity of your condition. If you wait to have symptoms before you start treatment, your liver may already be severely damaged.

Symptoms that may be related to chronic hepatitis C are varied. Although hepatitis C damages the liver, 80% of people with the disease do not have symptoms. In those who do, symptoms may not appear for 10-20 years, or even longer. Even then, the symptoms usually come and go and are mild and vague. Unfortunately, by the time symptoms appear, the damage may be very serious.

• A minority of people have symptoms during the early acute phase of the infection. These symptoms typically develop 5-12 weeks after exposure to HCV. Some people describe the symptoms as being flu-like. The symptoms may last a few weeks or months.
  • Nausea
  • Vomiting
  • Diarrhea
  • Loss of appetite
  • Fatigue
  • Pain over the liver (on the right side of the abdomen, just under the rib cage)
  • Jaundice - A condition in which the skin and the whites of the eyes turn yellow
  • Dark-colored urine (may look like cola or tea)
  • Stools become pale in color (grayish or clay colored)

• Prolonged nausea and vomiting can cause dehydration. If you have been vomiting repeatedly, you may notice the following symptoms:
  • Fatigue or weakness
  • Confusion or difficulty concentrating
  • Headache
  • Not urinating
  • Irritability

• Chronic hepatitis C can lead to cirrhosis of the liver in many people, a condition traditionally associated with alcoholism. Cirrhosis is a condition in which healthy liver tissue is replaced by fibrous tissue, followed by scar-like hardening. As this happens, the liver gradually begins to fail, or lose its ability to carry out its normal functions. Eventually, symptoms develop. Symptoms of cirrhosis include the following:
  • Fluid retention causing swelling of the belly (ascites), legs, or whole body
  • Persistent jaundice
  • Fatigue
  • Disturbances in sleeping
  • Itchy skin
  • Loss of appetite, weight loss, wasting
  • Vomiting with blood in the vomit
  • Mental disturbances such as confusion, lethargy, extreme sleepiness, or hallucinations (hepatic encephalopathy)