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What Are the Symptoms of Hepatitis C?

The symptoms of hepatitis C virus infection differ widely from one person to another. After being exposed to the virus, some people experience a short bout of symptoms that may include fever, loss of appetite, extreme fatigue, and pain on the right side of the abdomen. But most people carry the virus for years without ever noticing any symptoms. Many don't know they have HCV until they are tested.

Some people, in fact, never develop clinical signs or symptoms of liver disease. Though they have been infected with the virus, their liver enzyme levels remain normal. At the other end of the spectrum are people with high levels of the virus in their blood, abnormal liver enzyme levels, and signs of serious liver damage. In between are people with mild symptoms or moderate elevation of liver enzymes. But even with mildly abnormal liver enzymes, most people feel just fine.

In the majority of people infected with hepatitis C, symptoms don't show up until the second or third decade after infection. By then, unfortunately, the virus has usually damaged the liver. That's why it's important for anyone who believes he or she may have been exposed to hepatitis C to see a doctor and ask about getting tested.

Early symptoms

Early symptoms of hepatitis are easily confused with those of other illnesses. They include such common complaints as the following:

  • Fatigue
  • Mild tenderness or discomfort on the right side of the abdomen
  • Nausea
  • Poor appetite
  • Muscle and joint pains
  • Weight loss, typically around five to 10 pounds
  • Itching of the skin
  • During a physical examination, doctors may notice mild enlargement of the liver. Some patients also develop unusual reddening of the palms of the hands, called palmar erythema.

Later symptoms

If the virus begins to cause damage to liver cells, more severe symptoms may appear. These include:

  • Dark urine
  • Fluid retention
  • Muscle weakness and wasting
  • Light-colored stools
  • Enlarged liver and/or spleen
  • Jaundice (yellowing of the skin or the whites of the eyes)
  • Skin abrasions
  • Accumulation of fluid in the abdominal cavity, a condition called ascites

Sometimes the effects of HCV extend beyond the liver. These conditions are called extrahepatic, or "outside the liver." Many are caused by the immune system's response to the virus. These conditions include:

  • Inflammation of the kidneys (glomerulonephritis)
  • A rare condition marked by abnormal immune reactions that can affect skin, blood, or the kidneys (essential mixed cryoglobulinemia)
  • A condition in which the skin becomes highly sensitive to light, resulting in sores and blisters (porphyria cutanea tarda)

Since hepatitis C can also do silent damage to your liver, it's important to get tested if you have one or more risk factors for the disease.

References

Chronic Hepatitis C: Disease Management, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), http://digestive.niddk.nih.gov/ddiseases/pubs/chronichepc/

Centers for Disease Control and Prevention. Hepatitis C FAQs for the Public (Symptoms). http://www.cdc.gov/hepatitis/C/cFAQ.htm#cFAQ15

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