Hepatitis C: An In-Depth Guide

Most people who have hepatitis C do not experience any symptoms when they first become infected (during the acute phase of their hepatitis C infection). Many people have hepatitis C for years—even decades—before any symptoms develop.

Getting tested is the only way to know if a person has hepatitis C. Anyone who may be at risk of a hepatitis C infection should get tested. A person should not wait until symptoms develop.

Symptoms of an acute infection

Few people show symptoms during acute infection (a hepatitis C infection for less than six months). These symptoms can include: fatigue; tenderness or an aching feeling on the right side of the abdomen; decreased appetite perhaps with weight loss; flu-like symptoms; nausea; tendency to bruise or bleed easily; jaundice (yellowing of the skin and whites of the eyes); rash; dark-coloured urine; and light or clay-coloured stools. These symptoms often go away after a short time.

Symptoms of a chronic infection

If the hepatitis C infection progresses to a chronic infection (a hepatitis C infection for more than six months), it can take years before symptoms develop. Symptoms of advanced liver disease caused by long-term chronic infection can include: jaundice; fluid build-up (ascites or edema); and blood in stool or vomit. Sleep disturbances, depression, weight loss, dry or itchy skin, and “brain fog” also occur in people with chronic hepatitis C but the cause of these symptoms remains uncertain.

Women and chronic hepatitis C

For women who develop chronic hepatitis C, liver damage generally happens more slowly than it does for men (about half as fast). This can change as a woman gets older—liver damage may happen more quickly for women who are going through menopause or who have completed their transition through menopause.

Symptom management

Some signs and symptoms can cause discomfort that can be managed. Others are significant medical complications, such as fluid build-up (ascites or edema), internal bleeding and jaundice. A person experiencing any symptoms should speak regularly with a healthcare professional. If symptoms become severe, a person should consider visiting a hospital emergency room. 

Signs and symptoms of hepatitis C infection may include the following:

• Blisters (poryphyria cutanea tarda)
• Blotchy skin (cryoglobulinemia)
• Depression
• Extreme confusion (hepatic encephalopathy)
• Extreme tiredness (fatigue)
• Flu-like symptoms
• Fluid build-up (ascites or edema)
• Joint pain (arthralgia)
• Loss of appetite (anorexia)
• Low sex drive (loss of libido)
• Lowered platelet count (thrombocytopenia)
• Nausea
• Problems with thinking ("brain fog")
• Purple or shiny itchy bumps (lichen planus)
• Rash or itchy skin (pruritis)
• Right upper side discomfort
• Sleep problems
• Stress (emotional strain or tension)
• Tingling or burning sensation (parasthesia or peripheral neuropathy)
• Vomiting blood (esophageal varices)
• Yellowing of the skin (jaundice)

Note: It is important to note that having certain symptoms does not automatically mean a person has hepatitis C. 

Revised 2019.