Updated January 17, 2024. Medically reviewed by Neka Miller, PhD. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.
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In the United States, hepatitis C is the most common chronic viral infection found in blood and spreads through blood-to-blood contact. Researchers suggest an estimated 2.7 million to 3.9 million people in the United States have hepatitis C. So what are the warning signs you should be aware of? Read on to learn more about the signs of hepatitis C.
Hepatitis C, also referred to as “hep C” and HCV (for “hepatitis C virus”) is a type of viral infection that can contribute to liver inflammation. Infections usually start in an acute phase before proceeding to a chronic phase that can lead to lifelong health issues resulting from severe liver damage.
Hepatitis C is spread through blood-to-blood contact. For this reason, the most common form of transmission is sharing needles, syringes, or other injecting equipment that has been contaminated with the virus. It can also come from improperly sanitized needles used for tattoos and piercings, and it can also potentially be transmitted via sexual intercourse.
The good news is that HCV infections are usually curable, both in acute and chronic forms, with specific kinds of oral medications. In about 15 to 25 percent of acute cases, the HCV infection will go away on its own, a process known as spontaneous viral clearance. However, left untreated, hepatitis C infections can progress to advanced liver disease, including cirrhosis of the liver, liver failure, liver damage, and liver cancer. If you want to prevent a chronic HCV infection from occurring, it’s important to be aware of the potential symptoms so you can seek the proper treatment.
You can easily check for hepatitis C from the convenience and privacy of home with the at-home Hepatitis C Test. Note that the Centers for Disease Control and Prevention (CDC) recommends hepatitis C screening at least once for all adults age 18+.
Perhaps the most difficult aspect of diagnosing or even noticing hepatitis C is that it often does not present any initial symptoms. For many acute forms of hepatitis C, symptoms may not appear for upwards of six months following the initial exposure to the virus.
Chronic forms of hepatitis C can essentially act as “silent infections” for several years, showing no symptoms until the disease has progressed, usually in the form of advanced liver problems. Once your liver function has become compromised, a number of different health issues can arise.
For this very reason, it’s important to treat hepatitis C as soon as it’s identified. Here are some of the most common signs of hepatitis C to be aware of.
The earliest symptoms of an acute hepatitis C infection will resemble that of a general viral infection. This can include:
These symptoms will usually develop about three weeks after the initial hepatitis C virus infection. These symptoms are easy to miss as warning signs of hepatitis C because they can easily be mistaken for other common health conditions.
You may experience pain in the abdomen as the virus contributes to inflammation of the liver. Inflammation is a natural immune response that is a way for your immune system to control and heal infections. But it can also lead to signs of inflammation in the body such as pain, swelling, and discomfort.
Jaundice is one of the most noticeable symptoms of a chronic hepatitis C infection and other liver conditions. The liver is responsible for secreting bile, an enzyme that helps with digestion and is primarily responsible for breaking down fats into fatty acids. Swelling or damage in the liver prevents the bile from reaching your stomach or otherwise exiting the liver. This causes the bile to build up and enter the bloodstream, causing jaundice.
Jaundice is characterized by a yellowing of the skin and in the whites of your eyes, a result of the greenish-yellow tinge of bile. With severe jaundice, bile salts that build up under the skin can contribute to itchiness.
Jaundice can also cause urine to appear darker in color. As bile is responsible for breaking down fats, your stools may seem oilier or greasier without the enzyme. Bile also usually comes out of the stools. Without bile, stools can appear pale or clay-like in color.
Ascites refers to an accumulation of fluid within the peritoneal and abdominal cavities. This can cause a strange swelling in the abdomen. The exact reason why ascites occurs is not fully understood, but most experts hypothesize that ascites is a side effect of portal hypertension, or elevated blood pressure within the veins of the liver. This becomes even more prominent in cases where the liver has become heavily scarred (cirrhosis), a possible complication resulting from an untreated hepatitis C infection.
Ascites is characterized by swelling in the stomach that can also spread to the wrists, ankles, legs, and chest. The increased weight in these parts of the body can lead to pain in the joints and muscles, and the fluid in the abdomen can put pressure on the lungs, making breathing difficult or painful.
Bruises normally form when a heavy impact or injury breaks small blood vessels (known as capillaries) under the skin. The blood leaks out, leaving a black-and-blue mark that feels tender to the touch. That leaking blood eventually gets absorbed back into the body and the capillaries heal.
Your liver acts as a filter for your blood, but damage or inflammation can cause clogs that force your blood back toward your spleen. Your spleen is responsible for storing more than a third of your body’s platelets, which are responsible for helping your blood clot, which factors into helping bruises heal. As the spleen swells, it still has a maximum number of platelets it can hold. That essentially causes the number of platelets to become diluted, meaning fewer platelets leaving the spleen. Fewer platelets can make you bruise easier or make healing take longer.
Spider angiomas, also referred to as spider nevus or nevus araneus, are spider-like blood vessels that appear as red dots with lines extending outward under the skin. This condition is usually associated with high estrogen levels. The liver plays an integral role in the synthesis of estrogen, and damage to the liver from hepatitis C can cause increases in estrogen.
Spider angiomas can appear almost anywhere on the body, but are most common on the face, forearms, hands, and upper chest. They usually fade as hepatitis C is treated, but spider angiomas that do not go away can be treated with laser therapy.
While it’s less of an individual symptom, cirrhosis is a common result of chronic hepatitis C infections. Cirrhosis refers to deep scarring of the liver. Whenever your liver gets injured, it repairs itself and leaves scar tissue. This is similar to how your body deals with any sort of tissue damage. Persistent damage causes more and more scar tissue to form. As that scar tissue stacks, your liver has a harder time functioning properly.
Advanced cirrhosis can be potentially life-threatening. Damage from cirrhosis can’t be reversed, but catching the condition early can prevent further damage and allow for better management.
1. Hepatitis C. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/liver-disease/viral-hepatitis/hepatitis-c. Accessed January 21, 2021.
2. Testing Recommendations for Hepatitis C Virus Infection. Centers for Disease Control and Prevention. https://www.cdc.gov/hepatitis/hcv/guidelinesc.htm. Accessed January 21, 2021.
3. Hepatitis C. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/hepatitis-c/symptoms-causes/syc-20354278. Accessed January 21, 2021.
4. Hepatitis C - Symptoms. National Health Service. https://www.nhs.uk/conditions/hepatitis-c/symptoms/. Accessed January 21, 2021.