What Are Signs and Symptoms of Hepatitis C and Cirrhosis?

The signs and symptoms of hepatitis C virus (HCV) vary from person to person. Symptoms may also change over time. Plus, symptoms may be different during the acute (short-term) phase than during the chronic (long-term) phase.

Acute HCV

Acute HCV is the early stage of the virus. More than 2 out of 3 people with HCV will not show symptoms during this time; This is called being asymptomatic. It is also why HCV often goes undetected during this phase.1,2

Those who do have symptoms usually have them 2 weeks to 6 months after coming in contact with the virus. The symptoms last anywhere from a few weeks to 2 months.1,2

The most common symptoms of acute HCV are:1,2

  • Fever
  • Fatigue
  • Abdominal pain
  • Nausea, vomiting, or loss of appetite
  • Joint pain or muscle aches
  • Yellowing of the skin or whites of the eyes (jaundice)
  • Dark urine
  • Light colored stools

Chronic HCV

As many as 50 to 80 percent of those with HCV will develop chronic HCV.3

Chronic HCV can go on for decades without many symptoms. The symptoms that are present are often vague. It can be hard for a person with HCV to determine if the symptoms they are having are from chronic HCV or another underlying medical condition.3

The most common symptoms of chronic HCV are:2,3

  • Fatigue or weakness
  • Trouble sleeping
  • Depression or anxiety
  • Abdominal pain
  • Nausea or loss of appetite
  • Diarrhea
  • Weight loss
  • Joint pain or muscle aches
  • Itching
  • Dark urine
  • Yellowing of the skin or whites of the eyes (jaundice)

Because many of these symptoms are vague or mild, chronic HCV often progresses for years without being diagnosed.

Cirrhosis

Over time, chronic HCV can lead to damage and scarring of the liver. The final stage of liver damage is called cirrhosis. Cirrhosis can be caused by HCV, other hepatitis viruses, fatty liver disease, high alcohol intake, and autoimmune issues.4

Compensated cirrhosis refers to liver scarring that does not cause many obvious symptoms. However, when damage is severe enough, the liver cannot keep up. This is called decompensated cirrhosis. People at this stage can have many symptoms.4

Common signs of cirrhosis, specifically decompensated cirrhosis, include:4

  • Significant yellowing of the skin and whites of the eyes (jaundice)
  • Itching
  • Muscle cramps
  • Spider veins
  • Abdominal fullness and fluid (ascites)
  • Fluid in the feet and legs
  • Brain fog or trouble concentrating
  • Upper gastrointestinal (GI) tract bleeding

Portal hypertension

The portal system refers to the blood vessels that run through the liver. When the liver becomes scarred, it becomes difficult for blood to flow through it. This is called portal hypertension. This slow down or block of blood flow can cause several of the symptoms common to cirrhosis. It can lead to fluid backup in the abdomen (ascites) or the lower limbs.4

Portal hypertension can also cause backup into other connected blood vessels. These vessels include those around the stomach, esophagus (the tube from the mouth to the stomach), and other parts of the abdomen. These vessels can become enlarged and are called varices. Varices may burst and can lead to bleeding.4

Hepatic encephalopathy

The liver is also responsible for removing toxins from our body. As cirrhosis develops, the liver has a harder time completing this job. Toxins build up and cause hepatic encephalopathy (HE). HE causes concentration problems, brain fog, sleep issues, confusion, and even coma.4

Other non-liver issues

People with HCV are also at risk for other conditions. Some of these conditions include diabetes, autoimmune issues, blood disorders, and problems with the skin or kidneys.2

If you have HCV, talk with your doctor about other conditions you might be at risk for. They can help you learn what other symptoms to watch for and decide if additional tests are needed.

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Written by: Casey Hribar | Last reviewed: August 2021