Hepatitis C: Disease course and symptoms

The symptoms of acute and chronic HCV infection

Many people strongly associate hepatitis infections with jaundice, which is the yellowing of the skin, eyes and mucous membranes. Jaundice rarely occurs in acute or chronic hepatitis C infection, and hepatitis A and B infections can also occur without jaundice.

In both acute and chronic hepatitis C infection some people may experience symptoms such as exhaustion, pain in the limbs, nausea, flatulence, feelings of fullness, abdominal pain, loss of appetite, pale-coloured stools or dark urine; however, these are all rather non-specific symptoms. Patients and doctors may often interpret these symptoms as signs of over-work or stress rather than as possible indications of hepatitis C infection.

Even when a doctor orders blood tests for a patient, hepatitis C infection is only detected for sure if there is a targeted search for the virus. Liver enzyme values, such as ALT and AST, are often increased, but this is not necessarily the case for everyone with hepatitis C.

Some people have hepatitis C for many years before the first symptoms appear. As a result of this, chronic hepatitis C often goes undetected for a long period of time. The damage to the liver continues quietly.

By the time hepatitis C has been diagnosed, many people have already developed the serious long-term consequences of the disease. It is not for nothing that hepatitis C is sometimes called the 'silent killer'.

This information was originally adapted from Hepatitis C: Understanding a silent killer, published by the European Liver Patients Association. It was updated in 2016.