Hepatitis C Symptoms in Women and Men

What hepatitis C symptoms look like

A new hepatitis C infection rarely announces itself. When it does, the signs are those of an inflamed liver: fatigue, nausea or poor appetite, pain in the belly, joint pain, dark urine, pale stools and yellowing of the skin or eyes, usually starting two to twelve weeks after exposure. Chronic infection is silent for years or decades; the first sign may be abnormal liver blood tests on a routine physical, or, much later, the signs of advanced liver disease – swelling of the belly or legs, easy bruising, confusion – which are a medical emergency, not a symptom to test for at home.

Why most people have no symptoms

The CDC estimates that about four in five people with a new hepatitis C infection have no symptoms, that more than half of infections become chronic, and that a large share of people living with chronic hepatitis C do not know it. It spreads mainly through blood – shared needles or other injection equipment, and less often through sex, where the risk is low for most couples but higher for men who have sex with men, people living with HIV, and sex that involves blood. A test is the only way to know. Symptoms do not shorten the time an infection takes to show up on a test, and having none does not mean you are clear.

What else causes the same symptoms

Fatigue and nausea have endless causes; jaundice and dark urine point to the liver but not to which cause – hepatitis A or B, alcohol, medications, gallstones and fatty liver all produce the same signs. The hepatitis C test looks only for hepatitis C.

When to see a clinician rather than wait for a test

Yellowing of the skin or eyes with confusion, severe abdominal pain, persistent vomiting, swelling of the belly or legs, or vomiting blood needs prompt medical care. If you are pregnant, tell your prenatal provider: the CDC recommends hepatitis C testing during every pregnancy, and a child born to a mother with hepatitis C is tested and, if infected, treated.

How hepatitis C is tested, and what the test cannot tell you

The standard test is a blood test for hepatitis C antibodies. A negative result means no evidence of infection – but antibodies take longer to appear than for most infections, so a negative soon after an exposure should be repeated, and for a recent exposure a test for the virus’s RNA can find infection weeks earlier; ask the physician. A positive antibody result means you were infected at some point and needs an RNA test to tell whether the virus is still present, because about a quarter of people clear it on their own and keep the antibody for life. The timing is on our When to Get Tested page, or call (866) 872-1888. More about the test is on our hepatitis C testing page.

After a positive result

Hepatitis C is curable. Modern antiviral pills, taken for eight to twelve weeks, cure more than 95% of people, with few side effects – this is not the hepatitis C of twenty years ago, when treatment was hard and often failed. A member of our care team calls you, explains the result, and arranges a consultation with a physician who orders the RNA test and, if the virus is present, refers you to a specialist for treatment. Until then, do not share razors, toothbrushes or needles, limit alcohol, and talk to the physician about what to tell partners; the risk through sex is low for most people but the conversation is worth having.