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Symptoms


You can have HCV and not know it. During the acute phase the disease is mild and many people do not have symptoms. Only 25% of persons will appear jaundiced (the skin and eyes turn yellow) during this phase. In chronic hepatitis, symptoms can come and go, lasting for several weeks or months at a time. HCV may persist for many years without any symptoms although it may be destroying liver cells at a slow rate. The reason for the absence of symptoms is that the liver has a large reserve of cells and so can function normally even when much of it has been destroyed.

The most common symptom of HCV infection

Lassitude - a lack of energy to the point where you feel you cannot exert yourself. This feeling of extreme tiredness goes beyond fatigue in that it persists even if you have a full night’s sleep.

Other symptoms

  • discomfort on your right side just below the rib cage (the right upper quadrant)
  • fatigue
  • nausea and vomiting
  • loss of appetite and weight loss
  • muscle and joint aches
  • itchy skin – usually no rash
  • poor sleep
  • depression
  • “brain fog” characterized by problems with short-term memory, concentration, and staying focused on tasks


The above symptoms can occur in the earliest stages of infection but more often tend to develop gradually. They cannot be directly linked to a particular stage of the disease or to any particular abnormal liver test.

Signs relating to liver failure

  • jaundice
  • dark urine and pale bowel movements
  • ascites (abdominal swelling due to fluid retention)
  • internal bleeding due to enlarged blood vessels in the esophagus or stomach
  • “easy bruising”
  • edema (swelling of the feet)

End stage liver failure

  • encephalopathy (a disease of the brain) is caused when the liver is unable to remove certain toxins (e.g., ammonia) from the blood after absorption from the intestine. These toxins reach the brain and cause confusion, drowsiness, extreme agitation, and sometimes coma.