Symptoms of Hepatitis C

Up to 80% of people with the Hepatitis C virus (HCV) have no signs or symptoms of the disease, even though they may carry it for many years. You can look and feel perfectly healthy, yet still be infected with HCV and infect others. Most patients do not have any hepatitis C symptoms until there is already cirrhosis, or even liver failure.

EARLY-STAGE SIGNS AND SYMPTOMS

In the early stages of HCV, the liver first becomes inflamed, or swollen. The hepatitis C virus damages the liver cells, which alerts the immune system to send in several of its defenses. While the liver tries to repair itself, scar tissue (fibrosis) forms at the same time.
During this stage, most people do not have any hepatitis symptoms.

If a person does have symptoms of HCV, he or she may experience any of the following:

Flu-like symptoms

People with HCV can, periodically, experience flu-like symptoms. These usually last from a few days to a week, sometimes longer. The most common symptoms are fever, chills, headaches, fatigue, and muscle aches.

Fatigue and sleep disturbances

Many people with HCV experience excessive tiredness and lack of energy at some stage. Fatigue can impact on work, family relations and other activities, causing the person to be withdrawn, moody, cranky and irritable. A good night's rest will not always help overcome fatigue. Fatigue may also be linked to other factors, such as depression.

Sleep problems vary widely for people who have hepatitis C and can include difficulty falling asleep, waking up a lot or sleeping excessively. Sleep disturbances are common among the general population and it is often difficult to work out what impact HCV is having on a person's sleeping patterns.

Dry mouth and mouth ulcers

Dry mouth may be due to the decreasing amount or quality of saliva. Symptoms of a dry mouth can include: bad breath; cracked lips; sore mouth and throat; difficulty eating and swallowing; mouth ulcers; tooth decay; and, tooth sensitivity.

Dry eyes

HCV can potentially cause dry eyes, which may be due to inflammation of the glands that produce tears.

Nausea and poor appetite

HCV may cause episodes of nausea, which can affect appetite. Although it is usually not accompanied by vomiting, it can be a very uncomfortable and debilitating symptom.

Pain or discomfort of the liver

Pain or soreness on the right side just below the ribs could be from the liver.

Muscle and joint pain

Common sites of joint pain are the hips, knees, fingers, and spine, although any joint can be a source of pain. Pain associated with HCV can move around and come and go. There is often a generalized feeling of aches and pains in the muscles, though some people report having pain in only one area of the body.

Fevers and night sweats

People with HCV may experience fevers, which may occur while sleeping. The fevers are usually low, typically less than 38.3 degrees. As the fever reduces, people may experience chills and sweating.

LATER STAGE SIGNS AND SYMPTOMS

In about 85 percent of people infected with the virus, the body is not able to completely get rid of the virus, resulting in chronic HCV. As the liver continues to be damaged and scarred, it may stop cleaning harmful wastes, toxins, and drugs from the blood and may also stop making enough of the proteins the body needs to function properly.

It is possible that before liver failure develops, people with hepatitis C may not even know that their liver is being damaged. They may not have any hepatitis C symptoms or notice any physical changes to their body.

However, when the liver becomes badly damaged with cirrhosis and liver failure occurs, several late hepatitis C symptoms can begin to appear, including:

• Fluid build-up in the stomach area and legs
• Slowing of mental function
• Bruising or bleeding very easily
• Itchy skin
• Jaundice
• Dark urine
• Personality changes
• Bleeding in digestive tract
• Insulin resistance
• Type 2 diabetes
• High blood pressure within the liver (portal hypertension)
• Sensitivity to medication
• Gallstones

Mood swings, anxiety and depression

Symptoms can include feelings of hopelessness, helplessness, irritability, lack of interest in your usual activities and extended periods of sadness and/or despair. These feelings may also be caused by issues unrelated to HCV.

‘Brain fog' and cognitive changes

Cognitive ability refers to a person's ability to think clearly and to concentrate. Some people with hepatitis C notice a change in their cognitive ability. A person may find they cannot concentrate for long periods of time or that their thought processes seem slower than usual. Some people may have difficulty coming up with words they want to say, or just feel mentally tired. These cognitive changes are sometimes called ‘brain fog'. Like other symptoms of hepatitis C, cognitive changes can come and go. These symptoms can be caused by other things unrelated to hepatitis C, including depression and anxiety.

Skin conditions

Skin dryness, itching, rashes and other skin complaints may come or go. Some skin problems may include skin rashes, blisters, scarring, pigmentation, milk white spots, and skin tightening. Superficial inflammation can lead to itchy flat white and purplish patches on the skin and white patches in the mouth.

HCV can cause damage to your liver, even if you don't have symptoms. You're also able to pass the virus to others without having any symptoms yourself. That's why it's important to be tested if you think you've been exposed to HCV or if you engage in behavior that puts you at risk.

References:
The Mayo Clinic: http://www.mayoclinic.com/health/hepatitis-c/
Hepatitis Australia: http://www.hepatitisaust ralia.com/about_hepatitis/complementary.html