Hepatitis C: Symptoms and Signs in Women and Men

In 1989, viral RNA characteristic of flaviviruses was found in the blood of patients with hepatitis "neither A nor B" — this is how the hepatitis C virus was discovered, and in 2020 the Nobel Prize was awarded for this. Since then, medicine has learned a lot about it, but the disease itself still knows how to hide: most infected people feel nothing. That is why it is logical to start the story about symptoms with the fact that there may be no symptoms at all.

What is hepatitis C and why is it often unnoticed

Hepatitis C is an inflammation of the liver caused by the HCV virus, which is transmitted through contact with infected blood. Infection is possible through sharing needles and other injection equipment, and during medical or dental procedures in countries with poor infection control. The virus is not transmitted through hugs, kisses, or sharing food and drink.

The disease can be acute, lasting up to six months, or chronic. About 80% of those exposed to the virus develop chronic infection, and in the first decades most patients feel nothing or almost nothing. Many live with HCV for 20 to 40 years without becoming seriously ill — but they remain a source of infection for others.

Acute form: first symptoms

The incubation period lasts from two weeks to six months; clinical manifestations more often occur after one and a half to two months. In some people with the acute form, within one to three months after infection, fever, fatigue, abdominal pain, loss of appetite, nausea or vomiting appear. They may be joined by dark urine, grayish or clay-colored stools, joint pain, and jaundice — yellowing of the skin and whites of the eyes, which is harder to notice on dark or tanned skin. In most people, however, the acute episode passes without any signs.

Chronic hepatitis C: signs

In the chronic form, there are usually no symptoms until complications develop — and this can happen decades after infection. If signs do appear, they may include pronounced fatigue, skin itching, anxiety and depression, problems with memory and concentration. Chronic hepatitis C may manifest only as fatigue or a moderate decrease in intellectual performance. Liver enzyme levels remain normal in 7–53% of patients, so a normal blood test alone does not rule anything out.

Symptoms of hepatitis C in women and men

The list of signs is the same in women and men: fever, fatigue, abdominal pain, nausea, jaundice, dark urine, light stools. The differences concern not the symptoms themselves but the course of the disease: liver cirrhosis more often develops in males, as well as in people with hepatitis B, HIV, and those who abuse alcohol. In patients with hepatitis C, alcohol abuse increases the risk of cirrhosis 100-fold. Sources do not describe separate "female" or "male" signs of the hepatitis C virus, so there is no need to look for special symptoms based on sex — testing is needed.

Does the liver hurt with hepatitis C

Abdominal pain in the acute form is mentioned as one of the possible symptoms, but it is nonspecific. One should worry not because of the nature of the pain but because of the combination of fatigue, jaundice, and changes in tests: without treatment, hepatitis C can lead to cirrhosis, liver failure, and liver cancer. Complications are unlikely if a person has been ill for less than 20 years, but with regular alcohol consumption or concomitant hepatitis B and HIV, they come faster.

How the virus is detected and when to see a doctor

The diagnosis is made based on medical history, examination, and blood tests. Additional tests may include other blood tests, liver ultrasound, and liver biopsy. Test results are ready within two weeks; if the result is negative but infection was recent, a repeat test after six months may be advised.

• fever
• pronounced fatigue
• nausea, vomiting, loss of appetite
• jaundice, dark urine, light stools
• skin itching, anxiety, memory impairment

You should see a doctor if you have symptoms of hepatitis C or if there is reason to think infection could have occurred. Further examinations and management are determined by the doctor.

Carrying the virus alone is not a reason to call an ambulance; 103 or 112 — for complications of cirrhosis: bleeding, including hidden (vomiting blood), confusion.

This article is for reference: it helps to recognize the disease and ask the doctor the right question in time, but does not replace consultation with a specialist.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer