Symptoms of Hepatitis C Virus (C)
Hepatitis C virus (HCV) infection can manifest as an acute condition, characterized by symptoms of liver inflammation that typically occur within six months following exposure to the virus. In most individuals, acute infections can progress to a chronic state, leading to lifelong liver inflammation if left untreated. It’s important to note that untreated chronic infection may result in serious complications, such as chronic liver disease, cirrhosis, liver failure, or liver cancer. Therefore, early diagnosis and appropriate treatment play crucial roles in managing the condition and preventing these complications.
Acute Hepatitis C Symptoms
In many cases, individuals with acute hepatitis C do not exhibit any symptoms. According to the World Health Organization’s statistics from 2019, around 80% of those diagnosed with acute hepatitis C do not experience any noticeable symptoms following initial infection. If symptoms do develop, they typically occur within two weeks to three months post-exposure, often resembling common flu symptoms. These may include:
- Joint or muscle pain.
- Mild fatigue.
- Nausea and vomiting.
- Loss of appetite.
- Abdominal pain or discomfort, particularly in the liver area.
- Jaundice, characterized by yellowing of the skin and eyes.
- Dark-colored urine.
- Fever exceeding 38 degrees Celsius.
Chronic Hepatitis C Symptoms
Chronic hepatitis C occurs when the virus remains in the bloodstream for more than six months following the acute infection phase. Diagnosis of chronic infection is confirmed through the presence of hepatitis C virus on at least two separate blood tests during this time frame. It is noteworthy that not every acute hepatitis case transitions to a chronic form; many individuals naturally eliminate the virus during the acute phase, referred to as spontaneous viral clearance. Incidental detection of chronic hepatitis C often occurs during routine medical check-ups, such as blood donation screenings or elevated liver enzyme levels, particularly alanine aminotransferase (ALT).
Management of chronic hepatitis C and its symptoms requires the use of specific antiviral medications. The symptoms of this condition can significantly vary; some individuals may experience minimal symptoms, while others may be severely impacted. Symptoms can diminish for extended periods and then reoccur. Chronic fatigue is one of the most prevalent symptoms associated with chronic hepatitis C, and its severity can differ among individuals. For some, completing daily tasks might be feasible without noticeable fatigue, while others may find their ability to work severely limited. Even after prolonged sleep periods, many chronic hepatitis C patients wake up feeling tired, as if they had not rested at all. Additional symptoms of chronic hepatitis C include:
- Muscle and joint pain.
- Nausea.
- Short-term memory problems along with difficulties in concentration and complex cognitive tasks, commonly referred to as brain fog.
- Mood swings.
- Anxiety.
- Depression.
- Dyspepsia.
- Bloating.
- Skin itching.
- Abdominal pain.
There may also be other symptoms associated with impaired liver function, including:
- Ascites, or fluid retention in the abdomen.
- Easy bruising.
- Frequent bleeding.
- Hepatic encephalopathy, characterized by confusion, drowsiness, or speech disturbances.
- Skin rashes or hives.
- Spider angiomas, presenting as spider-like blood vessels under the skin.
- Swelling or edema in the legs.
- Weight loss.
As previously mentioned, neglecting treatment for chronic hepatitis C may lead to severe liver diseases, ranging from mild to severe, including cirrhosis or liver cancer. Typically, chronic liver diseases can progress over several decades without displaying any signs or symptoms. Prolonged inflammation can result in tissue scarring known as liver fibrosis, with severe scarring termed cirrhosis. Symptoms of cirrhosis may include jaundice, vomiting blood, dark stools, and fluid buildup in the legs and abdomen. Statistics from the World Health Organization indicate that the likelihood of developing cirrhosis in chronic hepatitis C patients ranges from 15-30% over two decades post-infection.
When to Seek Medical Attention
Individuals should consult a healthcare professional if they experience persistent symptoms noted earlier or if symptoms recur frequently. These symptoms do not necessarily indicate a hepatitis C infection; however, it is essential to confirm with a medical professional. A specific blood test for the hepatitis C virus is necessary for diagnosis. Moreover, individuals at risk of hepatitis C should discuss the need for testing with their doctors, even if no symptoms are present. This includes individuals who have a history of intravenous drug use, whether recent or past.
Treatment for Hepatitis C
Treatment is not always necessary for acute hepatitis C, as the immune response may effectively eliminate the infection. However, treatment is vital for chronic hepatitis C cases. Early-stage treatment is crucial to prevent serious liver-related complications. The goal of treatment is to achieve a sustained virologic response, indicating no detectable hepatitis C virus in the body at least three months after completing therapy. The choice of the most suitable medication and treatment duration largely depends on several factors, including the hepatitis C genotype, level of liver damage, coexisting health conditions, and prior treatments. It is important to note that treatment guidelines and available medications evolve as research advances. Therefore, discussions about the optimal treatment approach occur between the healthcare provider and the patient, with ongoing monitoring throughout the treatment process.
Chronic hepatitis C is typically treated using antiviral medications. Recent advancements in research have led to the development of new direct-acting antiviral agents that provide significant results within a short timeframe, often around eight weeks. These newer medications may be used alongside existing treatments and tend to have fewer side effects. Examples of recent direct-acting antiviral medications that a physician may prescribe include Daclatasvir, Elbasvir/Grazoprevir, Glecaprevir/Pibrentasvir, and Ledipasvir/Sofosbuvir.
At the conclusion of the prescribed treatment course, a blood test is conducted to determine the presence of the hepatitis C virus. If the test indicates that the virus is still present, the doctor may recommend an additional treatment course. Patients with chronic hepatitis C should make regular visits to their healthcare providers to assess liver function through physical examinations and tests, including blood tests, ultrasound imaging, and Fibroscan assessments. Other tests may also be required. In severe cases due to hepatitis C complications, liver transplantation may be necessary. During this procedure, the damaged liver is removed and replaced with a healthy one, usually sourced from deceased donors or, in some cases, a living donor. However, it is important to understand that a liver transplant does not eliminate hepatitis C itself and the infection may recur, necessitating continued antiviral treatment to prevent damage to the transplanted liver.
Currently, there is no vaccine available to prevent hepatitis C infection, although doctors may recommend vaccination against hepatitis A and B viruses. Coinfections with these viruses can complicate chronic hepatitis C and contribute to further liver damage if contracted after hepatitis C infection.
For more information on hepatitis C treatment, please refer to the following article: (Hepatitis C treatment).
Video on Causes of Hepatitis C
This video discusses the causes of hepatitis C.