Hepatitis C (hep C) is a liver infection that is curable for some people. Without treatment, it can become a long-term health issue.

Read on to learn more about hep C, including symptoms you should never ignore when you have hep C or are at a high risk of getting it.

Hep C is a type of liver infection caused by the hepatitis C virus. It causes inflammation of the liver and can lead to serious health issues.

Research suggests that 2 million people in the United States had hep C in the years 2013–2016, and the rate of new hep C infections continues to climb.

Hep C spreads through contact with the blood of someone who has the virus. Most people get hep C by sharing needles, but it can also be transmitted by having sex without a condom or another barrier method with someone who has hep C or sharing personal care items with someone who has it.

Additionally, a baby can contract hep C from a birthing parent during childbirth.

There are two types of hep C:

  • Acute hep C: This occurs in the first 6 months of hep C infection. In some cases, a person’s body can fight off the hep C virus on its own, so the infection and related symptoms last for only a short time. However, in more than half of people who contract hep C, the infection will become chronic.
  • Chronic hep C: In up to 85% of people who contract hep C, the infection may persist for longer than 6 months, becoming chronic hep C. Chronic hep C lasts a long time and can lead to serious health issues such as liver cancer and liver failure if it’s not properly treated.

Most people with acute hep C don’t have any symptoms, but 1 of every 3 or 4 people with acute hep C will experience symptoms such as high fever, fatigue, abdominal pain, and loss of appetite. These symptoms usually start a few weeks after a person contracts the virus.

Chronic hep C may not cause any symptoms until it progresses and starts to cause liver complications. This can happen decades after exposure to the virus, so many people with chronic hep C do not know they have it until it has caused significant liver damage.

If left untreated, chronic hep C can lead to liver failure, liver cancer, and even death. This is why people who are at high risk for hep C — such as those who currently inject drugs or have injected drugs in the past — should get regular hep C screenings from a healthcare professional.

Hep C is treated with direct-acting antiviral medications, which can cure 95% of hep C cases.

However, many people either don’t have access to treatment or don’t know they have hep C until it has caused significant liver damage.

What’s more, health insurance eligibility restrictions make it difficult for people to seek hep C treatment. Many insurance companies require that a person be sober or have significant liver damage before they will cover hep C treatment.

Because of this, only 1 in 3 people with health insurance get proper treatment for their hep C.

People without health insurance often don’t get treatment because of the high cost of medication, difficulty accessing doctors who treat hep C, or a lack of transportation.

Major healthcare organizations are fighting to improve access to hep C treatment for all people, regardless of insurance status.

Acute and chronic hep C can cause a variety of symptoms, many of which are vague and nonspecific.

You should not assume that all the symptoms you experience are related to hep C. It’s important to make sure any symptoms you have are not related to other serious conditions that require treatment.

People with hep C are more likely to develop other health conditions, such as hypothyroidism, which require different medical treatment than hep C.

If you’ve received a diagnosis of hep C or are at high risk for it and you’re experiencing any of the following symptoms, contact a doctor.

Dark urine

Dark urine can be a symptom of hep C. When your liver isn’t functioning appropriately, it causes a buildup of bilirubin, a yellow pigment that is a byproduct of the breakdown of red blood cells.

Urine usually doesn’t contain very much bilirubin because a healthy liver helps remove bilirubin from your body. A damaged liver can’t properly process bilirubin, so eventually its byproduct, urobilinogen, builds up in your blood and can travel into your urine. This causes your pee to turn a dark brownish color.

Clay-colored stool

Your liver produces a yellowish-green fluid called bile that helps you digest fats. Bile is made up of bilirubin, bile salts, and cholesterol. Your poop color, which is typically brownish, is influenced by bile.

If your liver is damaged by hep C and does not produce enough bile, the color of your poop may change. Light-colored poop can be a symptom of hep C-related liver damage

Abdominal pain

People with acute and chronic hep C can experience pain in their abdomen due to liver inflammation. The liver is located in the upper right part of the abdomen, so upper right quadrant pain is a common symptom in people with hep C.

Some people may experience sharp pains over their liver, while others report severe generalized abdominal pain.


Jaundice is a yellowing of the skin and the whites of the eyes that’s caused by a buildup of bilirubin in the blood.

Around 1 in 5 people who have acute hep C symptoms will experience jaundice. In people with chronic hep C, jaundice can be a symptom of cirrhosis, which is scarring of the liver.

Nausea or vomiting

Feeling nauseated is a common symptom of hep C. Both the disease itself and the medications used to treat it can cause nausea.

In more severe chronic hep C cases, scarring of the liver can cause a person to vomit blood. If you’re vomiting blood, seek emergency medical care immediately.

Loss of appetite

Loss of appetite is an early symptom of acute hep C, but people with chronic hep C may also experience changes in appetite and food intake.

Some research has found that people with chronic hep C have taste changes, which can lead to reduced food intake and weight loss.


Feeling tired all the time can be a symptom of acute and chronic hep C. People with hep C commonly report a lack of energy, which is caused by the hep C virus. People with more advanced hep C and liver damage may experience severe fatigue.

Hep C treatment can help improve hep C-related fatigue, but some people may experience fatigue as a side effect of the antiviral medications used to treat hep C.

Joint and muscle pain

The hep C virus activates your immune system, which can trigger pain in the muscles and joints.

People with hep C commonly also have rheumatic diseases, which affect the joints, tendons, ligaments, bones, and muscles. And some medications used to treat rheumatic diseases such as arthritis can worsen hep C.

If you have a rheumatic disease and hep C, your doctor will work with a rheumatologist to come up with a treatment plan that’s safe for your liver.

Fluid retention

Liver damage can cause fluid to build up in certain parts of your body, such as your legs and abdomen.

People with hep C-related cirrhosis may notice a swollen belly and fluid retention in their lower legs, ankles, and feet. If you’re experiencing fluid retention, it’s important to contact your doctor right away.

Other symptoms

Other symptoms that may be related to hep C include dry eyes, fever, itchy skin, and irritable bowel and bladder symptoms.

Hep C can lead to a number of health complications, so it’s important to visit your doctor regularly if you have hep C. If you’re at high risk for hep C and haven’t been feeling well or are experiencing any of the symptoms listed above, make an appointment to get screened for hep C right away.

Hep C symptoms can be intermittent and go away for long time periods before returning, so don’t ignore any symptoms, even if they last for only a few days.

Here are some questions people often ask about hep C and worsening symptoms:

What are the final stages of hep C?

If the hep C virus causes significant and irreversible liver disease, it can lead to end stage liver disease and liver failure.

What happens in end stage liver disease?

In end stage liver disease, your liver starts to shut down because it’s too damaged to continue functioning. The only treatment for end stage liver disease is a liver transplant. Hep C is the most common reason for liver transplants in the United States.

Most people with hep C who receive a liver transplant will experience a recurrence of the hep C virus.

How long does it take for hep C to destroy your liver?

Chronic hepatitis usually damages the liver slowly. On average, it takes about 20 years for the hep C virus to cause significant scarring of the liver.

How long can you live with hep C without treatment?

People with chronic hep C can live for decades without hep C treatment. However, early treatment saves lives, as the antiviral medications used to treat hep C can help protect against liver damage and reduce the risk of liver cancer.

Hep C is an infection that affects your liver.

Antiviral medications can cure hep C in most people, but many people with hep C don’t receive medical treatment for a variety of reasons.

If you have hep C or are at a high risk of getting it, it’s important to visit a doctor for proper treatment and screening. If you don’t have insurance or need help affording hep C treatment, check out this article for more resources.