Symptoms and Severity of Chronic Hepatitis C | Hepatitis Central

The latest research & treatment news about Hepatitis C infection, diagnosis, symptoms and treatment.

Menu Search

Liver Restoration: New Hope for Advanced Hep C

Back to News Homepage

SeraCare Aiming to Improve Early Diagnosis of Hepatitis C

Symptoms and Severity of Chronic Hepatitis C

Print this page

Some medical tests are more accurate than others in ascertaining how severe Hepatitis C infection is – and that severity may or may not be associated with how much an infected person suffers with Hepatitis C’s symptoms.

Hepatitis C is a notoriously nasty liver virus that affects four times more people in the U.S. than HIV, the virus that causes AIDS. Like HIV, the symptoms of chronic Hepatitis C can vary greatly. While a large proportion of those with Hepatitis C have no symptoms at all, others can have nearly disabling symptoms of liver disease. Sometimes there seems to be no rhyme or reason to differentiate between who feels great and who feels awful with this virus. However, there are a handful of circumstances practically guaranteed to worsen the symptoms of someone battling chronic Hepatitis C.

Liver Health Measurements

Chronic Hepatitis C infection can be tricky to track because the only true indicator of how far the illness has advanced is a liver biopsy or equivalent method.

  • Biopsy – A liver biopsy is a procedure where a small piece of liver tissue is removed for examination under a microscope. Under high magnification, the sample is evaluated for signs of liver scarring (liver damage).
  • Biopsy Alternative – While a liver biopsy remains the medical gold standard for determining the extent of liver disease, newer alternatives have emerged. The two most lauded involve the use of magnetic resonance and specialized blood tests to detect the degree of liver scarring.

Since liver biopsies are somewhat invasive and carry some risk, they are typically used sparingly. Unfortunately, the biopsy alternatives require more studies to prove their accuracy so that they can become part of Hepatitis C medical protocol. Instead, most physicians rely on liver function tests and viral load counts to evaluate the apparent severity of Hepatitis C. Although seemingly indicative of liver health, liver function tests and viral load counts do not always correlate with the degree of liver damage. Regrettably, the degree of liver damage is the only way to know the extent of someone’s liver disease.

Hepatitis C Symptoms

It would seem logical that the more chronic Hepatitis C has damaged a liver, the more pronounced someone’s symptoms are. While this seems logical, it is not always a reliable association. This is mostly because the symptoms associated with Hepatitis C are also symptoms caused by so many other health issues. Complicating an understanding of Hepatitis C’s symptoms is that an estimated 80 percent of those infected are asymptomatic. For those who do have symptoms, they may not appear for a decade or two after initial infection with this liver virus.

Even when Hepatitis C has steadily assaulted a liver for many years, symptoms can be intermittent, mild and vague. Unless derived from a different cause, those who experience pronounced Hepatitis C symptoms usually already have significant damage to their liver.

Typical Hepatitis C symptoms, include:

  • fatigue
  • sporadic abdominal pain
  • reduced appetite
  • weight loss
  • nausea/vomiting
  • depression
  • jaundice
  • dark urine/pale stool
  • fluid retention
  • skin itchiness
  • coughing/vomiting blood
  • confusion

What Worsens Hepatitis C Infection (and, thus, its symptoms)

Even with a relatively low viral load and liver function tests that are not alarming, severe symptoms are still possible. The following are three repeatedly proven ways to worsen liver damage from Hepatitis C and exacerbate symptoms:

  1. Drinking Alcohol – any amount of alcohol dramatically magnifies the Hepatitis C virus’ ability to cause liver damage. Alcoholics with chronic Hepatitis C are especially vulnerable to having advanced liver disease.
  2. Co-Infection With HIV – The risk of developing liver damage is much higher in those co-infected with Hepatitis C and HIV than those only infected with Hepatitis C. People with both viral infections do best with aggressive treatment, close supervision and guidance by their physician.
  3. Certain Medications – Many drugs are very harsh on the liver and should not be taken by those with Hepatitis C. Anyone with liver disease must carefully evaluate every medication he or she takes – including over-the-counter drugs – with his or her doctor.

Although those with chronic Hepatitis C are usually required to evaluate their health with periodic liver function and viral load tests, these results often don’t translate into symptoms or disease severity. Until there is a simpler way to determine the extent of liver scarring in those with chronic Hepatitis C, those infected should be aware of how drinking alcohol, co-infection with HIV and certain medications can impact their health – both by worsening their symptoms and by causing more liver damage.

References:, I’m Always Sick, Retrieved September 16, 2010, WebMD, LLC, 2010., Progression of hepatic fibrosis in patients with hepatitis C: a prospective repeat liver biopsy study, S D Ryder, Retrieved September 16, 2010, Gut, 2004., Hepatitis C Frequently Asked Questions, Retrieved September 16, 2010, AIDS Action Committee of Massachusetts, 2010., Hepatitis C, Retrieved September 16, 2010, WebMD, Inc., 2010., Hepatitis C and HIV Treatment–PEGASYS® (Peginterferon alfa-2a), Retrieved September 16, 2010, Genentech USA, Inc., 2010.

1 Comment

Liver Restoration: New Hope for Advanced Hep C

Back to News Homepage

SeraCare Aiming to Improve Early Diagnosis of Hepatitis C

Requirements for using and reposting articles

Comments provides information regarding hepatitis and liver disease. Comments are available to the community in order to discuss these topics and obtain answers to questions through community members. The Editors at will not be responding to questions or comments posed in article comments.