Hepatitis C

Alternative Names

Symptoms

Many people who are infected with the hepatitis C do not have symptoms.

If the infection has been present for many years, the liver may be permanently scarred -- a condition called cirrhosis. In many cases, there may be no symptoms of the disease until cirrhosis has developed.

The following symptoms could occur with hepatitis C infection:

• Abdominal pain (right upper abdomen)
• Ascites
• Bleeding varices (dilated veins in the esophagus)
• Dark urine
• Fatigue
• Generalized itching
• Jaundice
• Loss of appetite
• Low-grade fever
• Nausea
• Pale or clay-colored stools
• Vomiting

Exams and Tests

Hepatitis C is often found during blood tests for a routine physical or other medical procedure.

• Elevated liver enzymes
• ELISA assay to detect hepatitis C antibody
• Hepatitis C PCR test
• Hepatitis C genotype. Six genotypes exist. Most Americans have genotype 1 infection, which is the most difficult to treat.
• Hepatitis virus serology
• Liver biopsy

References

Shiffman ML, Suter F, Bacon BR, et al. Peginterferon alfa-2a and ribavirin for 16 or 24 weeks in HCV genotype 2 or 3. N Engl J Med. 2007;357:124-34.

Wong T. Hepatitis C: a review for primary care physicians. CMAJ. 2006;174:649-59.

Rocca LG. Management of patients with hepatitis C in a community setting: diagnosis, discussions and decisions to treat. Ann Fam Med. 2004; 2:116-124.