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Acute infection: When a person becomes infected with hepatitis C, there are often no initial symptoms.

• Approximately 80% of newly infected patients are asymptomatic.
• The remaining 20% of newly infected patients have symptoms that include fatigue, abdominal pain, nausea, loss of appetite, or a condition known as yellow jaundice. Jaundice occurs when a yellow-colored compound called bilirubin builds up in the body, tinting the whites of the eyes and skin. At the same time, the urine may take on a dark brown 'cola' color and stools may become gray or light tan.
• These symptoms typically develop 4-12 weeks after exposure to HCV. Some people describe the symptoms as being flu-like.

Chronic Infection: Most of the time, the body's immune system cannot 'cure' itself of the virus. Among people who acquire HCV, approximately 75% to 85% will fail to clear it from their bodies and will become chronically infected. Most chronically infected people do not have symptoms or have only vague symptoms such as fatigue. However, even asymptomatic patients may have active or progressive liver damage.

Chronic hepatitis C can lead to scarring or 'cirrhosis' of the liver, a condition also associated with alcoholism. Cirrhosis is a condition in which the healthy liver tissue is replaced by fibrous tissue, followed by scar-like hardening. As this happens, the liver gradually begins to fail, or looses its ability to carry out its normal functions. Of the chronically infected people, 15% to 30% will eventually develop cirrhosis, often 20 to 30 years after the initial infection. Eventually, symptoms develop. Symptoms of cirrhosis include the following:

• Fluid retention causing swelling of the belly (ascites), legs (edema), or whole body (anasarca)
• Persistent jaundice
• Fatigue
• Disturbances in sleeping
• Itchy skin
• Loss of appetite, weight loss, wasting
• Vomiting with blood in the vomit
• Mental disturbances such as confusion, lethargy, extreme sleepiness, or hallucinations (hepatic encephalopathy)

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