Hepatitis C is known as the silent virus because many people who contract it are able to live symptom-free for some time. In fact, it can take up to six months for symptoms to present themselves after infection, and 70 to 80 percent of people with acute hepatitis C never experience symptoms at all.

Acute hepatitis C can also become chronic in up to 85 percent of cases, and delayed symptoms can appear 10 years or more after infection, without warning.

The following are key hepatitis C symptoms that you should never ignore if you experience them.

Hepatitis C attacks the liver, which is located in the upper right half of your abdomen. While pain in the abdomen can be caused by other conditions, like gallstones or problems in the pancreas, a painful liver can also point to a more serious issue such as chronic liver disease or even liver cancer.

If you experience any pain or discomfort in your abdomen, don’t wait for it to go away. Make an appointment with your doctor.

If you notice a change in your appetite, there’s no need to panic. But sometimes when hepatitis C progresses, the liver dysfunction that results causes a buildup of excess fluid in the abdomen called ascites. You feel full and your abdomen may become balloon-shaped as though you’ve eaten a lot — even if you haven’t. This symptom could potentially be a sign that your hepatitis C infection has advanced to a more serious form of liver disease.

If you notice abdominal discomfort and bloating, call your doctor’s office to arrange a visit.

If you’re losing weight without trying, hepatitis C may be the cause. A chronic infection by hepatitis C may lead to liver scarring, called cirrhosis. When you suffer from cirrhosis, you are often unable to maintain an appropriate amount of nutrition due to loss of appetite, frequent vomiting, digestion abnormalities, and the secretion of hormones. As a consequence, you may lose weight as your body breaks down important tissue.

A yellow tint to your skin or eyes is known as jaundice. As red blood cells get older, they are taken apart in the body and release bilirubin, a yellow substance that is modified by a healthy liver to be excreted.

If your liver is damaged, it won’t be able to process the bilirubin. This causes it to build up in the body, leading to skin discoloration. It can even cause a darker than normal urine and lighter stool.

While 20 percent of people with hepatitis C report pruritus, or itchy skin, it’s important to note that it’s most common when people are developing later-stage liver disease or cirrhosis (liver scarring).

If you experience extreme itchiness in your hands, feet, or all over your body, you should bring this up to your doctor right away.

A common side effect of hepatitis C is that the body retains fluids. Edema (swelling) occurs when there’s a buildup of fluid in the tissues of the legs, ankles, or feet. Your legs might take on a puffy appearance or become dimpled and shiny.

If you have edema, a doctor can prescribe a water pill (diuretic) to help flush unwanted liquids from your system.

When the liver becomes damaged, estrogen levels can spike. One symptom of these higher-than-average hormone levels are spider-like blood vessels (spider angiomas) that appear underneath the skin. They resemble tiny red dots with lines protruding from them.

These marks tend to fade on their own, but you can also get laser treatments to remove them if you want. More importantly, these markings are a sign that your liver isn’t functioning as it should.

When your liver isn’t working to its full capacity, ammonia that isn’t being processed begins circulating in your blood. When ammonia heads into the brain, this can lead to a serious condition called hepatic encephalopathy. Symptoms of this complication include slurred speech and confusion.

The body’s liver is the organ responsible for absorbing, transporting, and storing iron. If your liver is damaged and these processes are interrupted, you can become iron deficient.

Common symptoms of anemias seen with liver damage include:

  • fatigue
  • dizziness
  • tongue swelling
  • brittle nails
  • tingling legs

It can be concerning when you experience a new symptom that could be related to hepatitis C. The most important piece of information to keep in mind is that your doctor will know right away what symptoms are problematic. Visit your doctor as soon as you can so that you can receive the proper treatment.