Hepatitis C is known as a silent virus because many people who contract it are able to live symptom-free for some time.

After initial exposure to the virus, it can take up to 6 months to test positive for acute hepatitis C. Even then, 80 percent of people living with hepatitis C never experience symptoms at all. When people do have symptoms, they’re often nondescript, such as fever or fatigue.

If symptoms of hepatitis C do occur, it’s usually within 2–12 weeks of infection. Symptoms that appear years after infection may be a sign of a more serious issue, such as liver damage due to hepatitis C.

Acute hepatitis C can also become chronic in up to 85 percent of cases.

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 other digestive issues, a painful liver can also be a sign of 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 a doctor.

Sometimes when hepatitis C progresses, the liver dysfunction causes a buildup of excess fluid in the abdomen called ascites.

As a result, you may 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.

Chronic hepatitis C may lead to liver scarring, known as cirrhosis. With cirrhosis, you’re often unable to maintain an appropriate amount of nutrition due to:

  • loss of appetite
  • frequent vomiting
  • digestion abnormalities
  • hormone secretions

As a consequence, you may lose weight as your body breaks down important tissue.

If you experience unexpected weight loss, check in with your doctor, as it may be a sign of cirrhosis or liver cancer.

A yellow tint to your skin or eyes is known as jaundice. As red blood cells get older, they’re broken down in the body and release a yellow substance called bilirubin.

Normally, the bilirubin is passed on to the liver and removed from the body through bile. However, if your liver is damaged, it won’t be able to process the bilirubin.

This causes a buildup of bilirubin in the body, leading to discoloration of the skin or eyes. It can even lead to darker than normal urine or lighter colored stool.

If you experience symptoms of jaundice, call your doctor. It could be a sign of severe liver disease.

Up to 20 percent of people living with chronic hepatitis C report pruritus, or itchy skin. It typically occurs without the appearance of a rash and isn’t relieved by scratching.

If you experience extreme itchiness in your hands, feet, or all over your body, you should bring this up to your doctor right away. This symptom is most common with later-stage liver disease or cirrhosis (liver scarring).

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

If you experience spider-like marks, be sure to tell your doctor. While they can fade on their own or be removed with laser treatment, more importantly, these markings are a sign that your liver isn’t functioning as it should.

With chronic hepatitis C, the body may retain fluids, which leads to swelling. This type of swelling, also known as edema, occurs when there’s a buildup of fluid in the tissues of the abdomen, legs, ankles, or feet. These areas might take on a puffy appearance or become dimpled and shiny.

If you experience unexplained edema in any parts of your body, get it checked out. Edema can be a sign of an underlying condition such as liver failure.

While it may improve with a prescription water pill (diuretic) that flushes unwanted liquids from your system, the cause of the edema should be investigated.

When your digestive system breaks down proteins, it creates a substance in the body called ammonia. Normally, ammonia is converted to urea in the liver, which is then excreted from the body through urine.

When your liver isn’t working as well as it should, elevated levels of ammonia start circulating throughout the body. When this excess ammonia heads to the brain, it can become problematic and lead to serious condition called hepatic encephalopathy.

Symptoms include cognitive changes such as:

  • confusion
  • concentration issues
  • reduced alertness
  • shortened attention span
  • slowed ability to perform mental tasks
  • slurred speech

Hepatic encephalopathy is a sign of severe liver disease. It occurs in up to 70 percent of people living with cirrhosis. Be sure to talk with your doctor if you experience these symptoms.

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, or anemic.

Common symptoms of anemia seen with liver damage include:

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

Anemia can be treated, but because it’s also a sign of liver damage, be sure to see your doctor if you experience these symptoms.

Screening for hepatitis C is recommended for all adults ages 18 years old and up, even those without symptoms or known liver disease. Certain individuals are especially at risk for hepatitis C, including those who:

  • are pregnant
  • are children born to mothers diagnosed with hepatitis C
  • have HIV
  • have a previous history of injectable drug use
  • have received maintenance hemodialysis

Talk with a healthcare professional if you think you’re at risk for hepatitis C or if you’ve been exposed to the virus. Do not wait for symptoms before getting screened.

If you’re experiencing any symptoms of an acute hepatitis C infection, see a healthcare professional. With the latest advances in treatment, over 90 percent of hepatitis C cases are curable. These medications can remove the virus from the body, which prevents symptoms associated with advanced liver disease.

Hepatitis C is often asymptomatic. However, certain symptoms may be a sign of something more serious, like liver damage.

Be sure to talk with your doctor if you’re at risk of hepatitis C, have been exposed to the virus or start to experience any new or unusual symptoms. With today’s treatments, hepatitis C can now be effectively treated with medication, which can also prevent liver disease.