Hepatitis is commonly described as either an acute or chronic illness.
An acute illness means a short, sharp illness which may be severe but from which most people recover within six months with no lasting effects.
A chronic illness is one that lasts longer than six months, possibly for the rest of a person’s life. Hepatitis C remains chronic in most cases, but it affects people quite differently.
Many people have no symptoms and are often unaware they have the virus. Symptoms, when present, can be vague. Some people experience extreme tiredness and feel unwell. A few have a short flu-like illness, occasionally with nausea, vomiting and jaundice, but this is unusual.
Symptoms can include:
- mild to severe fatigue
- alcohol intolerance
- concentration problems (‘brain fog’)
- anxiety
- loss of appetite
- pain in the liver area
- nausea
- flu-like symptoms such as fever, chills, night sweats and headaches
- jaundice - uncommon in hepatitis C but may occur during the early phase of infection.
There may be other symptoms not mentioned here. Some of the symptoms may come and go and it is not unknown for people to be diagnosed as having ME or chronic fatigue syndrome.
Approximately 25% of infected people recover completely. It is not known why some people are successful at fighting off the disease. The rest remain infected, which means in these people the liver stays inflamed. Many will only have mild inflammation which may never develop further.
Others will go on to develop cirrhosis some 20, 30 or even 40 years after being infected.
Several factors play a role in the development of cirrhosis. On average, people who acquire the infection at an older age have a more rapidly progressing disease. Studies show that heavy consumption of alcohol and co-infection with another virus, HIV or hepatitis B are important factors in the progression of chronic hepatitis to cirrhosis.
Injecting drug users who have not had hepatitis B (which can be checked by blood test) are strongly advised to consider vaccination to prevent co-infection.
Hepatitis A vaccination may also be recommended, as an attack of hepatitis A in a person with pre-existing liver disease can produce a much more serious illness. One research study revealed that this has proved fatal in some cases.