In the chronic stage, patients typically go years or decades with no symptoms. This is sometimes referred to as "latent" or "dormant" hepatitis C. Eventually, the chronic hepatitis becomes active with liver inflammation and scarring. Left untreated, this can progress to cirrhosis, liver failure, liver cancer (hepatocellular carcinoma), and death. The initial symptoms of chronic hepatitis C are:
- Weakness and fatigue
- Nausea
- Loss of appetite
- Muscle and joint aching
- Weight loss
As chronic hepatitis C progresses to liver failure (hepatic decompensation), additional symptoms develop including:
- Dark urine
- Light colored bowel movements
- Jaundice (yellowing of the skin and eyes)
- Itching
- Swelling of the abdomen (ascites) due to fluid accumulation
- Swelling of the legs and feet (edema) due to fluid accumulation
- Vomiting blood
- Confusion
- Easy bruising and bleeding
- Generalized abdominal pain
These symptoms and physical changes occur because when the liver fails, it can no longer carry out its necessary functions. These functions include removing toxic substances from the blood, fighting infection, metabolizing various drugs, creating certain important proteins, manufacturing blood clotting factors, and storing vitamins, minerals, sugars and fat for use by the body.
