Course of infection


Important messages:
- The first stage of a hepatitis C infection is called an 'recently acquired hepatitis C' by doctors. After six months, an infection is called 'chronic'. The body sometimes heals itself from the infection during the acute stage. This is less likely to happen if you are HIV positive.
- Many people who have hepatitis C experience few or no symptoms.
- If hepatitis C is not treated, the virus can cause severe liver damage after ten to thirty years of infection.

Recent or chronic infection

The first six months of hepatitis C infection is called 'recently acquired hepatitis C' by doctors. If you still have the virus in your body after six months, it officially becomes a 'chronic' infection.


In the phase of a recently acquired hepatitis C infection, there is a small chance that your body will heal itself of the virus.

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You have a 30–40% chance of self-healing if you are HIV negative. This chance falls to 10-15% if you are HIV positive. Your doctor will know after four to six weeks if your body has healed itself. You do not have to worry if your body does not heal itself. Hepatitis C can almost always be cured with medication.

Symptoms of recently acquired hepatitis C

Most cases of recently acquired hepatitis C infection do not produce any symptoms.

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If you experience any symptoms at all, it will mostly be a vague feeling of being unwell. You can also get yellowish skin and eyes.

Possible symptoms
• poor appetite
• nausea and vomiting
• abnormal tiredness
• flu-like symptoms
• fever (high temperature)
• pain in the stomach
• yellowish eyes and skin (jaundice)
• dark urine (the color of cola)
• light-grey feces (like the color of putty)

How soon you experience symptoms of acute hepatitis C (if you experience any at all) differs from person to person. Symptoms show up on average seven weeks after infection. But some people experience symptoms two weeks after infection, while others only experience symptoms after 26 weeks.

Symptoms of chronic hepatitis C

About half of those with chronic hepatitis C infection experience symptoms. The number of symptoms may increase as time goes by.

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Possible symptoms
• tiredness
• joint and muscle pain
• loss of appetite
• you feel unwell (general malaise)

Symptoms of advanced chronic hepatitis C
• yellowish eyes and skin (jaundice)
• fluid build-up in the stomach
• mental confusion
• bleeding in the food pipe (or gullet/esophagus - the tube in the body that takes food from the mouth to the stomach)

Some people experience 'brain fog'. This feels as if your head is filled with a thick fog that prevents you from thinking clearly. Others experience depression.

Long-term effects of hepatitis C

If hepatitis C is not treated, the virus can cause severe liver damage after ten to thirty years of infection.

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An untreated hepatitis C infection can lead to liver fibrosis (= scarring of the liver). Some people suffer liver cirrhosis (= liver shrinkage). In the worst-case scenario, the liver stops working properly, making a liver transplant necessary. Hepatitis C also increases the risk of liver cancer.

How soon liver damage occurs depends on

• your age: it happens less quickly if you are young
• how much alcohol you drink: even moderate drinking can cause liver damage
• whether you have other infections, such as HIV or hepatitis B

Other problems

Chronic hepatitis C doesn’t only affect the liver. It also raises the risk of heart and coronary artery disease, and diabetes. If you are HIV positive, the risk of getting these diseases is even greater.