Hepatitis C is a viral infection that primarily targets the liver, causing inflammation that can lead to significant organ damage over time. The infection is transmitted through contact with blood containing the Hepatitis C virus (HCV). The disease begins as a short-term, acute infection. Recognizing the signs of this initial phase is important because early detection offers the best opportunity to prevent the infection from becoming lifelong.
The Acute Phase and Incubation Period
The incubation period, the time between initial exposure and the onset of symptoms, typically lasts between two and 12 weeks. Symptoms usually appear around six to seven weeks, though they can take up to six months to manifest. This initial period, defined as the first six months following acquisition, is called the acute phase of infection.
Every case of long-term infection begins with this acute phase. If the infection persists beyond six months, it transitions into chronic hepatitis C. Only about 15 to 30 percent of people spontaneously clear the virus during the acute phase.
Specific Early Symptoms
When symptoms occur during the acute phase, they are often non-specific, resembling a common flu-like illness. These manifestations can include a low-grade fever, general fatigue, muscle or joint aches, loss of appetite, and nausea.
Symptoms more directly indicative of liver inflammation include abdominal pain, typically felt in the upper right quadrant. Inflammation can lead to a buildup of bilirubin, causing jaundice, which is a yellowing of the skin and eyes.
Disruptions in bilirubin processing also cause changes in waste elimination. Urine often becomes noticeably darker than usual as the kidneys attempt to excrete excess bilirubin. Conversely, stools may become light, clay-colored, or pale because less bilirubin reaches the digestive tract.
Why Early Signs Are Often Missed
A significant challenge in identifying acute Hepatitis C is the high rate of asymptomatic cases. Approximately 70 to 85 percent of individuals infected with HCV do not experience noticeable symptoms during the acute phase. This lack of warning signs allows the virus to progress silently, making early diagnosis difficult.
Even when acute symptoms appear, they are usually mild and non-specific, easily mistaken for a cold or the flu. This misinterpretation or absence of symptoms means many people do not seek medical attention, and the infection progresses to the chronic stage unnoticed.
Next Steps: Testing and Diagnosis
Because the virus often causes no symptoms, testing is the only reliable way to confirm an infection. Individuals who believe they may have been exposed should consult a healthcare provider for screening, as early detection is important for preventing long-term complications.
Diagnosis typically involves a two-step blood test process. The first is the HCV antibody test, which determines if the body has produced antibodies, indicating past or current exposure. If the antibody test is positive, a second test, the Nucleic Acid Test (NAT) for HCV RNA, is performed. This RNA test confirms if the virus is actively present and replicating, signifying a current infection.