Many people who are infected with hepatitis C do not have symptoms.

If the infection has been present for many years, the liver may be permanently scarred, a condition called cirrhosis. In many cases, there may be no symptoms of the disease until cirrhosis has developed.

The following symptoms could occur with hepatitis C infection:

• Abdominal pain (right upper abdomen)
• Ascites
• Bleeding varices (dilated veins in the esophagus)
• Dark urine
• Fatigue
• Generalized itching
• Jaundice
• Loss of appetite
• Low-grade fever
• Nausea
• Pale or clay-colored stools
• Vomiting

The following tests are done to help diagnose hepatitis C:

• ELISA assay to detect hepatitis C antibody
• Hepatitis C genotype. Six genotypes exist. Most Americans have genotype 1 infection, which is the most difficult to treat.
• Hepatitis C RNA assays to determine virus levels (called viral load)

The following tests are done to identify and monitor liver damage from hepatitis C:

• Liver function tests
• Albumin level
• Prothrombin time

Liver biopsy can show how much damage has been done to the liver.