Many people with hepatitis C feel entirely well and have few or no symptoms. It is helpful to think of two phases of infection with hepatitis C virus. An acute phase when patient first become infected and a chronic (persistent) phase in people where the virus remains long-term.

Acute phase

Acute means 'new' or 'for a short time'. This phase lasts for the first six months. When first infected with the virus, most people have no symptoms, or only mild ones. If symptoms do occur, they develop about 7-8 weeks after being exposed to the virus and may include: feeling sick, vomiting and feeling generally unwell.

• In about 1 in 5 cases the virus is cleared from the body by the immune system within 2-6 months. If this happens then person will have no long-term effects from the virus. Younger people and women are more likely to clear the virus in this way.
  
• In about 4 in 5 cases, the virus remains active in the liver and bloodstream long-term. This is called chronic infection with hepatitis C.

Chronic phase

A chronic hepatitis C infection is when the infection lasts for longer than six months. The course of the chronic infection varies considerably between people and it is very unpredictable. Of those people who develop chronic infection:
Some people have mild or no symptoms. However, even if you have no symptoms, you can still pass on the hepatitis C virus to others who may develop problems.

Some people develop some symptoms due to persistent inflammation of the liver. For example, feeling sick, lack of appetite, intolerance of alcohol, pains over the liver, jaundice and depression.
The most common symptoms of chronic hepatitis C are:

Fatigue	Nausea, vomiting
Low-grade fever	Jaundice
Headaches	Sensitivity to light
Slight sore throat	Stiff or aching joints
Loss of appetite	Itchy skin

About two-thirds of people with chronic hepatitis C infection develop cirrhosis over a period of about 20-30 years. Cirrhosis is like a 'scarring' of the liver which can cause serious problems and 'liver failure' when it is severe. Some people with chronic hepatitis C have no symptoms for many years until they develop cirrhosis. Only when the liver starts to fail with cirrhosis do symptoms appear. A small number of people who develop cirrhosis go on to develop liver cancer.