Symptoms of Hepatitis C

Robert Hindes, MD, cofounded BeyondWest Pharmaceuticals in 2012. Prior to his work at BeyondWest Pharmaceuticals, Robert Hindes, MD, served as the vice president of clinical development at Pharmasset in Princeton, New Jersey. Pharmasset developed sofosbuvir, a nucleotide polymerase inhibitor, recently submitted by Gilead to the U.S. Food and Drug Administration for approval. A regimen of sofosbuvir, combined with either ribavirin or another antiviral drug, is considered the most effective treatment among the several anti-HCV drugs expected to be approved over the next 2 years.

In the U.S., the peak incidence of acute hepatitis C was estimated to be 180,000 cases per year in the mid 1980s, but declined to about 30,000 in 1990, due to effective screening of stored blood, needle exchange programs and greater awareness of high risk behaviors. The majority of patients with acute hepatitis C infection are asymptomatic, so diagnosis is usually made during the chronic phase of infection. However, symptoms develop in about 20% to 30% of adults with acute HCV infection. The onset of symptoms usually occurs from 3 to 12 weeks after exposure. Symptoms may include fever, fatigue, a lack of appetite, and dark or discolored urine. More severe signs of infection may include nausea, vomiting, joint pain, and jaundice.

Hepatitis C infection is considered to be chronic when HCV RNA is present in the blood for at least 6 months after onset of acute infection. In approximately 75%-85% of infected individuals, the virus does not clear by 6 months after exposure, and chronic hepatitis develops.