Those who are acutely symptomatic may exhibit fever, fatigue, decreased appetite, nausea, vomiting, abdominal pain, dark urine, grey-coloured faeces, joint pain and jaundice (yellowing of skin and the whites of the eyes).Because new HCV infections are usually asymptomatic, few people are diagnosed when the infection is recent.Yet, people who inject drugs and people in prisons are not often included in national responses.In countries where infection control practices are or were historically insufficient, HCV infection is often widely distributed in the general population.
However, in many countries, the genotype distribution remains unknown.
In those people who go on to develop chronic HCV infection, the infection is also often undiagnosed because it remains asymptomatic until decades after infection when symptoms develop secondary to serious liver damage.
After a person has been diagnosed with chronic HCV infection, they should have an assessment of the degree of liver damage (fibrosis and cirrhosis).
However, when HCV infection becomes chronic, treatment is necessary. WHO’s updated 2018 guidelines recommend therapy with pan-genotypic direct-acting antivirals (DAAs).
DAAs can cure most persons with HCV infection, and treatment duration is short (usually 12 to 24 weeks), depending on the absence or presence of cirrhosis.