Generally, symptoms only appear once advanced liver damage has occurred.
These signs and symptoms are features of liver cirrhosis ("hardening of the liver tissue") which results from persistence of the hepatitis C virus. These include ascites (swelling of the abdomen with fluid), jaundice, deterioration of mental state (hepatic encephalopathy), vomiting blood or passing out altered blood in the stools. Of course, there is the dreaded complication of liver cancer.
Generally, cirrhosis appears in at least 20% of patients within 20 years of infection. Cirrhosis can be accelerated by concomitant alcohol use.
Liver cancer develops after 30 years and occurs only in a background of liver cirrhosis.
It is interesting to note that hepatitis C has clinical manifestions beyond the liver. These are as a result of its effect on the immune system, and are called extrahepatic manifestions. The extrahepatic manifestions include: