What are the symptoms and how does hepatitis C progress?

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It is helpful to think of two phases of infection with hepatitis C virus. An acute phase when you first become infected, and a chronic (persistent) phase in people where the virus remains long-term.

Acute phase

When first infected with the virus, most people have no symptoms, or only very mild symptoms. 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. Some people become jaundiced (yellow). It is unusual to get severe symptoms. So, most people who become infected are not aware of it at first. Following the initial infection:

In about 1 in 5 cases the virus is cleared from the body by the immune system within 2-6 months.
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

Of those people who develop chronic infection:

Some people remain well throughout life. They develop no damage or problems to the liver. However, even if you have no symptoms, if you have chronic infection you can still pass on the virus to others who may develop problems. For example, you may pass on the virus if you share needles for injecting drugs.
Some people develop some symptoms due to persistent inflammation of the liver such as: muscle aches, tiredness, feeling sick, lack of appetite, intolerance of alcohol, pains over the liver, jaundice, depression. Symptoms vary in severity and some people have liver inflammation without feeling any symptoms.
About 1 in 5 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. (See separate leaflet called 'Cirrhosis'.) 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 develop liver cancer after a further period of time.