The Symptoms of Hepatitis C in Males

Hepatitis C is more prevalent in men and often more severe

Senior man getting a medical exam
Ariel Skelley / Getty Images

Hepatitis C is a viral infection that affects about twice as many men as women. Though largely asymptomatic in its earlier going, men are more likely to display symptoms like appetite loss, loss of weight, yellow discoloration of skin or eyes, and body aches, among others. In addition, males are more likely to experience the most severe effects of this disease, which include scarring or “fibrosis” of the liver; this can lead to cirrhosis, a hardening and shrinking of the organ, and even cancer.

Senior man getting a medical exam
Ariel Skelley / Getty Images

Men & Hepatitis C

There’s some debate in the medical community as to why there are gender differences when it comes to hepatitis C. What is known is that cases in women are more likely to be cleared without treatment.

Whereas approximately 89 percent of men develop chronic hepatitis C after initial infection, this figure is only about 63 percent in women.

In addition, men are more likely to develop liver cirrhosis (scarring of the liver) due to infection and see significantly faster disease progression overall.

What’s happening? Though more research is needed, consensus in the medical community is building that the differences have to do with the presence of the hormone, estrogen, in women. The exact mechanism is unknown, but its presence in the liver has been seen to reduce damage to the organ. In addition, the faster progression of cirrhosis in hepatitis C-infected men has been linked to comparatively higher rates of heavy alcohol consumption in this population.      

Frequent Symptoms

Hepatitis C arises as an acute infection, meaning there may be flu-like symptoms when the disease is first contracted. As noted above approximately 15 to 25 percent of acute hepatitis C infections clear up on their own, and the condition can be asymptomatic for long periods of time. This makes it a “silent infection,” and many people have it for years without knowing it, making it particularly dangerous.

At a higher rate than women, men with acute hepatitis C experience any of the following:

  • Fatigue
  • Reduced appetite
  • Fever
  • Rapid weight loss
  • Joint pain
  • Dark urine
  • Gray-colored feces
  • Jaundice (yellow discoloration) in skin and eyes

These symptoms present as more severe in males, and they tend to arise between two and 26 weeks after exposure to the virus. 

Rare Symptoms

Alongside the above symptoms, some men with hepatitis C develop a cascade of rarer symptoms. These are related to the progression of damage to the liver and arise in more prolonged, chronic cases. They include:

  • Development of spider veins in the skin
  • Itchiness in the skin
  • Easier bleeding and bruising
  • Swelling in the legs

In these chronic cases, the primary issue is liver cirrhosis, which causes this organ to harden and shrink. Since the liver is such an essential organ—it’s instrumental in filtering blood coming from the digestive tract and is what detoxifies chemicals and metabolizes drugs—this progression is particularly alarming.


Even more concerning is the well-established link between chronic cases of hepatitis C and liver cancer. A retrospective study published in the journal, CA Cancer Journal for Clinicians, in 2017 noted that risk of developing this cancer ranges as high as approximately 5 percent in chronic hepatitis C cases. Naturally, such occurrences heavily influence treatment, and prognosis becomes very poor.

In addition, hepatitis C in men can lead to a range of other complications, including:

  • Enlarged Blood Vessels: Chronic cases can cause blood vessels to swell, which can lead to serious internal bleeding problems.
  • Enlarged Spleen: Disorders in the liver due to hepatitis C can lead to inflammation of the spleen, which is associated with lower white blood cell and platelet count.
  • Gallstones: Disruption in the flow of bile (the digestive fluid formed by the liver) to the gallbladder can lead to the formation of these calcium deposits.
  • Sensitivity to Medications: Since the liver is closely associated with the processing of drugs in the body, hepatitis C-related damage can increase sensitivity to them.
  • Type 2 Diabetes: Arising because of a resistance to the hormone, insulin, hepatitis C can lead to the development of type 2 diabetes.
  • Kidney and Lung Failure: Chronic cases can also lead to serious problems in the kidneys and lungs.
  • Compromised Immunity: Because of its effects on the spleen, chronic hepatitis C can also compromise the body’s ability to combat infection and disease.

Notably, according to the Centers for Disease Control (CDC), approximately 25 percent of HIV-infected people also have hepatitis C. These cases are particularly troubling because men with this coinfection are more likely to see acute cases become chronic.

When To See a Doctor

What’s galling about hepatitis C is that it all-too-often goes undetected for a long time; some carry it for 10-20 years without any signs. If you or a loved one is experiencing any of the above-listed symptoms, of course, seek out treatment as soon as possible. The best bet, oftentimes, is screening for this disease to prevent its progression.

In the US, an estimated 3.5 million people have hepatitis C—that’s over 2 million men—and around half of these carry it without knowing it.

Testing for hepatitis C can be of paramount importance for certain groups of men. These include:

  • Older Men: According to the CDC, one of the primary risk factors for having hepatitis C is age. Formerly, it was recommended that those born between 1945 and 1965 be tested. However, in April 2020 the CDC expanded its recommendation to include screening for all adults ages 18 to 79.
  • Those With HIV: Men diagnosed with HIV, as noted above, have an elevated rate of coinfection. Doctors recommend testing every three months for this cohort.
  • Recipients of Donated Blood: If you’ve received blood prior to 1992, testing is also strongly recommended.
  • Users of Injected Drugs: Current or former users of injected drugs are also particularly prone to developing this disease as it is often transmitted by blood.
  • Sexually Active Men: The CDC recommends that men that are sexually active with multiple partners get regular testing. In particular, if a current or previous partner has been diagnosed, screening is absolutely paramount.
  • Needle-Stick Injury: Healthcare workers who’ve experienced needle-stick injury with hepatitis C positive blood should opt for screening.

It never hurts to be safe; with the number of people who carry this disease unknowingly, care should certainly be taken. That said, with regular testing and prompt treatment, hepatitis C can be taken on.

If you have hepatitis C or believe you do, the best bet is to be proactive. Seek out the care you need and talk to loved ones and family; the sooner you get on the path towards treatment, the better off you’ll be. With the right support system, this disease can be taken on and eradicated.

A Word From Verywell

Hepatitis C, especially in chronic cases, can be frightening, and there’s no doubt that symptoms and outcomes can become quite severe. The good news, however, is that there are a number of antiviral medications available, and this disease can be overcome. Care needs to be taken, but the prognosis is especially positive if the infection is caught in its earlier stages. Furthermore, therapies are continuing to improve and evolve for chronic hepatitis C. Despite the challenges, it’s safe to say the future is bright for those who have this condition.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Baden R, Rockstroh J, Buti M. Natural History and Management of Hepatitis C: Does Sex Play a Role?Journal of Infectious Diseases. 2014;209(suppl 3):S81-S85. doi:10.1093/infdis/jiu057 

  2. Centers for Disease Control. Hepatitis C Questions and Answers for Health Professionals.

  3. Torres H, Shigle T, Hammoudi N et al. The oncologic burden of hepatitis C virus infection: A clinical perspective. CA Cancer J Clin. 2017;67(5):411-431. doi:10.3322/caac.21403

  4. Schillie S, Wester C, Osborne M, Wesolowski L, Ryerson AB. CDC Recommendations for Hepatitis C Screening Among Adults — United States, 2020. MMWR Recomm Rep 2020;69(No. RR-2):1–17. DOI: 10.15585/mmwr.rr6902a1.

By Mark Gurarie
Mark Gurarie is a freelance writer, editor, and adjunct lecturer of writing composition at George Washington University.