Medically reviewed by Elaine Fields, MSN, APRN, FNP-C, CARN-AP — Director of Addiction Services, Fresh Start Health Centers · Last reviewed: October 5, 2026
Most people with hepatitis C feel fine. That is exactly what makes it dangerous. The virus can live in your body for years, even decades, while it slowly damages your liver. In Kentucky, where hepatitis C rates are among the highest in the country, knowing the early signs and when to get tested can protect your health. Fresh Start Health offers hepatitis C testing and treatment at four Eastern Kentucky clinics in Ashland, Grayson, Morehead, and Vanceburg.
Why Hepatitis C Often Has No Symptoms
Hepatitis C is a virus that infects the liver. It spreads mainly through blood, most often through shared needles, syringes, or other drug equipment. Some people clear the virus on their own, but many develop a long-term, or chronic, infection.
According to the CDC, many people with hepatitis C do not look or feel sick, so they do not know they are infected. Most people with chronic hepatitis C will not have specific symptoms for 20 years or more. Some notice only vague problems, like constant tiredness or low mood, that are easy to blame on stress, work, or getting older.
This silent stretch is when testing matters most. By the time clear symptoms show up, the liver may already be scarred.
Early Signs of Hepatitis C
When symptoms do appear soon after infection, they usually show up 2 to 12 weeks after exposure. Early (acute) hepatitis C can cause:
- Feeling tired or worn out
- Fever
- Loss of appetite
- Nausea, stomach pain, or vomiting
- Joint pain
- Dark urine or clay-colored stools
- Yellow skin or eyes (jaundice)
Only a minority of people get these signs. The CDC notes that jaundice may occur in only 20% to 30% of people, and nonspecific symptoms like fatigue or stomach pain in only 10% to 20%. In other words, not having symptoms does not mean you do not have hepatitis C.
Signs of Long-Term Liver Damage
Without treatment, chronic hepatitis C can lead to liver scarring (cirrhosis), liver failure, and liver cancer. Signs of advanced liver damage can include:
- Bruising or bleeding easily
- Itchy skin
- Swelling in the belly or legs from fluid buildup
- Unexplained weight loss
- Confusion, drowsiness, or slurred speech
- Small, spider-like blood vessels on the skin
These signs, described by the Mayo Clinic, mean the liver has been under strain for a long time. If you notice any of them, call a provider right away. Getting tested years earlier, before damage builds up, is the better path.
When to Get Tested for Hepatitis C
You do not need symptoms to get tested. The CDC recommends hepatitis C testing for:
- All adults 18 and older, at least once in their lifetime
- Pregnant women, during each pregnancy
- Anyone who has ever injected drugs, even once or long ago
- People living with HIV
- People with abnormal liver tests or liver disease, or who are on dialysis
- People who received blood or an organ transplant before July 1992
- Health care and emergency workers after a needlestick or blood exposure
- Children born to a mother with hepatitis C
If you have an ongoing risk, such as sharing needles or other drug equipment, the CDC recommends regular testing, not just a one-time test. And anyone who asks for a hepatitis C test should be able to get one.
How the test works
For people without a known risk of exposure, screening begins with a blood draw for an HCV antibody test. After an exposure to hepatitis c the HCV antibodies typically become detectable in about 7–8 weeks and generally remain positive for life. A positive antibody test does not necessarily mean you currently have hepatitis C. A different HCV RNA test is used to determine whether the virus is present in your blood: A detectable HCV RNA test means you have an active hepatitis C infection that requires treatment.
If you may have been exposed within the past several months, your health care provider may skip the antibody screening test and order an HCV RNA test instead. This is because HCV antibodies can take 7–8 weeks to appear, while HCV RNA can typically be detected within 1–2 weeks after exposure. If you were previously cured of hepatitis C and have had a possible exposure since treatment, you will need an HCV RNA test to rule out reinfection.
Why Testing Matters in Eastern Kentucky
Kentucky has carried one of the heaviest hepatitis C burdens in the nation. In 2023, Kentucky reported 5.9 acute hepatitis C cases per 100,000 people, placing it among the states with the highest rates, according to CDC surveillance data. Much of that is tied to the opioid epidemic, which has hit Appalachian communities in Boyd, Carter, Rowan, and Lewis counties hard.
Many people in our region have never been tested, often because they feel healthy, worry about cost, or have to drive a long way to see a specialist. At Fresh Start Health, we bring testing and treatment closer to home. You can visit our clinics in Ashland, Grayson, Morehead, or Vanceburg, and many follow-up visits can happen through telehealth. To compare local options, see our guide to hepatitis C testing in Eastern Kentucky.
Hepatitis C Is Curable
A positive result is not a life sentence. Today’s hepatitis C medicines are generally well tolerated, come in tablet form, need to be taken only once daily, and usually require only 8 to 12 weeks of treatment. According to the CDC, treatment cures more than 95% of patients, usually without side effects. Results vary by person, and your provider will build a plan around your health history.
Fresh Start Health accepts Kentucky Medicaid, Medicare, and many commercial insurance plans. Coverage varies, so contact your plan for specifics, and our team can help you check your benefits. Learn more in our article on Kentucky Medicaid coverage for the hepatitis C cure and our overview of hepatitis C treatment in Kentucky.
Frequently Asked Questions
What are the first signs of hepatitis C?
Most people have no early signs at all. When symptoms do appear, usually 2 to 12 weeks after exposure, they can include tiredness, fever, nausea, stomach pain, loss of appetite, joint pain, dark urine, clay-colored stools, or yellow skin and eyes. Because these signs are mild or missing in most people, a blood test is the only reliable way to know.
Can you have hepatitis C for years without knowing it?
Yes. Most people with chronic hepatitis C have no specific symptoms for 20 years or more, according to the CDC. During that time the virus can slowly damage the liver. That is why the CDC recommends that every adult get tested at least once, even if they feel healthy.
How do I get tested for hepatitis C in Eastern Kentucky?
Fresh Start Health offers hepatitis C testing at our clinics in Ashland, Grayson, Morehead, and Vanceburg. Testing starts with a simple blood draw. If your antibody test is positive, an RNA test shows whether the infection is active. Call (606) 225-8200 to schedule. We accept Kentucky Medicaid, Medicare, and many commercial insurance plans.
Is hepatitis C curable, and does Kentucky Medicaid cover treatment?
Yes. Today’s hepatitis C medicines are pills taken for 8 to 12 weeks, and they cure more than 95% of patients, according to the CDC. Kentucky Medicaid and many insurance plans cover hepatitis C treatment, though coverage varies, so contact your plan for specifics. Our team can help you check your benefits.
Get Tested for Hepatitis C Close to Home
If you have never been tested, or you have any of the risk factors above, now is a good time. Testing is quick, and if you test positive, we can start treatment without sending you somewhere else. Call us at (606) 225-8200 or use our chat function to schedule, and learn more about our hepatitis C treatment program.
This content is for informational purposes only and is not a substitute for professional medical advice.