If you ever experimented with IV drugs (even once), snorted cocaine through a straw, had a blood transfusion before 1992, or have ever received abnormal results on a liver function test, you need a hepatitis C test—whether or not you're feeling tired. "Most of my patients are pillars of the community today—the things they did in their youth are well behind them," says liver disease expert Michael W. Fried, MD, director of hepatology at the University of North Carolina at Chapel Hill. "Once you're feeling persistently tired, liver damage may have begun."
Why It's Overlooked: "Many family doctors won't ask about risky behavior in your distant past—especially if you don't look the part now," Fried says. "If you're feeling tired and know you have risk factors, tell your doctor so you can be tested."
Other Symptoms: Jaundice, diminished appetite, fever, aches, and other flulike symptoms may occur soon after infection. But often the only symptom is fatigue 20 or 30 years later.
Tests: First, a blood check for hepatitis C antibodies. If results are positive, further testing includes a liver enzyme check and possibly a liver biopsy to assess liver health.
Treatment: Weekly injections of peginterferon plus daily ribavirin capsules. This combination can cure about 50 percent of hepatitis C, Fried says.