A person whose annual physical examination shows “normal liver function” was found to have hepatitis C during a preoperative examination. It is true that the symptoms of hepatitis C patients are more insidious than those of hepatitis B, which makes early detection quite difficult. However, the progression of the onset of hepatitis C is not slow at all. According to statistics, the time between diagnosis and death for many hepatitis C patients is only 5 to 10 years, so today, when the whole country is highly concerned about hepatitis B, we cannot ignore the existence of hepatitis C and the threat to human health as well! Recently, I met a gentleman surnamed Wang in the outpatient clinic, who said that he often felt mentally weak recently, even after a big sleep, he still felt fatigued and even exhausted, and when he rested, he just wanted to rest at home, often accompanied by a low fever. Mr. Wang, who is usually physically fit, has been free of minor ailments for many years, and his medical examinations have been very normal. His daughter was worried about her father’s health and suspected that he had chronic hepatitis B. At his daughter’s urging, Mr. Wang finally went to the hospital. The examination report showed that Mr. Wang’s liver function indicators were slightly high, but the hepatitis B two-to-one test found all indicators to be normal. After ruling out the possibility of hepatitis B, the doctor suggested that he do a hepatitis C antibody test. Unexpectedly, the test result was positive, which surprised Mr. Wang very much. After further examination, it was found that the hepatitis had developed to the stage of cirrhosis. In shock, Mr. Wang wondered how he got hepatitis C. Because his liver function was normal in the annual physical examination. I found out after detailed questioning that Mr. Wang had had a blood transfusion 10 years ago because of a car accident. I guess that’s how he quietly got infected with hepatitis C. Faced with the diagnosis report, Mr. Wang regretted why he did not take the initiative to ask for hepatitis C checkups every year. If I had known, I wouldn’t have developed cirrhosis now. The tricky hepatitis C symptoms are difficult to detect Unlike hepatitis B, hepatitis C is a serious liver disease caused by a blood-borne, hepatitis C virus. Symptoms of chronic hepatitis C virus infection are very unremarkable, mainly in the form of fatigue and low-grade fever, and more patients have no symptoms at all. Patients with chronic hepatitis C can go up to 20 years without any noticeable symptoms, and some patients may also have itchy skin or develop localized joint (e.g., hand) pain similar to rheumatoid arthritis. What makes it tricky for doctors is that patients with hepatitis C generally have no particularly obvious symptoms, and even if they are infected with hepatitis C, typical liver function tests barely detect any abnormalities or only find a slightly higher than normal transaminase (ALT) value. According to a recent clinical trial of hepatitis C conducted at the European Liver Institute, a large proportion of hepatitis C virus-infected patients had normal conventional liver function tests, showing that the conventional liver tests currently used still miss or misdiagnose many hepatitis C patients. Clinicians have long relied too heavily on liver function index tests, however, it was not until the last two decades of clinical research that it was determined that liver health cannot depend solely on liver function tests, which may still be normal even in the early stages of the disease and in the advanced stages of cirrhosis. High-risk groups should be promptly examined It is recommended that high-risk groups be actively tested for antibodies to the hepatitis C virus to facilitate early detection, diagnosis and treatment of hepatitis C. Those with unexplained liver function abnormalities should alert themselves to hepatitis C virus infection and get tested for hepatitis C early. Since hepatitis C is a blood-borne disease, anyone with a history of blood transfusion (especially those with a history of blood transfusion before 1992), sexual promiscuity and those who have shared razors, dental tools, tattoo paraphernalia, etc. should be tested for hepatitis C. In addition, dentists, nurses and beauticians are also at high risk for hepatitis C virus infection and should pay high attention and be alert to this disease and actively consult their doctors for hepatitis C screening.