How does hepatitis C usually begin?

Asymptomatically. This is a viral infection which over time causes liver damage. It is typically transmitted from one person to another by sharing needles, Cocaine straws and by blood transfusions received before 1991. It can cause fatigue but most have no symptoms.
Usually with nothing. Most people who are exposed to hepatitis c have no symptoms, or maybe a mild flu-like illness. Less than 20% will develop nausea, fever, and turn yellow (jaundice). This is why hepatitis c is called the "silent epidemic". About 25% of people will spontaneously clear their infection. The rest go onto chronic infection, but still may only have tiredness until very late in their disease.