Hepatitis C natural history

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Varun Kumar, M.B.B.S. [2]; Assistant Editor-In-Chief: Nina Axiotakis [3]

Natural History

Of every 100 people infected with the Hepatitis C virus, about

• 75–85 people will develop chronic Hepatitis C virus infection; of those,
• 60–70 people will go on to develop chronic liver disease
• 5–20 people will go on to develop cirrhosis over a period of 20–30 years
• 1–5 people will die from cirrhosis or liver cancer

Complications

• Hepatitis C infection can continue over many years leading to chronic hepatitis
• Over years, liver may undergo extensive damage and scarring resulting in cirrhosis
• Liver failure
• Hepatocellular carcinoma may occur in patients with chronic hepatitis C infection.

Prognosis

• Acute Infection

  • 20% recover
  • 80% have persistent infection

    • 30% of these patients develop cirrhosis

• Genotype

  • Predicts response to treatment
  • Genotype 1 less responsive than types 2 & 3