Hepatitis C natural history
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.[1]
In diagnosis of cirrhosis (Ishak scores, 5-6) in patients with hepatitis C, the aspartate aminotransferase to platelet ratio index (APRI) ratio > 1 suggests cirrhosis with accuracy of:[2]
- Sensitivity = 79%
- Specificity = 78%
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
References
- ↑ Nash KL, Woodall T, Brown AS, Davies SE, Alexander GJ (2010). "Hepatocellular carcinoma in patients with chronic hepatitis C virus infection without cirrhosis". World Journal of Gastroenterology : WJG. 16 (32): 4061–5. PMC 2928460. PMID 20731020. Retrieved 2012-02-26. Unknown parameter
|month=ignored (help) - ↑ Gara N, Zhao X, Kleiner DE, Liang TJ, Hoofnagle JH, Ghany MG (2013). "Discordance among transient elastography, aspartate aminotransferase to platelet ratio index, and histologic assessments of liver fibrosis in patients with chronic hepatitis C." Clin Gastroenterol Hepatol. 11 (3): 303–308.e1. doi:10.1016/j.cgh.2012.10.044. PMID 23142332.