Disease Course of Hepatitis C
Research has shown that if 100 people are infected with hepatitis C, about 25 of those will clear the virus completely within two to six months of infection, but will continue to have hepatitis C antibodies in their blood.
About 75 of the 100 people who do not clear the virus will develop ongoing (or chronic) infection and are at risk of developing cirrhosis of the liver. Of the 75 people who develop chronic hepatitis, about 20 people will not experience any noticeable illness or symptoms. However, they can still transmit the virus to others.
After an average of 15 years, between 40 and 60 of the 75 people with chronic hepatitis C will experience some symptoms and develop some liver damage.
After 20 years, between five and ten people with liver damage will develop cirrhosis. Between two and five of these people will experience liver failure or develop a form of liver cancer known as hepatocellular carcinoma.
Duration of infection is the most likely determinant of the risk of cirrhosis and liver cancer. Other factors which affect the progression of liver disease include:
- age when first infected (people infected over the age of 40 years, experience faster disease progression)
- male gender
- alcohol use
- co-infection with hepatitis B virus and/or HIV
- obesity (Poynard, T., et.al; 2001)
There is no evidence to confirm whether genotype influences disease progression.
Poynard, T., Ratziu, V., Charlotte, F., Goodman, Z., McHutchison, J. G. & Albrecht, J. (2001). Rates and risk factors of liver fibrosis progression in patients with chronic hepatitis C. Journal of Hepatology, 34(5), 730–739.