Hepatitis C Progression

The fact that one is infected with Hepatitis C (HCV) need not always mean that one can be afflicted with a liver disease. It takes many years, sometimes, even decades for Hepatitis C to bring about life-threatening diseases of the liver.
Once HCV enters a human body, it infects the cells named hepatocytes in the liver. A very small fraction of people (about 25%) really experiences any symptom of infection that includes fatigue, reduction in appetite, nausea, jaundice (yellowing of skin and eyes). Nevertheless, it is seen that most infected do have an increase in liver enzymes – like alanine aminotransferase (ALT) which is detected by a simple blood test. An increased ALT level indicates the damage of some liver cells by HCV.
Of the lot who are infected with HCV, 15-20% are able to clear the virus from their bodies within six months; infants and young women have been seen to do this spontaneously. But, the majority who are infected become chronic (infection stays in them for life) unless treated.Among the chronic patients, 15% have normal liver enzymes, even though HCV is detected in their liver and blood.


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Though the development of progressive liver disease or experience in symptoms is not so common, people with normal ALT levels are at risk of liver damage from HCV. The rest usually complain about symptoms like abdominal discomfort, fatigue, nausea, muscle ache etc.
5-20% of the people infected will develop cirrhosis, as a result of widespread liver damage over a period of 20-30 years. Progression to cirrhosis is quicker in older people, obese and the immune suppressed. Heavy alcohol can also accelerate this, more so in men who take five drinks a day and in women who take three drinks a day.
Cirrhosis is not life threatening but it affects the functioning of liver and increases the chance of liver cancer. Out of 100 HCV patients, it is seen that 1-5 die out of the consequences of a chronic infection like liver cancer or liver failure.
HCV also increases the chance of cardiovascular disease and cancer. If cured, however, they have a normal life expectancy. To summarize, it can be said that out of a 100 affected with HCV, 75-80 will develop chronic HCV infection and out of these 60-70 will develop chronic liver disease, 5-20 will develop cirrhosis over a period of 20-30 years and 1-5 will die of liver cancer or cirrhosis.

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