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Introduction

Progression of hepatitis C

Trying to understand how hepatitis C progresses and what effects the virus will have on the body is a complicated matter. The laboratory test to identify the virus was only developed in 1989. This has given us only a relatively short time in which to try and study the disease. Although a great deal has been learnt about what can take place during the first 20 years of infection, less is known about what happens after that.

In order to understand the likely progression of the virus it is necessary to know the approximate date when someone was first infected. This is difficult as many people with HCV do not know when or how they became infected.

One of the main dilemmas with HCV infection is that those infected have very different experiences with it. While some people clear the virus in the very early stages, most do not. These people will then go on to develop a long term or chronic infection. The course of the disease then is very hard to predict. While after twenty years of being infected one person may have no liver damage, another will develop cirrhosis and sometimes liver failure or even liver cancer.

The range and degree of symptoms also varies significantly.

Many people remain asymptomatic (without symptoms) for years. Others will experience fatigue, depression, digestive problems and many others from the many varied extra-hepatic (outside of the liver) symptoms of hepatitis C infection. But the symptoms people suffer are not necessarily an indication of whether they have liver damage or not. One person may have almost no liver damage and yet their quality of life be severely affected while someone with extensive scarring of the liver can find themselves completely symptom free. Nor can existing blood tests, viral load, liver enzyme levels or HCV genotype reliably forecast the outcome of untreated HCV infection.

Despite these difficulties we still understand a great deal about how the disease generally progresses and as research into HCV continues our knowledge of its progression will increase.

Stages of hepatitis C

Hepatitis C is considered to have four stages: