Viral Hepatitis

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FAQ: How does hepatitis C progress?

for Veterans and the Public

Frequently Asked Questions

Q: How does hepatitis C progress?

When someone is first infected with hepatitis C, most likely they have no symptoms and are unaware. Occasionally people are aware by feeling ill such as fatigue, loss of appetite, weakness or sometimes having a yellow color in their skin or eyes. Although having any symptoms at all is rare, if they do occur, they usually go away within a few weeks.

Around 15-20% of people who are infected will spontaneously fight off the virus on their own and they will not have a chronic hepatitis C infection and no long term damage occurs.

But around 75-80% of people will develop chronic infection. Most of the time, people with chronic hepatitis C have no symptoms at the time of infection and no symptoms for years or even decades of chronic infection. The virus will be with them until they are successfully treated with hepatitis C medications.

Around 20% of people with chronic infection will slowly have gradual damage in the liver over years and will eventually develop cirrhosis (severe scarring of the liver). This can take 15-20 years or more from the time of the initial infection. Around 80% of people with chronic infection will not develop this much scarring and will not develop cirrhosis.

Cirrhosis, or the replacement of liver cells with permanent scar tissue, occurs in about one in five people with HCV. Cirrhosis can lead to problems such as bleeding from veins in the esophagus, fluid buildup in the belly, and damaged brain function. Approximately 15% of people with cirrhosis will develop liver cancer (hepatocellular carcinoma, or HCC) during their lifetime. Drinking excessively can double the chance of liver cancer in people infected with HCV.