Page 243 - fourth year book

HEPATITIS C VIRUS

What are the signs and symptoms of chronic HCV infection?

Most persons with chronic HCV infection are asymptomatic. However,
many have chronic liver disease, which can range from mild to severe,
including cirrhosis and liver cancer. Chronic liver disease in HCV-
infected persons is usually insidious, progressing slowly without any

signs or symptoms for several decades.

In fact, HCV infection is often not recognized until asymptomatic
persons are identified as HCV-positive when screened for blood
donation or when elevated alanine aminotransferase (ALT, a liver
enzyme) levels are detected during routine examinations.

Why do most persons remain chronically infected with HCV?

A person infected with HCV mounts an immune response to the virus,
but replication of the virus during infection can result in changes that
evade the immune response. This may explain how the virus establishes

and maintains chronic infection.

What are the chances of someone developing chronic HCV
infection, chronic liver disease, cirrhosis, or liver cancer or

dying as a result of Hepatitis C?

Of every 100 persons infected with HCV, approximately

 75–85 will go on to develop chronic infection

 60–70 will go on to develop chronic liver disease

 5–20 will go on to develop cirrhosis over a period of 20–30 years

 1–5 will die from the consequences of chronic infection (liver
cancer or cirrhosis)

Box 1: Risk factors for hepatitis C virus (HCV) infection

High risk of HCV infection is associated with:
• Any history of injection drug use
• Contaminated blood or blood products or organ transplantation before July
1990

• Incarceration
• Needlestick or sharp injuries

• Procedures (e.g., injection, vaccination, surgery, transfusion, ceremonial
rituals) involving reuse or sharing of contaminated equipment in parts of the
world with

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