Hepatitis C (cont.)

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What is the usual progression of chronic hepatitis C infection?

Our understanding of the natural progression (history) of HCV infection still is evolving.

Of 100 people infected with HCV, it is estimated that 75 to 85 will become chronically infected, 60 to 70 will develop liver disease, 5 to 20 will develop cirrhosis and 1 to 5 will die from complications of liver disease such as cirrhosis or liver cancer.

Scientists are learning more about what causes some people to have milder problems and others to have serious complications. Drinking alcohol and acquiring other hepatitis viruses are risk factors for severe disease. Thus, persons who have chronic hepatitis C infection should avoid drinking and should be vaccinated against the other hepatitis viruses (A and B).

Liver cancer (hepatocellular carcinoma) is associated with cirrhosis due to chronic HCV infection. Some experts recommend screening patients with HCV infection and cirrhosis for liver cancer every six months with abdominal ultrasound examinations and a blood test for alpha-fetoprotein (a marker for liver cancer). The effectiveness of this screening is unclear.

Who is at high risk and should be tested for hepatitis C infection?

Currently, screening for HCV is not recommended as part of a routine physical examination. Rather, testing should be done among:

  • Individuals at high risk for infection including current and past users of injectable drugs and persons exposed to infected blood or organs from infected persons
  • Children born to chronically infected mothers
  • People who received blood, blood products, or transplanted organs prior to 1992
  • Persons with abnormal levels of liver enzymes in the blood

These are not the only circumstances under which testing for HCV infection may be done. In general, testing is recommended when exposure to the virus is suspected.

Medically Reviewed by a Doctor on 2/2/2014

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