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Hepatologist

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Chronic hepatitis C: prognosis

Alexey Portnov, medical expert
Last reviewed: 23.04.2024

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The prognosis for chronic hepatitis C is very variable. In some cases, the disease has a benign course with spontaneous improvement within 1-3 years, in others, progression is observed with transformation into cirrhosis of the liver. According to a study in Italy, chronic hepatitis developed in 77% of 135 patients with posttransfusion hepatitis. By the end of the 15-year period, 65 patients with liver biopsy had cirrhosis. A half of patients with cirrhosis developed life-threatening complications. According to Japanese authors, before the development of cirrhosis after posttransfusion hepatitis passes 20-25 years, until the development of hepatocellular carcinoma - about 30 years. In patients with posttransfusion chronic HCV infection treated in specialized centers of the United States, the disease was progressive and led to death from liver failure and hepatocellular carcinoma.

In general, despite the biochemical and histological signs of liver disease, chronic hepatitis with a prognosis is long-term, as it is asymptomatic, and liver failure develops in late terms.

The relationship between HCV infection and hepatocellular carcinoma has been established in studies in Spain, Italy, Japan and the USA.

Adverse events include a very high activity of serum transaminases, the presence of active cirrhosis from liver biopsy data, a "viral load" (high HCV-RNA), genotype 1b and some concomitant diseases such as alcoholic liver disease or HBV infection. A positive test for HCV-RNA after the end of interferon therapy indicates a high probability of relapse.

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