![]() ![]() Patients who develop cirrhosis have a 1%–4% annual risk of developing hepatocellular carcinoma and a 3%–6% annual risk of hepatic decompensation for the latter patients, the risk of death in the following year is 15%–20% ( 7). Of every 100 people infected with HCV, approximately 5–25 will develop cirrhosis within 10–20 years. What are the chances of someone with HCV infection developing cirrhosis or liver cancer? This may explain how the virus establishes and maintains chronicity ( 7). Why do most people remain chronically infected with HCV?Ī 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. More than half of people who become infected with HCV will develop chronic infection ( 6, 7). What is the likelihood of HCV infection becoming chronic ![]() Factors that are predictive of spontaneous clearance of HCV include having jaundice, elevated ALT level, and hepatitis B virus surface antigen (HBsAg) positivity younger age, being female being infected with HCV genotype 1 and having certain host genetic polymorphisms, most notably those near the IL28B gene ( 6, 7). Only those with current infection as evidenced by a positive HCV RNA test need treatment. Recent data reveal that up to approximately half of people who test anti-HCV positive do not have current chronic infection ( 1), indicating they may have experienced spontaneous clearance after acute infection. Is it possible for someone to become infected with HCV and then spontaneously clear the infection? ![]()
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