Natural History of HCV-induced Liver Disease

After exposure to the hepatitis C virus (HCV) only a minority of patients will resolve the infection spontaneously, and the prognosis of these patients is excellent. Patients with chronic HCV infection may develop hepatic fibrosis and can experience symptoms, although these remain largely non-specific up to the point cirrhosis has established. At the stage of cirrhosis, liver failure and hepatocellular carcinoma are the most important causes of the increased mortality. The rate of disease progression varies considerably among patients, and has been associated with several host and virus-related factors. Assessment of the patient's individual risk for disease progression is relevant for guidance and clinical decision making, especially with all upcoming antiviral treatment improvements. Importantly, successful antiviral therapy has shown great potential to prevent chronification among patients with acute HCV infection as well as to prevent cirrhosis-related morbidity and mortality among those patients with chronic HCV infection.

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