make a prognosis. Elevated levels of aminotransferase, a liver enzyme, are a sign that the disease is causing liver damage. But even this marker isn’t a perfect predictor. As many as 30 percent of patients with liver damage have normal levels of aminotransferase.
A look at the numbers
When patients ask, “What will happen to me?” the best answer doctors can give is to explain how the disease progresses in an average group of patients. Of every 100 people infected with HCV:
75 to 85 may develop long-term infection; of those:
- 60 to 70 may develop chronic liver disease
- 5 to 20 may develop cirrhosis (scarring of the liver) over a period of 20-30 years
- 1 to 5 are likely to die of the consequences of long-term infection, either from liver cancer or cirrhosis.
As those numbers show, most people infected with hepatitis develop chronic infections. Among them, most have some signs of liver damage. But the numbers are also reassuring.
Fewer than 7 percent of those with chronic hepatitis C die of complications from the virus. That means that for a large majority of people, the virus isn’t fatal. In many, it causes nothing more than mild symptoms such as fatigue.
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The changing picture of HCV infection
There’s more good news coming out of clinical trials and pharmaceutical laboratories. The combination treatment used today is more effective than anything doctors were able to offer when the disease emerged in 1989. Combination therapy can eliminate the virus in about half of all patients. Some combination treatments can do even better.
One 2007 study of nearly 1,000 hepatitis C patients showed a cure rate of 99 percent after treatment with peginterferon and ribavirin — with a number of patients remaining disease-free for as long as seven years. The prognosis for people infected with HCV is brighter than ever. And it’s likely to get even brighter as doctors learn more effective combinations of existing drugs and as new drugs are developed.