The Stages of Hepatitis C Progression

Doctor William C Lloyd Healthgrades Medical Reviewer
Medically Reviewed By William C. Lloyd III, MD, FACS
Written By Sarah Lewis, PharmD on May 9, 2021
  • serious-man-leaning-against-wall
    Hepatitis C infection starts with exposure to the virus.
    The hepatitis C virus spreads through direct contact with infected blood. Today, the main risk factor is sharing needles and other equipment for IV drugs. Healthcare workers are also at risk through needle-stick injuries on the job. Other less common ways to contract hepatitis C include having unprotected sex or sharing razors or other personal items with an infected person. Infected moms can also pass it to their babies.
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    Acute hepatitis C infection is the first stage.
    The acute phase of hepatitis C infection is a short-term illness. It occurs within the first six months after exposure to the virus. Most people—about 80%—never experience any symptoms. So you may not realize you’re infected. That’s why it’s important to talk with your doctor about hepatitis C testing if you’re at risk. About 15 to 25% of people with acute hepatitis C will clear the infection without treatment and may never know they had it.
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    Early warning signs of hepatitis C may occur in some people.
    Some people experience symptoms with acute hepatitis C. Symptoms are usually mild and resemble the flu. They include fatigue, fever, body aches, nausea, lack of appetite, and maybe even upper belly pain. These symptoms can last from 2 to 12 weeks. If your doctor diagnoses acute hepatitis C, you can get treatment at this stage. And treating acute hepatitis C reduces the risk of progressing to chronic hepatitis C.
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    Most cases of acute hepatitis C progress to chronic hepatitis C.
    Most people—up to 85%—who have acute hepatitis C will progress to chronic hepatitis C. Like acute hepatitis C, many people still don’t have any symptoms. More than 3 million Americans have chronic hepatitis C, and many aren’t aware they are actively infected. Unfortunately, they can still spread the infection even when they don’t have symptoms. And people can go for years before symptoms develop and they seek medical treatment.
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    Chronic hepatitis C is the second stage.
    Chronic hepatitis C is a long-term illness. It occurs when your body can’t clear the virus and a long-term infection develops. Many people have chronic hepatitis C for 15 years or longer before symptoms appear. As a result, it’s common to have liver problems by the time you realize you’re sick. The good news is newer treatments are easier to take and more effective than ever.
  • woman-getting-liver-biopsy
    Chronic hepatitis C leads to liver damage.
    Chronic hepatitis C causes liver damage. It starts with inflammation and progresses to fibrosis—scarring of the liver—and cirrhosis without treatment. Cirrhosis is permanent scarring of the liver. Hepatitis C is the leading cause of cirrhosis in the United States. It’s also the leading cause of liver cancer. If you have cirrhosis or liver cancer, hepatitis C treatment may still be an option. While treatment can’t reverse permanent damage, it can improve the overall health of your liver.
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    End-stage liver disease from hepatitis C requires liver transplantation.
    End-stage liver disease from hepatitis C means the virus has damaged the liver to the point where it stops working. The only treatment for this stage is a liver transplant. In fact, hepatitis C is the most common reason for liver transplantation in the United States. But hepatitis C almost always returns if drug treatment didn’t work before liver transplant surgery. So you may need to take medication after surgery. Fortunately, newer treatments have a high response rate and are improving outcomes after liver transplantation.
The Stages of Hepatitis C Progression

About The Author

Sarah Lewis is a pharmacist and a medical writer with over 25 years of experience in various areas of pharmacy practice. Sarah holds a Bachelor of Science in Pharmacy degree from West Virginia University and a Doctor of Pharmacy degree from Massachusetts College of Pharmacy. She completed Pharmacy Practice Residency training at the University of Pittsburgh/VA Pittsburgh Healthcare System. 

  1. Hepatitis C. American Academy of Family Physicians.

  2. What Are the Symptoms & Signs of Hepatitis C? American Liver Foundation.

  3. After Treatment Ends. American Liver Foundation.

  4. What Can Happen – Complications of Chronic Hepatitis C. American Liver Foundation.

  5. Hepatitis C FAQs for the Public. Centers for Disease Control.

  6. Gilead Announces Phase 2 Results for Sofosbuvir-Based Regimens in Hepatitis C Patients Before and After Liver Transplantation. Gilead.

  7. What I Need to Know About Hepatitis C. National Institute of Diabetes and Digestive and Kidney Diseases.

  8. Hepatitis C. World Health Organization.

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Last Review Date: 2021 May 9
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.