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The Phases of Hepatitis C

Acute Phase

The six month period of time after hepatitis C first enters your body is called the acute phase. Approximately 30 percent of people are able to clear the disease from their body naturally during this time.

During the acute phase, most people experience no symptoms at all, or they develop non-specific symptoms such as appetite loss or fatigue. Only about 20 percent of people who first get the virus develop jaundice.

Since symptoms are usually vague, most people do not know to seek medical help.


It’s important to note that if you are infected with hepatitis C and successfully clear the virus, you are not protected against reinfection.

Chronic Phase

The 70 percent of people whose bodies are unable to fight off the hepatitis C virus during the first six months of infection enter the chronic phase (long-term infection).

Chronic phase is diagnosed after the infection is identified on at least two different hepatitis C virus (HCV) RNA tests. The chance of your body naturally clearing the virus during the chronic phase is highly unlikely.

Nearly 25 to 30 percent of people who reach the chronic phase of hepatitis C will get cirrhosis.


Cirrhosis is a disease that permanently damages and changes the structure of your liver. During this process, healthy liver cells are replaced by scarred tissue.

How Fast Does It Happen?

Cirrhosis doesn’t happen overnight. First, the virus infects your liver cells and causes inflammation in your liver. Inflammation leads to scar tissue building up in your liver (fibrosis). Over time, the liver builds up so much scar tissue that it becomes hard. This hardening of the liver is called cirrhosis.

Liver with cirrhosis.

Liver with cirrhosis.

On average, it takes about 20 to 30 years for significant scarring and hardening of the liver to develop. Factors such as alcohol use and having HIV can accelerate this process.

Why Cirrhosis Is Serious

Cirrhosis makes it difficult for your liver to carry out normal functions (purifying blood, making and storing vital nutrients). If your liver is completely unable to do its job, your disease has progressed to decompensated cirrhosis.

Signs of decompensated cirrhosis:

The five-year survival rate with decompensated cirrhosis is approximately 20 percent. If you have decompensated cirrhosis with symptoms, referral to a liver transplant center is recommended.

Approximately 20 percent of people who get cirrhosis eventually develop liver cancer.

Liver Cancer

Liver cancer caused by hepatitis C is called hepatocellular carcinoma (HCC) and is the third most common cause for cancer-related death in the world. In patients with cirrhosis, the risk of developing HCC is between 2 to 5 percent per year.

In the early stages of liver cancer, there are usually no symptoms. Thus, regular screenings are essential. Tumors in the liver can be detected with a non-invasive ultrasound screening. If you have cirrhosis, we recommend you have an ultrasound screening every six months. Learn more about HCC diagnosis and treatment at UC San Diego.

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