Chronic Liver Diseases


 Acute Hepatic Failure


 Pediatric Liver Diseases

Viral Hepatitis C ( Hep C; HCV ) leading to Chronic Liver Diseases or Acute Liver Failure

Viral hepatitis C is one of the most important causes of chronic liver disease in the United States. It accounts for about 15% of acute viral hepatitis, 60 - 70% of chronic viral hepatitis, and up to 50% cirrhosis, end-stage liver disease, and liver cancer. 1.6% of the U.S. population, or an estimated 4.1 million Americans, have antibody to HCV (anti-HCV), indicating ongoing or previous infection with the HCV and 3.2 millon people are living with chronic viral hepatitis C. Hepatitis C causes an estimated 10,000 to 12,000 deaths annually in the United States.

Acute Viral Hepatitis C

Acute viral hepatitis varies largely from mild symptoms requiring no treatment to fulminant hepatic failure needing liver transplantation. In younger people acute viral hepatitis is more likely to be asymptomatic. Viral infection accounts for more than 50% of the cases of acute hepatitis in the United States

Chronic Hep C

HCV is one of the most common causes of chronic liver disease in the United States and the most common cause of chronic viral hepatitis. Majority of chronic viral hepatitis patients will remain asymptomatic or mildly symptomatic, abnormal liver blood tests being the only manifestation. At least 75% of people infected with hepatitis C develop chronic hepatitis C.

Incidence of HCV

In the United States, an estimated 3.2 millon people are living with chronic viral hepatitis C. Many do not know they are infected with HCV. Each year an estimated 17,000 persons become infected with viral hepatitis C. About 4 million people in the United States have antibodies to HCV, meaning they have been infected with the hepatitis C virus at some point; as many as half of them do not know they have the infection.

Risk of Viral Hepatitis C

Hep C is among the leading causes of liver cancer and the most common reasons for liver transplantation. It is believed to be the cause of about 15-20% of all cases of acute (new, short term) viral hepatitis and half of all cases of cirrhosis, end-stage liver disease, and liver cancer.

Liver Cirrhosis due to Hep C

Approximately 20% of patients with chronic viral hepatitis C eventually develop liver cirrhosis. Although some patients with liver cirrhosis are asymptomatic, others develop life-threatening complications. The clinical illnesses of chronic viral hepatitis C and liver cirrhosis may take months, years, or decades to evolve.

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Studies and publications on Hep C

  • Armstrong GL, Wasley A, Simard EP, et al. The prevalence of hepatitis C virus infection in the United States, 1999 through 2002. Annals of Internal Medicine. 2006;144:705-714.
  • Conjeevaram HS, Fried MW, Jeffers LJ, et al. Peginterferon and ribavirin treatment in African American and Caucasian American patients with chronic hepatitis C genotype 1. Gastroenterology. 2006;131:470-477.
  • Fried MW, Shiffman ML, Reddy KR, et al. Peginterferon alfa-2a plus ribavirin for chronic hepatitis C infection. New England Journal of Medicine. 2002;347:972-982.
  • Hadziyannis SJ, Sette H Jr, Morgan TR, et al. Peginterferon alfa-2a and ribavirin combination therapy in chronic hepatitis C: a randomized study of treatment duration and ribavirin dose. Annals of Internal Medicine. 2004;140:346-355.
  • Manns MP, McHutchison JG, Gordon SC, et al. Peginterferon alfa-2b plus ribavirin compared with interferon alfa-2b plus ribavirin for initial treatment of chronic hepatitis C: a randomised trial. Lancet. 2001;358:958-965.
  • Strader DB, Wright T, Thomas DL, Seeff LB. Diagnosis, management, and treatment of hepatitis C. Hepatology. 2004;39:1147-1171.
Viral hepatitis C

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