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475555 tn?1469307939

Disease progression statistics

Does anyone know where I can get some statistics on how many people with hepatitis progress to end-stage liver disease, particularly with reference to genotype, age, ALT/AST, etc.?


80 Responses
Avatar universal
From what I've found it's about 20%...
Try a google search for hcv and cirrhosis.
Avatar universal
Mike 20% sounds WAY too high. The stats that are mentioned in the Center for disease control state about 1-5% die from Hepatitis C.
362971 tn?1201990634
I don't think they really know. HCV is a failrly recent discovery. Most people that have it are in the range of up to about 30 years. Anyone before 1989 is a guess because they couldn't test for it before then.
  I am guessing that I had it for about 30-35 years before treating recently. My Biopsy  said stage 3 about 7 years ago.

446474 tn?1446351282
Of the studies I have seen on this issue (many of them are from 2005, 2003) there are too many unknown factors to be able to predict exactly who will progress to cirrhosis without treatment. And now with the current treatments many people of would have progressed have clear themselves of HVC. Such as...

* Age of patient. (older = faster progression)
* How long have they had the virus.
* Amount of drinking and drugging over the years.
* Grade of liver inflammation over time.
* Genotype. Subtype.
* ALT and ALT level history.
* Coinfection factors.
* Genetic factors? etc. etc.

But here is some info to give a general idea.

The Natural History of Hepatitis C Virus (HCV) Infection
Stephen L. Chen and Timothy R. Morgan
International Journal of Medical Sciences
ISSN 1449-1907 www.medsci.org 2006 3(2):47-52

Progression of Liver Fibrosis
In the setting of persistent hepatitis C viremia, the rate of progression of liver fibrosis varies widely. There have been extensive studies focusing on the natural course
of disease progression from chronic hepatitis C to cirrhosis, HCC, and death. The liver biopsy is the gold standard for the grading and staging of chronic hepatitis
C. The activity of liver disease or grade, is gauged by the number of mononuclear inflammatory cells present in and around the portal areas, and by the number of dead or
dying hepatocytes. The structural liver damage, also known as fibrosis or stage, is variable in chronic HCV infection. Fibrosis implies possible progression to cirrhosis. In mild cases, fibrosis is limited to the portal and periportal areas. More advanced changes are defined by fibrosis that extends from one portal area to another, also known as "bridging fibrosis.”
Cirrhosis develops in approximately 10% to 15% of individuals with chronic HCV infection. There are external and host factors that can increase the risk of progression of liver disease. Multiple studies have shown that chronic alcohol use is a major external risk factor for the progression of chronic hepatitis C to cirrhosis and HCC. Host risk factors include older age at time of infection, male gender, the degree of  inflammation and fibrosis present on the liver biopsy, coinfection with human immunodeficiency virus (HIV) or hepatitis B virus (HBV), and comorbid conditions such as immunosuppression, insulin resistance, non-alcoholic steatohepatitis, hemochromatosis, and schistosomiasis.

Table 2. Risk Factors for Advanced Progression of Liver
Risk Factors
Alcohol consumption ( >30 g/day in males, >20 g/day in females)
Age at time of infection > 40 years
Male gender
Degree of inflammation and fibrosis on liver biopsy
Coinfection with HIV or HBV
Comorbid disease

October 2007
Alan Franciscus, Editor-in-Chief

The term cirrhosis is derived from the Greek term scirrhus and is used to describe the orange or tawny surface of the liver.Chronic hepatitis C infection can lead to liver damage, through the development of fibrosis (scarring) tissue in the liver. After years
or decades of constant assault by the hepatitis C virus, liver fibrosis can become so extensive that the architecture of the liver is altered as a result of excessive scarring, development of small nodules, and changes in liver tissue. This is called cirrhosis. As cirrhosis further develops, scar tissue replaces healthy liver cells and the ability of the
liver to perform its many functions is impaired.
It is important to remember that the majority of people with hepatitis C do not develop cirrhosis. Hepatitis C is a slowly progressive disease and only about 10-25% of people with chronic hepatitis C develop cirrhosis, but this process usually takes many years or decades.

Avatar universal

I think, you are trying to convince yourself that you don't need a treatment.  I think you need to listen to Dr. D's advice and re-think your strategy.

All the best!!
475555 tn?1469307939
Thanks to everyone who posted a reply on this topic. All the info helps in making a decision.

Re Tallahasee's post, I made it clear that my hep MD already told me not to treat now and to wait. If anything, I'm trying to find convincing argumemts for treating, not for not treating. And so far I haven't found them. With less than a 30% chance of eliminating the virus (more like 20% I think), and probably a better-than-70% chance of never developing cirrhosis before I die of old age, not treating now seems like the best course, although I haven't made any decision yet.

Dr. Dieterich's advice is just another opinion, nothing more. I don't recall seeing his name on the "Spokesmen for God" list. The U.S. MDs who are involved in drug trials want everyone to treat so that there are more guinea pigs for the trials and more drug sales by the companies paying them huge sums to conduct those trials. So please don't tell me I should dutifully close my mind and blindly do what I'm told. If I was that type, I'd just not treat at all like my hep MD says instead of looking for more info here.

So, yours truly is still collecting information, trying to think objectively in the face of prejudice and pseudo-science, and generally biding his time while working out a good supplement/nutrient/food strategy.

Thanks again, all!

Avatar universal
Well, % of SVR is all relative.

I was given only 10%
475555 tn?1469307939
Sorry, but could you make that a little clearer? I couldn't understand your last post.


Avatar universal
I heard this on a Vertex webcast.  I believe that it came from the current issue of hepatology, or some professional publication but it was THIS MONTHS, at this point maybe last months issue (I posted it in an alcohol thread but I can't remember the specifics).

They claimed that the old saw about "most will die with HCV not from it is a notion which needs to be reviewed.  It was based on a review of the demographics of the HCV infected population (keep in mind that approximately 2/3rds of us are currently likely undiagnosed) after 20 years.  Only a small amount died; maybe 5% and 16% were cirrhotic.

Fast forward a decade.  The article was about a meta-analysis in which many studies were combined in an effort to get a snapshot or what the HCV infected population looked like after 30 years.

The median age of death was 55 years of age.

After 20 years of infection the rate of cirrhosis was 16%
After 30 years of infection the rate of cirrhosis was 41%.

The death rate has more than doubled in the past decade.

Vertex has made reference to a different study which suggested that given enough time all HCV infected people will end up with cirrhosis; it's just a question of time.  Sorry that I don't have links to either of these studies.

Sooooooo the stats are discouraging.

Now some good news.  I've been told that they expect something like a cure within about 5 years.  There are many new compounds and therapies that are making great strides.  I believe there was also good news on a vaccine in development.  Perhaps the outlook is gloomy if you look into the far future IF we don't treat.  There is a lot of evidence which suggests that we won't have to wait long however.

Avatar universal
The point is

--- you may have 80% of SVR prediction and be unlucky and fall into 20% of re-lapsers/ un-responders.

You never know your response, until you try it.

I would suggest, treat for 3 months and see if you respond (and if you have at least 2 log viral drop).  Also, you don’t know your tolerance level to the treatment, until you try it.

I was always pretty lucky and tolerated well my Interferon treatments.

I was diagnosed in 1995 (was 26 years old) - received degrees, grew professionally and personally and never knew that the side effects can be an obstacle in living your life.

Unfortunately, I was a non-responder -- zero!

I only was responsive to Infergen -- I was on it from 1998 - but I never achieved a SVR until I double dosed daily Infergen (see Magnum's horror Infergen story) for the straight second year of treatment.  I was given only 10% chance to SVR.

Well, now, 1 year later, I'm still UND -- however, since I was a so difficult case -- I was told that I still did not achieve a SVR status-- my Dr. will give this status (hopefully) at 2 years post treatment status.

All I want to do is to encourage you to treatment -- you will never know your response, until you try it.

All the best!!
Avatar universal
I was in clinical trial at Mayo in '96 that helped establish the interferon / riba therapy. 5 million units injected every other day.....now they coat the interferon with a glycol to make it one shot a week and time release.....UND since then. We are still a few years away from an RX therapy - but there are trials going on that promise a lot.....enroll  in a trial or do the therapy.... but don't put it off very long - even if you are asymptomatic there is fibrosis and other damamge going on........
Avatar universal
I know that generally speaking, more than two-thirds of people who have chronic hepatitis C do not progress to cirrhosis over 20 to 30 years.
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