Acute vs. Chronic HCV Infection

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Acute vs. Chronic HCV Infection

Acute Hepatitis C infection is the period of time that begins with

the intial infection, and includes the incubation period and the

possible appearance of clinical illness.

Because the hepatitis C virus has the ability to evade the immune

response in many people, about 85 percent of patients with acute HCV

infection develop persistent infection.

Chronic hepatitis C, defined as persistently elevated alanine

aminotransferase (ALT) levels more than 6 months after illness onset,

develops in about 70 percent of cases.

Symptoms of Acute HCV Infection

Not everyone infected with the hepatitis C virus has symptoms of

infection. Studies have shown that 60 to 70 percent of patients with

acute HCV infection have no discernable symptoms.

Approximately 20 to 30 percent of patients may be ill with jaundice.

About 10 to 20 percent of acutely infected people have vague and non-

specific symptoms that can be can be easily mistaken for other

illnesses.

When present, symptoms have been described as " flu-like " and can

include:

Fatigue: a feeling of weariness of exhaustion

Liver pain: discomfort or tenderness in the upper right quadrant of

the abdomen, which may be associated with enlargement of the liver

Nausea and decreased appetite

Pain in muscles and joints.

When patients with acute HCV infection seek medical attention, about

80 percent have elevated levels of bilirubin and alanine

aminotransferase (ALT). Only about 15 percent of patients require

hospitalization.

In rare cases, HCV infection can cause fulminant hepatic failure.

This complication is more likely to occur when patients have other

diseases that impair their immune systems, such as HIV, or have pre-

existing liver disease.

HCV Incubation and the Appearance of Symptoms

Incubation is the period of time between exposure and infection, and

the manifestation of the disease.

The incubation period for newly acquired acute hepatitis C ranges

from two weeks to six months, with an average incubation period of

six to seven weeks.

Blood tests can detect the presence of the HCV virus in blood after 1

to 3 weeks of infection.

By the time symptoms appear, 70 to 80 percent of patients have

detectable antibodies to HCV. HCV antibodies can be detected in

about 90 percent of infected people by 3 months after the appearance

of symptoms.

Ultimately, HCV antibodies become detectable in over 95 percent of

HCV-infected persons.

Although the period of acute HCV infection is variable, one of the

more prominent characteristics features is fluctuating blood levels

of alanine aminotransferase, sometimes by hundreds of units per

week.

Over time, ALT levels can return to normal, but may later be followed

by prolonged, symptomless ALT elevations indicating active chronic

disease.