Chronic Hepatitis C: Expert Insights from Dr. Hsu - Gastroenterology and Hepatology

Could you please provide more context or information regarding your question for Dr. Hsu?

Dear Dr.
Hsu,
Hello! You are an authority in the field of liver disease research in our country, and I sincerely appreciate your responses.
I apologize for continuously asking you questions, and I hope you don't mind.
1.
I have seen reports indicating that if hepatitis C infection is not caused by blood transfusion, it is less likely to progress to chronic hepatitis C compared to infections acquired through transfusion.
Is this report accurate? If so, what is the approximate rate of progression to chronic hepatitis C?
2.
If a person is fortunate enough to spontaneously clear hepatitis C, will the antibodies to hepatitis C disappear? If they do disappear, how long does it typically take?
3.
If someone is indeed diagnosed with chronic hepatitis C but has maintained normal liver function for many years, is it possible for them to remain asymptomatic for an extended period? If they are willing to pay for treatment, is it effective? Are the side effects significant?
Dr.
Hsu, I truly appreciate your time in answering these questions.
Thank you very much!

Sally, 40~49 year old female. Ask Date: 2006/10/27

Dr. Xu Jinchuan reply Gastroenterology and Hepatology

Hello! 1.
I have never heard such a statement.
2.
It is possible for it to disappear, but there is no specific timeline for its disappearance.
In Taiwan, there is approximately a 70% chance that an infection with Hepatitis C will progress to chronic Hepatitis C.
3.
There is still such a probability, and the effectiveness of this treatment is not ideal, so it is not encouraged.

Reply Date: 2006/10/27

More Info

Hello! Thank you for your thoughtful questions regarding Chronic Hepatitis C (HCV). I appreciate your interest in understanding this complex condition, and I’m happy to provide insights based on current medical knowledge.

1. Transmission and Chronicity: It is indeed true that the mode of transmission can influence the likelihood of developing chronic Hepatitis C. Studies suggest that individuals who acquire HCV through blood transfusions or intravenous drug use have a higher risk of developing chronic infection compared to those who contract the virus through sexual transmission or other means. The overall rate of progression to chronic Hepatitis C is approximately 55% to 85% for those infected through blood exposure, while the rate is lower for other transmission routes. However, it’s essential to note that individual factors such as age, immune response, and co-infections can also play significant roles in determining whether the infection becomes chronic.

2. Spontaneous Viral Clearance: Some individuals with acute Hepatitis C do experience spontaneous viral clearance, meaning their immune system successfully eliminates the virus without treatment. In such cases, HCV antibodies (Anti-HCV) typically remain detectable for a long time, often for years, even after the virus is cleared. However, there are instances where these antibodies may eventually decline or become undetectable, but this is not common. The timeline for antibody disappearance can vary widely among individuals, and it is not a reliable indicator of viral status.

3. Chronic Hepatitis C with Normal Liver Function: Yes, it is possible for individuals with chronic Hepatitis C to maintain normal liver function for many years without significant inflammation or fibrosis. This condition is sometimes referred to as "inactive chronic Hepatitis C." Regular monitoring of liver function tests (LFTs) and imaging studies is crucial to ensure that the liver remains healthy. If you are considering treatment, it is essential to discuss this with your healthcare provider. Current antiviral therapies, particularly direct-acting antivirals (DAAs), have shown high efficacy rates, often exceeding 95% in achieving sustained virologic response (SVR), which is considered a cure. Side effects can vary, but most patients tolerate these medications well, with common side effects being mild and manageable.

In summary, understanding the nuances of Hepatitis C is crucial for effective management. If you or a loved one is navigating this condition, regular follow-ups with a healthcare provider specializing in liver diseases are essential for monitoring liver health and determining the best treatment options. Thank you for your questions, and I wish you the best in your health journey!

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