predictors of disease progression

Last reviewed 04/2022

  • Predictors of HCV disease progression include:
    • alcohol consumption
      • alcohol is strongly associated with increased likelihood of progression to severe liver complications
      • progression to cirrhosis is higher in those who drink excessively
      • faster progression is found in those who have previously drunk more than 50 units of alcohol a week for more than five years
    • age at infection
      • patients who acquire hepatitis C at an older age have a more rapidly progressing disease and reduced time from infection to cirrhosis
    • gender
      • men are more likely to progress to cirrhosis than women
    • ethnicity
      • chronic hepatitis C appears to progress less rapidly in African-American patients than non African-American patients
      • the disease may be worse in Asian patients
    • co-infection with human immunodeficiency virus (HIV) or hepatitis A and/or B
      • patients who are also co-infected with either HIV and/or hepatitis B and/or A are likely to progress to serious disease more rapidly
    • viral genotype
      • no effect on disease progression but different genotypes have different sensitivities to therapy
    • weight
      • body mass index above 25 has been associated with hepatic steotosis and, in some studies, more rapid disease progression
    • smoking
      • smoking is an independent risk factor of hepatic inflammation in patients with chronic hepatitis C


  1. RCGP (2007).Guidance for the prevention, testing, treatment and management of hepatitis C in primary care.