These patients have a secondary risk of portal hypertension, liver failure, and other complications. There are significant racial differences with respect to frequency of infection worldwide. In the US, it is more common among members of minority populations. The effect of ethnic background on the risk of developing significant liver disease is undefined. The age at time of initial infection likely has important implications in the natural history of infection, as individuals who are infected at a younger age tend to have a decreased risk of progression to cirrhosis and hepatocellular carcinoma.
Infections are often inapparent or subclinical.
Fatigue is most often reported. Some patients with chronic infection have findings consistent with chronic liver disease such as hepatomegaly, ascites, splenomegaly, and spiders. Direct percutaneous exposure is the primary means of transmission. Blood transfusions Historically, most HCV infections are derived from blood transfusions. Risk of transfusion-borne HCV began to decline in 1986 when surrogate marker screening of blood donors started.