Hepatitis C is chiefly transmitted via blood. Transfusion and sharing needles is the commonest mode of transmission. Vertical transmission occurs in 5% of babies born to Hepatitis C positive mothers.

Chronic HCV infection develops in most persons (75%-85%) who get the acute disease.

Most studies have reported that cirrhosis develops in 10%-20% of persons with chronic hepatitis C over a period of 20-30 years, and HCC in 1%-5%

increased alcohol intake, being aged greater than 40 years at infection, and being male are associated with more severe liver disease

Extra-hepatic manifestations of chronic HCV infection are considered to be of immunologic origin and include cryoglobulinemia, membrano-proliferative glomerulonephritis, and porphyria cutanea tarda.

Antiviral therapy is recommended for patients with chronic hepatitis C who are at greatest risk for progression to cirrhosis. These persons include anti-HCV-positive patients with persistently elevated ALT levels, detectable HCV RNA, and a liver biopsy that indicates either portal or bridging fibrosis or at least moderate degrees of inflammation and necrosis. (Making a liver biopsy almost necessary to do before treating)

Alpha-interferon and Ribavirin, used together have demonstrated a substantial increase in sustained response rates, reaching 40%-50%, compared with response rates of 15%-25% with interferon alone