[Clinical aspects, course and extrahepatic manifestations of hepatitis C]

Hepatitis C virus infection occasionally causes acute icteric hepatitis. However, primary infection is usually asymptomatic. Viral clearance occurs only in 20%; most patients develop a chronic hepatitis, which tends to be hardly symptomatic for many years. The risk of progression to cirrhosis, hepatocellular carcinoma and end-stage liver disease is associated with the severity of histopathological changes, and is increased by additional factors, such as excessive alcohol intake or coinfection with hepatitis B virus and HIV. Immunologically mediated extrahepatic manifestations of hepatitis C, in particular essential mixed cryoglobulinemia, can often be observed. Occasionally, they lead to fatal complications.