Symptoms and Sequelae of Chronic Infection
The persistent immunological attack on chronically infected hepatocytes leads to long-term damage to the liver. This involves:
destruction of hepatocytes, which results in a release of alanine aminotransferase (ALT)
cirrhosis, which is caused by accumulation of fibrous tissue and cannot be cured. The progress of cirrhosis may be stopped if the cause is removed. Compensated cirrhosis occurs when some residual liver function remains, but decompensated cirrhosis occurs when the liver has ceased to function. At this stage patients require a liver transplant
hepatocellular carcinoma, which can be induced directly by activation of oncogenes, or indirectly through chronic liver injury and inflammation
severe liver damage, which eventually results in liver failure and death.