“About 80% of those exposed to the virus develop a chronic infection. Most experience minimal or no symptoms during the initial few decades of the infection, although chronic hepatitis C can be associated with fatigue. Hepatitis C after many years becomes the primary cause of cirrhosis andliver cancer. About 10–30% of people develop cirrhosis over 30 years. Cirrhosis is more common in those co-infected with hepatitis B or HIV, alcoholics, and those of male gender. Those who develop cirrhosis have a 20-fold greater risk of hepatocellular carcinoma, a rate of 1–3% per year, and if this is complicated by excess alcohol the risk becomes 100 fold greater. Hepatitis C is the cause of 27% of cirrhosis cases and 25% of hepatocellular carcinoma worldwide.”