A study on the clinical spectrum of Hepatitis C virus infection from a tertiary care center in Sub-Himalayan India-spontaneous clearance, a neglected phenomenon.

Hepatitis C virus (HCV) infection has varied clinical manifestations. Noninvasive tools can be useful to assess the severity of liver disease and the rate of spontaneous clearance. HCV infection was determined by antibody or RNA-based tests over a period of 18 months in 8030 samples from the Gastroenterology department. Noninvasive indicators (AST-to-platelet ratio index and fibrosis-4 index) were computed. HCV RNA load was compared with Child-Turcotte-Pugh score. Rate of spontaneous clearance was estimated. About 3.2% of patients were found to have HCV. Fatigue, anorexia, and nausea were the primary complaints followed by ascites and encephalopathy. Extrahepatic features such as autoimmune hepatitis and non-Hodgkin's lymphoma were rare. There was an absence of advanced liver cirrhosis (κ = 0.96) in the majority of cases. Spontaneous HCV resolution was seen in 10.37%.