... HCC. An understanding of the natural history of hepatitis C is essential to effectively manage, treat, and counsel individuals with HCV infection. Key words: Natural history, acute, chronic, ... acute, chronic, hepatitis C, liver fibrosis, cirrhosis, hepatocellular carcinoma, HCV, HCC 1. Introduction Chronic hepatitis C is the most common cause of chronic liver disease and cirrhosis, and ... subtypes have made the search for an HCV vaccine challenging. There is strong evidence demonstrating the association of chronic HCV infection to cirrhosis and hepatocellular carcinoma (HCC)....