🦠 Acute vs Chronic Hepatitis Progression Simulator

Viral Hepatitis Exposure

Hepatitis virus enters the bloodstream and reaches the liver.

• 60–150: Incubation (Hep B) (days average)
• 14–84: Incubation (Hep C) (days average)
• Liver: Primary target organ (hepatocytes infected)
• 3+: Transmission routes (blood, sexual, perinatal)

How infection begins

Virus particles enter hepatocytes and begin replicating.

Age at exposure matters

Younger age at infection raises chronic Hepatitis B risk.

Virus type matters for C

Hepatitis C often turns chronic regardless of age.

Acute Immune Response

The immune system detects infected hepatocytes and mobilizes.

• Day 30–60: Peak viral load (post-exposure)
• 10–100×: ALT enzyme spike (normal levels)
• ~4–6 wk: T-cell response onset (after exposure)
• ~30%: Symptomatic adult Hep B (jaundice, fatigue)

Cytotoxic T cells activate

CD8+ T cells target infected hepatocytes directly.

Liver inflammation rises

Immune attack elevates liver enzyme levels.

Antibody production begins

B cells start producing neutralizing antibodies.

Clearance or Persistence

Immune strength decides whether the virus is eliminated.

• ~95%: Adult Hep B clearance (rarely chronic)
• ~10%: Infant Hep B clearance (mostly chronic)
• ~20–25%: Hep C clearance (any age) (spontaneous)
• ~75–80%: Chronic Hep C rate (across all ages)

Age drives Hep B outcome

Immature infant immunity favors chronic infection.

Hepatitis C resists clearance

Rapid viral mutation evades antibody responses.

A probabilistic fork

Clearance probability sets which path unfolds.

Acute Resolution

The virus is fully cleared and lasting immunity remains.

• ~95%: Anti-HBs seroconversion (acute adult Hep B)
• ~16 wk: Enzyme normalization (after resolution)
• Yes: Lifelong immunity (for resolved Hep B)
• Very Low: Reinfection risk (protective antibodies)

Virus is eliminated

Hepatocytes clear infection completely within months.

Memory cells remain

Long-lived immune memory prevents future infection.

Liver function recovers

Inflammation subsides and enzymes normalize.

Chronic Progression

Persistent virus drives ongoing liver inflammation and damage.

• ~254M: Chronic Hep B carriers (WHO estimate)
• ~50M: Chronic Hep C carriers (WHO estimate)
• ~20%: Cirrhosis risk (20yr) (untreated chronic cases)
• ~100×: Liver cancer risk (vs uninfected)

Virus persists low-level

Immune system fails to fully eliminate the virus.

Chronic inflammation builds

Ongoing damage gradually causes liver fibrosis.

Long-term risks rise

Cirrhosis and liver cancer risk climb over decades.