A diagnosis of chronic hepatitis C means the battle between the virus and the immune system that occurs during the acute stage has finally been won by the virus. It is now highly unlikely that the virus can be cleared without treatment. How the disease then progresses varies significantly from person to person. After many years some people will have minimal liver damage with no scarring while others can progress to cirrhosis (extensive scarring of the liver) within less than ten years. On average it takes about twenty years for significant liver scarring to develop.It is still not known whether chronic hepatitis C infection inevitably leads to cirrhosis. At present it is thought that this is a very likely outcome, although for some people it may take at least 50 years or more. They may well die of other unrelated diseases or conditions before cirrhosis develops. The rate of progression of liver damage cannot be accurately determined by liver enzyme levels, viral load or by genotype.