A 38-year-old man from rural India presents with jaundice, dark urine, and right upper quadrant pain. Investigations reveal elevated transaminases (ALT 2800 U/L, AST 2200 U/L), elevated bilirubin, and positive Anti-HCV antibody with detectable HCV RNA. Regarding hepatitis C pathogenesis and natural history, all of the following are true EXCEPT:

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