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Hepatitis C (C) is an inflammation of the liver that occurs due to infection of the human body with a virus (hepatitis C virus). In the process of its reproduction, liver tissue is damaged, cirrhosis and oncological pathologies develop.

What is Hepatitis C?

Hepatitis C is a viral liver disease. He is also called the "affectionate killer". This disease sneaks up on the sly, proceeds without clear signs and leads to dire consequences: liver cancer or cirrhosis.

Sometimes infection with this virus can proceed without any symptoms for several years. But after 15-20 years of inflammatory liver damage, hepatitis C can provoke a destructive change in the liver with a cancerous tumor or.

The virus has an interesting feature. It is constantly changing. Today, there are 11 variants of it - genotypes. But after being infected with one of them, the virus continues to mutate. As a result, up to 40 varieties of one genotype can be identified in a patient.

Virus resistance

The hepatitis C virus does not multiply in cell cultures, which makes it impossible to study in detail its resistance in the external environment, however, it is known that it is slightly more stable than HIV, dies when exposed to ultraviolet rays and can withstand heating up to 50 ° C. Sick people are the reservoir and source of infection. The virus is found in the blood plasma of patients.

Both those suffering from acute or chronic hepatitis C and those with asymptomatic infection are contagious.

You can inactivate an infection (HCV):

  • disinfectant solution (detergents containing chlorine, bleach in a ratio of 1: 100);
  • washing at 60 ° C for 30-40 minutes;
  • boil the item for 2-3 minutes.

Forms

Hepatitis C can take the form of an acute or chronic infectious disease. The acute form can turn into a chronic one (this is more often the case), and the chronic one, in turn, can have exacerbation episodes.

Acute viral hepatitis C

Acute hepatitis C is a viral disease caused by an HCV infection entering the bloodstream and leading to damage and subsequent destruction of the liver. Infection with this virus occurs not only by the parenteral route, since the causative agent of this disease can be found not only in the blood of a sick person, but also in other body fluids (semen, urine, etc.).

Chronic form

Chronic hepatitis C is a viral inflammatory liver disease caused by a blood-borne virus. According to statistics, newly emerging hepatitis C becomes chronic in 75-85% of cases, and it is infection with the C virus that takes the leading place in the number of severe complications.

This ailment is especially dangerous because it can be absolutely asymptomatic for six months or several years, and its presence can only be detected by performing complex clinical blood tests.

How is hepatitis C spread from person to person?

The main route of infection with hepatitis C is through blood, so donors are always tested for the presence of the virus. Small amounts can be found in lymph, saliva, menstrual blood in women, and seminal fluid in men. The virus can live from 12 to 96 hours. The likelihood of infection depends on the intensity of the lesion and the state of the body's immunity.

Due to the difficulties in accumulating a sufficient amount of the test material and the absence of surviving patients, the pathogen has not been fully determined.

After the virus enters the bloodstream, it enters the liver with the blood stream and, thereby, infects its cells, then the process of multiplication of infected cells takes place. This virus mutates and changes its genetic structure with ease.

It is this ability that leads to the fact that his difficult to identify in the early stages.

There are three main routes of transmission of the virus:

  1. blood contact (through blood),
  2. sexual,
  3. vertical (mother to child)

The virus is unstable in the external environment, therefore it is not transmitted by the household route when using common household items, clothes and dishes. The pathogen is contained in blood, semen, vaginal secretions and breast milk, but it does not multiply on the skin and saliva, it is not released into the external environment, therefore, it is impossible to become infected with hepatitis C by airborne droplets or through touch.

Bloodborne transmission of hepatitis C

Transmission of hepatitis C is primarily through blood. Serum and blood plasma of carriers of infection is dangerous even a week before the onset of symptoms of the disease and retains the ability to infect for a long time.

In order for the transmission of infection to occur, a sufficient amount of contaminated blood must enter the bloodstream, therefore the most frequent route of transmission of the pathogen is to introduce it through a needle during an injection.

The first risk group is drug addicts. Also, transmission in this way can be done with:

  • tattoo,
  • piercing,
  • in the process of acupuncture,
  • in hospitals for blood transfusion or other manipulations,
  • when carrying out manicure and pedicure,
  • using common manicure tools,
  • visiting a dental office, with improper observance of the measures for disinfecting instruments.

Sexual transmission

Factors contributing to hepatitis C infection through sexual intercourse:

  • violation of the integrity of the inner surface of the genital tract and oral cavity, their bleeding;
  • inflammatory diseases of the genital organs;
  • sexual intercourse during menstruation;
  • concomitant diseases of the urinary and genital tract, HIV infection;
  • promiscuous sex;
  • the practice of anal sex;
  • traumatic sex in an aggressive manner.

Risk factors

There is a risk of infection during various medical procedures if sterility requirements are not observed. You can get infected in the following situations:

  • various surgical interventions;
  • injection procedures;
  • gynecological manipulations, including abortion;
  • transfusion of blood and its components;
  • diagnostic manipulations with blood sampling;
  • dental procedures;
  • performing manicure, pedicure;
  • stuffing tattoos;
  • unprotected sex with a person with hepatitis;
  • during childbirth and lactation (vertical route of infection from mother to child).

It is also possible to single out certain groups of persons for whom the transfer of this disease is more difficult:

  • people who abuse alcohol;
  • persons with;
  • with chronic liver diseases, as well as with another kind;
  • older persons, as well as children - in these cases, among other things, they may often be contraindicated in full measures of antiviral treatment.

Hepatitis C cannot be transmitted:

  1. airborne droplets when sneezing, talking;
  2. when hugging, touching and shaking hands;
  3. with mother's breast milk;
  4. through food and drink;
  5. while using household items, common dishes, towels.

In extremely rare cases, the household transmission route is recorded, but the condition for the development of the disease is the ingress of the patient's blood into the wounds, abrasions or cuts of a healthy person.

The first signs in men and women

After infection, hepatitis is very secretive. Viruses multiply in the liver, gradually destroying its cells. Moreover, in most cases, a person does not feel any signs of the disease. And since there are no complaints and visits to the doctor, there is no treatment.

As a result, in 75% of cases, the disease becomes chronic, and serious consequences arise. Often, a person feels the first signs of the disease only when cirrhosis of the liver has developed, which cannot be cured.

There is a small list of signs that may indicate the presence of the hepatitis virus:

  • growing weakness;
  • fast fatiguability;
  • asthenia (general weakness of all organs and systems of the body).

Such manifestations are typical for any colds, chronic diseases or poisoning (intoxication). Later, the following may appear:

  • jaundice;
  • the abdomen may increase in volume (ascites);
  • spider veins may appear;
  • lack of appetite;
  • nausea;
  • joint pain (a rare symptom);
  • possibly an increase in the spleen and liver.

In general, we can say that the first signs are symptoms of intoxication and liver dysfunction.

Symptoms of hepatitis C

The incubation period of viral hepatitis C ranges from 2 to 23 weeks, sometimes delaying up to 26 weeks (due to one way or another of transmission). The acute phase of infection in the overwhelming majority of cases (95%) is not manifested by pronounced symptoms, proceeding in an anicteric subclinical variant.

Late serological diagnosis of hepatitis C may be associated with the likelihood of an "immunological window" - a period when, despite the existing infection, antibodies to the pathogen are absent, or their titer is immeasurably small.

In 61% of cases, viral hepatitis diagnosed by laboratory 6 or more months after the first clinical symptoms.

Signs of acute hepatitis C

Most of those infected do not notice any symptoms of the disease at all, so the acute phase is often not diagnosed. The patient may note:

  • exanthema - skin rashes (by type);
  • flu-like syndrome (fever, short-term fever, pain in muscles, joints);
  • general malaise (fatigue, loss of appetite);
  • dyspeptic syndrome (nausea, vomiting, heaviness in the stomach, pain in the right hypochondrium);
  • jaundice syndrome (yellow skin or sclera of the eyes, lightening of feces, darkening of urine);
  • on palpation, there is a moderate increase in the size of the liver, sometimes the spleen.

Chronic Hepatitis C Symptoms

Unfortunately, in 80% of cases, hepatitis C has a primary chronic course. For many years, the disease flows latently, practically not manifesting itself. A person is unaware of his illness, leads a normal life, drinks alcohol, aggravating his condition, has unprotected sex and infects others. The liver function in hepatitis C remains compensated for a long time, but often such imaginary well-being ends in acute liver failure.

For the chronic stage of the disease, the following symptoms (clinical manifestations) are characteristic:

  • general malaise, in which sleep patterns are disturbed;
  • feces become light;
  • you can feel the heaviness and mild pain in the right hypochondrium;
  • a rash appears on the body that looks like an allergy;
  • an increase in body temperature, which occurs periodically throughout the day;
  • appetite is disturbed, there is an aversion to food;
  • Dry and pale skin, hair loss, brittle and flaky nails are the consequences of a lack of vitamins and disorders of iron metabolism, for which the liver is responsible. Often in patients with hepatitis, there is a pronounced deficiency of B vitamins and iron, leading to (anemia).

The hepatitis C virus infects not only the liver, but other organs as well. If a person has been ill for a long time (10 years or more), then he may develop the so-called extrahepatic symptoms of hepatitis C. More than half of these symptoms are associated with cryoglobulinemia - a disease sometimes caused by the hepatitis C virus, in which special proteins are found in the patient's blood - cryoglobulins.

Complications

Complications of hepatitis C:

  • liver fibrosis;
  • steatohepatitis - fatty degeneration of the liver;
  • cirrhosis of the liver;
  • liver cancer (hepatocellular carcinoma);
  • portal hypertension;
  • ascites (an increase in the volume of the abdomen);
  • varicose veins (mainly in internal organs);
  • hidden bleeding;
  • hepatic encephalopathy;
  • accession of a secondary infection - hepatitis B virus (HBV).

With the use of alcoholic beverages, the symptoms increase, and the pathological damage to the liver is accelerated up to 100 times.

Complications can be recognized by the following signs:

  • a severe exacerbation begins, which is characterized by bloating with general weight loss, since water begins to accumulate in the abdominal cavity;
  • the liver becomes scarred (connective tissue);
  • so-called asterisks, venous veins appear on the body.

The appearance of the above signs and changes in the body is a signal to a person that he needs to check himself and start timely treatment.

Diagnostics

The diagnosis is made on the basis of:

  • the presence of data on a possible method of infection - the so-called starting point (it is characteristic that in about half of the infected, the cause of the disease cannot be identified);
  • the presence of specific clinical manifestations (with icteric form);
  • determination of IgM and IgG to HCV;
  • detection of HCV RNA (HCV-RNA) by polymerase chain reaction;
  • changes in the biochemical blood test [increased levels of liver enzymes (ALT, AST), hyperbilirubinemia];
  • positive thymol test.

Treatment of hepatitis C (C) in adults

Successful therapy includes an integrated approach: medicines are combined with folk methods, diet, examinations are regularly carried out, patients monitor physical activity, rest regimen.

Treatment is directed at the following actions:

  • eliminate the virus from the blood;
  • reduce, remove the inflammatory process in the liver;
  • prevent the formation of a tumor, transformation into cirrhosis.

How to treat hepatitis C should be decided by a specialist. He prescribes medications taking into account the individual characteristics of the organism, the genotype of the virus, the severity of the disease.

Why do you need to treat hepatitis C under the supervision of a doctor?

  1. The supervision of a specialist is necessary since there is a risk of activation of the disease with active damage to the liver tissue and extrahepatic lesions - the entire period of carriage of the virus, this threat remains.
  2. The supervision of a specialist includes the determination of liver function tests and blood serology (PCR study of the activity of the infectious process).
  3. If an unfavorable picture of liver tests is detected, or a high viral load (a high level of virus genetic material detected in the blood), then antiviral and hepatoprotective therapy is required because the risk of developing liver cirrhosis is high.

Drugs for treatment

The specificity of hcv therapy depends on a number of factors that can influence a positive or negative result:

  • Patient gender;
  • Age;
  • Duration of the disease;
  • Virus genotype;
  • The degree of fibrosis.

The goal of antiviral therapy is the complete recovery of the patient and the prevention of inflammatory and degenerative lesions: fibrosis, cirrhosis and cancer. Most specialists for the treatment of hepatitis C use double therapy with interferon, aimed at combating HVS, and ribavirin, which accelerates the work of the former.

The patient should receive interferon daily... Another treatment regimen involves the introduction of short-acting interferon every three days and pegelated interferon once a week.

Specific drugs that fight the causative agent of the disease are Ribavirin, Zeffix. The first acts as a means of antiviral therapy, which helps to reduce the concentration of the pathogen in the body by affecting its reproduction.

Pros and cons:

  • The advantage is high efficiency in combination with interferon drugs;
  • the downside is that one of the side effects is dose-dependent.

The choice of the scheme and the duration of the course of treatment is determined by the type of virus, the stage of the disease and the course of the infectious process. The course of combined treatment with interferon + ribavirin lasts an average of 12 months.

No need to self-medicate and use suspicious drugs and drugs. Before using any medicinal product, be sure to check with your healthcare professional. self-treatment can harm your body. Please take this disease seriously.

Diet

The general principles of nutrition for patients are:

  • Providing complete protein (1.0–1.2 g per kg of body weight).
  • An increase in its content at. It is noted that with viral hepatitis C, there is a pronounced fatty degeneration of hepatocytes.
  • Protein restriction in liver failure in the stage of decompensation and threatening coma.
  • Adequate fat content up to 80 g / day.
  • Providing complex carbohydrates (they should be 50% of the energy value) through the use of cereals, cereals, vegetables and fruits.
  • Enrichment of the diet with vitamins (groups B, C, folates).
  • Control of salt content (limited to 8 g, and with edema and ascites - up to 2 g).
  • Inclusion of specialized products in the diet (protein composite mixtures for protein correction of the diet).

To unload the liver, a hepatitis C patient needs to compose his menu so that it does not contain foods that are prohibited for consumption. People with hepatitis are completely prohibited from drinking alcoholic beverages and spicy foods. You also need to give up the consumption of fats of unnatural origin (fats, margarine) and those that are poorly absorbed (lard, palm oil, lard).

Allowed Products
  • meat, fish of dietary grades, high-quality boiled sausage;
  • cereals, pasta;
  • vegetables, fruits, berries;
  • butter, vegetable oil;
  • dairy products with low fat content;
  • eggs - no more than 1 per day (hard-boiled, you cannot fry);
  • sauerkraut (not sour);
  • soups based on vegetables and cereals;
  • natural juices (not sour);
  • rye, wheat bread (yesterday's);
  • green or black weak tea;
  • compotes, jelly;
  • marshmallow, jelly, jam, honey, marshmallows.
Prohibited foods
  • muffins, freshly baked bread;
  • meat broths, soups based on them;
  • canned food,
  • any smoked meats, salinity;
  • salted fish, caviar;
  • fried, hard-boiled eggs;
  • mushrooms;
  • conservation;
  • sour berries, fruits;
  • ice cream;
  • chocolate;
  • alcohol;
  • hot spices, salt in large quantities;
  • fatty dairy products;
  • legumes;
  • sparkling water;
  • margarine, cooking oil, lard;
  • onions, sorrel, garlic, radish, spinach, radish.

Patients should follow Diet No. 5 during remission, and during exacerbation - No. 5A. The range of products of this option corresponds to Diet No. 5, but it contains a more thorough culinary treatment - boiling and mandatory wiping or puréing. The diet is applied for 2-4 weeks, and then the patient is transferred to the main table.

Forecast for a person

Hepatitis C, undoubtedly, can threaten with serious complications, however, favorable prognosis is not excluded with this diagnosis, moreover, for many years the disease may not manifest itself at all. During this period, it does not require any special treatment - the main thing is to ensure appropriate medical supervision. It implies regular checks of liver function, as a result of which, in case of activation of hepatitis, appropriate antiviral therapy is provided.

How long do people live with hepatitis C?

For the general course of hepatitis C, statistics have the following possible outcomes per 100 patients under consideration:

  1. from 55 to 85 patients will face the transition of hepatitis into a chronic form;
  2. for 70 patients, chronic liver disease may become relevant;
  3. from 5 to 20 patients in the next 20-30 years will face the development of cirrhosis of the liver against the background of hepatitis;
  4. from 1 to 5 patients will die as a result of the consequences provoked by chronic hepatitis C (again, this is cirrhosis or liver cancer).

Prophylaxis

Main preventive measures:

  • compliance with personal hygiene measures;
  • handling hands and using gloves when handling blood;
  • rejection of casual, unprotected sexual relationships;
  • refusal to take narcotic drugs;
  • receiving medical, cosmetic services in officially licensed institutions;
  • conducting regular preventive examinations with possible professional contact with blood.

If the household has an HCV-infected person:

  1. Avoid contact of open cuts, abrasions of an infected person with household items in the house, so that his blood does not have the opportunity to remain on those things that other family members use;
  2. Do not use general personal hygiene items;
  3. Do not use this person as a donor.

Hepatitis C is a very dangerous disease, because for a long time it may not show itself in any way. It is important to undergo diagnostics on time and if a virus is found in the blood, it is imperative to start treatment under the supervision of a specialist. Take care of yourself and your health!

More than 500,000 people worldwide suffer from hepatitis C! And this is data without taking into account those people who are not even aware of their illness.

In many cases, the pathology develops imperceptibly, without vivid clinical symptoms. In an instant, the situation can change dramatically when the disease is accompanied by unforeseen complications.

As a rule, such cases end in disastrous ways. If you are interested in the question: “what is the danger of hepatitis C?”, Then the answer can be very sad, because as a consequence of the disease is cirrhosis of the liver or oncodiagnosis.

Hidden enemy: hepatitis C

The form of hepatitis C should be understood as an infectious disease provoked by a virus. It is transmitted through blood.

During the blood flow, the virus enters the cells of the liver organ. There it multiplies rapidly, progressing with renewed vigor.

It should be noted that after conducting a study, scientists were able to come to the conclusion that more than 85 percent of patients with hepatitis C do not even suspect that they have such a serious pathology.

This is due to the fact that the disease does not make itself felt by vivid external signs, while the liver, without stopping, is destroyed.

It is possible that in the remaining 15 percent of sick people feel unwell. They complain of weakness, rapid fatigue, and even suffer from asthenia.

But you must admit that the same symptoms are inherent in other diseases and, taking them into account, it turns out to be very difficult to diagnose hepatitis.

The disease does not stand still. It destroys the liver, and therefore the answer to the question: "is hepatitis C dangerous?" - will always be positive.

This process accelerates alcohol, the consumption of drugs, which contribute to changes in the body. The situation is getting worse with every use of prohibited substances.

Ways of transmission of hepatitis C

It is possible to become infected with the hepatitis C virus in different ways. It can enter the organ through the blood.

The parenteral route is appropriate if non-sterile medical syringes or instruments have been used.

It can be transmitted through cutting household items that are used for nail care, for example, scissors. The virus is widespread among drug addicts.

The sexual transmission of hepatitis C is also not excluded. It passes during intercourse, like HIV or other sexually transmitted pathologies.

The fetus of a pregnant woman can also get sick. This happens when the mother was carrying a child with acute hepatitis.

Fortunately, too many such cases have not been recorded. In 5-10 percent of cases, the baby acquired the disease from the mother while in her womb.

The risks of infection are minimal in hospitals. Doctors mainly use disposable syringes, as well as other other instruments, having previously carried out high-quality sterile treatment, which provides for multistage: washing with soap and soda solution, wiping with disinfectants, sterilizers, etc.

Threatening: Hepatitis C

An infectious agent that attacks the liver causes the organ to begin to die. Some of the cells remain alive, but since the immunity is weak, the body is not able to fully resist pathology.

But is hepatitis C dangerous for organs other than the liver? Yes, it provokes serious tissue changes in the liver, which leads to serious consequences in the entire structure of the body.

There is not a single organ that would not be affected in the future by the means of this virus. Giving an answer to the question of how dangerous hepatitis C is, you need to list all those organs that will subsequently suffer a blow from the virus.

Heart

Pathology will, as it progresses, provoke the development of portal hypertension or cirrhosis of the liver.

In turn, these ailments reduce the rate of systemic blood pressure. This causes the cardiovascular system to be under stress.

Pathology leads to the fact that the patient is diagnosed with the formation of heart failure. The pumping function of the organ will be disabled.

Lungs

In the case of a severe course of pathology, a person may develop cirrhosis of the liver. This ailment contributes to an increase in pressure in the area of ​​the pulmonary artery, which provokes shortness of breath.

Portal hypertension flows into more serious stages of pathology. Abdominal fluid becomes inflamed as it enters the pleural space.

Breathing becomes even more problematic as the bag around the lungs harms the lungs.

Digestive systems

When hepatitis C develops into serious complications, a person begins to lose weight dramatically, he is overcome by vomiting and bouts of nausea.

Cirrhosis provokes bleeding of the rectum or the veins of the esophagus. The affected organ is no longer able to cope with the task of producing albumin protein in the amount that the human body needs.

The result of this process is the exhaustion of the patient. But the worst thing is that against the background of these events, liver cancer can develop.

Kidney

The blood supply to the kidneys will be the result of a decrease in blood pressure. This suggests that the blood filtration capacity will be significantly lower.

This deviation from the norms leads to the development of renal failure. Doctors call this form of pathology hepato-renal syndrome.

Hematopoietic system

A disruption in the work of the coagulation system provokes a serious risk of bleeding.

Similar processes can occur not only from the veins of the esophagus, but also from the arteries of the brain. Anemia and stroke are common with hepatitis C.

Nervous system

In addition to the above complications, the human body will suffer greatly from liver failure. Toxins accumulate in the liver when the organ itself is unable to remove them from its body. After a while, the patient begins to suffer from disorientation. It is possible that he will lose his normal state of thinking, begin to carry delirium, and in some cases a coma may come.

Genitourinary system

Failures in the genitourinary system after hepatitis C are fraught with infertility for the female half of the patients, and impotence for the male.

It should be noted that many of the above pathologies will not be the result of direct exposure to the C virus, but of those complications that hepatitis provokes in the presence of an infection in the body.

There are cases when it does not make itself felt for a long time, proceeding asymptomatically, or does not respond to medical therapy.

Hepatitis C treatment course

In the treatment of hepatitis C, medicine is gaining momentum every year. Modern doctors argue that this form of the disease is treatable, and therefore it is worthwhile to get vaccinated against pathology on time, so that in the future it does not go through a difficult stage of recovery.

If you plan a competent therapeutic therapy in time, then the percentage of recovery will be from 50 to 80. These indicators will vary depending on the type and stage of the disease.

A hepatologist must make a correct diagnosis. For these purposes, the patient will need to undergo a series of tests, thanks to which the specialist will be able to prescribe an effective therapeutic course.

It is possible that in addition to blood tests, it will be necessary to undergo an ultrasound scan, and a biopsy of the liver organ may also be required.

This information will make it possible to draw up a complete picture of the state of the liver, determine the degree of damage and indicate the diagnosis.

Only in this case, you can count on a safe and effective therapeutic therapy, which will soon put the patient on his feet.

If a person has a chronic form of hepatitis C, then there are some other differences. The doctor will have to individually solve the problem, choosing which drugs will be most effective.

Based on many years of practice, we can conclude that 2 drugs called Ribavirin and Interferon are popular with doctors.

The complex effect of these drugs can increase the effectiveness of the treatment course. These are not just words, because special studies have been carried out that have proven that the funds can really be useful in the treatment of hepatitis C.

The danger of an advanced form of hepatitis C is that the disease is difficult to treat. The doctor sets himself the goal of stopping the virus from multiplying.

Such inhibition of the process will reduce the level of recovery and stop the development of fibrosis.

Healthy life predictions

It has already been noted above that the virus can become chronic. To accurately assess the danger of hepatitis C, you need to understand what it threatens when it ends up in the human body.

The likelihood of the degeneration of hepatitis C into cirrhosis or cancer, if there is no proper supportive therapy, is very high.

To say exactly how long a person with hepatitis C will live is possible only by assessing the rate of development of pathology.

This indicator is determined in view of the patient's lifestyle, as well as compliance with the norms of diet therapy.

It is important that the patient removes all bad habits from his lifestyle. These include: the use of alcohol, drugs, smoking.

The thing is that, on the contrary, they act as impulses for the accelerated process of pathology.

It is important that the patient's life be free from worries, anxiety and constant stress.

The psycho-emotional component of the lifestyle is also of great value for the purpose of recovery.

If a person is faced with any nervous shock, then these factors will become levers for starting a mechanism that has an irreversible effect.

In addition, a systematic visit to an infectious disease doctor, as well as routine examinations of patients with hepatitis C should be a part of life.

These measures enable doctors to know exactly about the state of the liver and how the body as a whole is feeling.

If signs of exacerbation of the pathology are identified, then the patient will more quickly oppose the progression of hepatitis C, following the exact instructions of the doctor.

When hepatitis C begins to progress to more severe stages, it is impossible to say for sure. Maybe this will not happen at all.

Here everything will depend on the responsibility of the patient to his health. You must always keep your finger on the pulse, doing everything that the attending physician says. By observing such requirements, the patient gets a chance to live a happy and long life without having problems.

Danger to others

People with hepatitis C do not pose a danger to others. You can shake hands with them, kiss and hug.

The virus cannot be transmitted in this way. But if infection with hepatitis C is observed, then the consequences are really dire.

This is due to the fact that the pathology is hidden. Today, it has not yet been possible to understand what is the main cause provoking the virus.

Carrying out diagnostics in accordance with a simple clinical blood test is complicated, but the task of drawing up a treatment regimen for hepatitis C form will be no less simple.

The contribution to the fight against this pathology is great. In our country, doctors have been fighting hepatitis C for more than 2 decades.

Despite the fact that it is still impossible to cure patients with a chronic form of the disease, one can definitely be proud of the fact that there is a chance to achieve long-term remission.

Thus, the virus enters an inactive phase, removing the risks of complications for the human body. Do not just think that many have managed to bypass this misfortune.

Indeed, in accordance with numerous studies, it was possible to find out that the diagnoses were confirmed in half of the infected people, the same number did not know that they were a threat to others, spreading the virus in the country.

If in the early stages hepatitis C can be completely cured, then in the later stages - the only measure to save the patient will be an organ transplant. This is not only a very risky operation, but also expensive.

Preventive measures

Hepatitis C has a tendency to mutation and reproduction of other subtypes of pathology. It is for this reason that the development of vaccinations remains unfinished.

The non-specific measures to prevent pathology include restrictive actions associated with protection against the penetration of infection into the body. Of course, it is worth making efforts to strengthen the immune system.

Transmission of hepatitis C is observed through contact with body fluids that have absorbed the virus, subcutaneous tissues or wounds.

Based on this information, the main prevention of the disease will be:

  1. Compliance with sanitary and hygienic standards in cases of using the services of medical institutions, beauty salons, dentistry. If possible, it is worth checking that employees of these institutions use disposable syringes and exclusively sterile surgical instruments.
  2. Limiting the number of non-condom-free sex with partners.
  3. Introduce into your daily routine the constant delivery of an analysis for the presence of the hepatitis C virus, if there are environmental conditions of an increased risk of infection.

Experts note that more than 20 percent of cases of penetration of the C virus into the body have an unclear etiology.

Hepatitis has struck even those who lead a healthy lifestyle, did not undergo blood transfusions, organ transplants.

The same problem has affected people who do not have more than one permanent sexual partner and are not interested in drug addiction.

Useful video

It's no secret that in 2014 Hepatitis C received the status completely curable infectious disease. This sensational verdict was made by infectious disease hepatologists from around the world at the annual European Congress on Liver Diseases (EASL).

New treatment protocols demonstrate 99% success, which is equivalent to a complete victory over the virus, as well as a consequence of medical progress. The editors of our site have prepared an article about modern methods of treatment, which will tell you about the benefits of taking new drugs and how to get them.

Causes

The etiology of hepatitis C is based on the presence of a virus and a susceptible organism, subject to the conditions of the infection mechanism. It must be said that this is one of the most persistent infections; it persists for up to 4 days on instruments and surfaces that contaminated blood has come into contact with.

At what temperature does hepatitis C virus die? Boiling destroys it within 2 minutes, and at 60 degrees Celsius it takes about half an hour.

Despite the fact that the virus was discovered more than thirty years ago, the controversy around it still continues. There are adherents of the theory that hepatitis C does not exist. However, the evidence base is the isolation of the RNA of the virus and antibodies to it in the course of specific studies.

According to the International Classification of Diseases (ICD-10), the hepatitis C code is B18.2.

The classification of hepatitis C divides the disease into two forms: acute and chronic. In the acute variant, the symptoms may not be present or they are similar to any other infectious hepatitis. The chronic course has phases such as latent (latent) and vivid clinical manifestations.

What is Hepatitis C? In fact, it is an infection that deliberately chooses the liver as a kind of "target". The pathogen, which has six genotypes, feels great inside hepatocytes (liver cells), and the immune system is powerless to destroy it without destroying at the same time the parenchyma (tissue) of the liver.

Type 1 hepatitis C is common across the globe. This is due to the fact that subsequent variants are most likely the result of mutation - a means of adapting the virus to ways of fighting against it. Type 3 of hepatitis C prevails among drug addicts.

Why is hepatitis C dangerous? First of all, the development of liver cirrhosis - a chronic irreversible process of replacement of the functioning parenchyma with dense fibrous nodes.

The hepatitis C virus has several routes of entry into the body. Among them:

  1. Parenteral. Indicates infection by contact with blood. Its quantity in this case does not matter: just a tiny drop, not distinguishable by the eye, can cause illness.
    Hepatitis C is transmitted during blood transfusions - this is a blood transfusion procedure, and hemodialysis - cleansing the body of metabolic products in case of kidney disease. Blood residues can be found on instruments for medical and non-medical manipulations - surgical and endoscopic examinations, manicure, tattooing, ear piercing and other types of piercing.
    There is a risk even when using someone else's toothbrush or shaving accessories, kissing, if the infected person and his partner have wounds in the mouth. Of course, organ transplantation implies the same possibilities for the transmission of hepatitis C, while transplantation implies immunodeficiency, due to which the infectious process proceeds more difficult and faster.
    One of the most common mechanisms is the entry of the hepatitis C pathogen into the body with the same syringe needle in people who inject drugs.
  2. Sexual. The danger is the discharge (secret) of the glands of the genital organs, abrasions and microtrauma due to damage to the mucous membrane during unprotected intercourse. The hepatitis C virus, as a rule, is contained in a secret in significant quantities only with an active process in the body; during the latency period, hepatitis C is rarely sexually transmitted.
  3. Vertical. This infection of the baby in the womb is transplacental (through the vessels of the uteroplacental blood flow) or during childbirth, when the baby is forced to come into contact with the maternal mucosa and may receive small injuries that open the "entrance gate" of the infection.
    Perhaps this mechanism provides an exhaustive answer to the question: is it possible to have children with hepatitis C? The disease does not affect reproductive function, i.e. the possibility of conception. The degree of viral load is important as a fundamental factor in the likelihood of transmission of the pathogen.
The source of infection can be not only the patient, but also the carrier of hepatitis C.

What it is? Carriage means a condition when the virus is in the blood, but does not cause harm; no symptoms
liver damage. At the same time, it can be transferred to another person, in whose body the disease is activated in full force.

Could hepatitis C be dangerous for family members who use the same household items as the patient? The contact-household route of transmission of this infection is not characteristic, however, with injuries to the oral mucosa, blood can remain on dishes, towels, and a toothbrush, therefore it is undesirable to pass them on to anyone.

What to do if you find hepatitis C? It is necessary to follow the instructions of the attending physician, who, if necessary, will prescribe additional diagnostic tests and select the optimal regimen of antiviral therapy.

Symptoms

The incubation period for hepatitis C lasts from two weeks to six months; The RNA of the virus binds to receptors on the cell surface and penetrates into the hepatocyte. Once under the reliable protection of a membrane impervious to immunity, the pathogen starts the process of replication (copying) and multiplies.

During this time, the course may be asymptomatic; inactive hepatitis C, or the latency period, can last for months and years.

In the presence of immunodeficiency or concomitant liver diseases, it shrinks.

The clinic of hepatitis C is characterized by the following symptoms:

  • constant weakness, fatigue, apathy, depressed mood;
  • decreased or lack of appetite, nausea, vomiting;
  • pain in the abdomen, mainly in the right hypochondrium;
  • enlargement of the liver (hepatomegaly), less often - the spleen (splenomegaly);
  • dark urine, gray feces;
  • yellowing of the skin, mucous membranes and sclera of the eyes;
  • joint pain.

These signs are observed in the acute period. Depressive disorders are quite common in hepatitis C, but they are not a specific mandatory symptom.

Does the liver constantly hurt? The chronic form is accompanied by the formation of cirrhosis and portal hypertension - a syndrome that develops as a result of an increase in pressure in the portal vein.

Then, when examining the patient, one can notice dilated saphenous veins on the anterior abdominal wall, the liver is often enlarged and the person experiences discomfort, pain in the right hypochondrium during exercise or nutritional errors. Serous fluid accumulates in the abdomen - this phenomenon is called ascites.

With fibrogastroduodenoscopy (examination of the gastrointestinal tract with an optical tube), dilated venous vessels of the esophagus and stomach are found. In the later stages, disturbances in the coagulation system are characteristic, since one of the functions of the liver is the synthesis of vitamin K and blood clotting factors.

They manifest themselves as nose, gastrointestinal bleeding of varying severity.

Such complications of hepatitis C indicate irreversible damage to the hepatic parenchyma.

Does hepatitis C give disability and what group? In fact, viral hepatitis with impaired liver function is the reason for this. Clinical and laboratory indicators and the ability to self-service and work are taken into account.

Can you work with hepatitis C? Since the virus is not transmitted through everyday contact, there is no need to limit the patient's activity in society, which includes professional aspects.

Diagnostics

Today, medicine has ample opportunity to confirm hepatitis C.

The carrier is detected only by laboratory data.

Diagnostic methods are divided into nonspecific (reflect the general picture of damage to the liver and the body as a whole) and specific (aimed at detecting the virus or the immune response to its presence):


Sometimes there is such a situation: there are antibodies to hepatitis C, but there is no virus. This is possible if self-healing has occurred - the immune system has managed to overcome the infection. Antibodies indicate that the immune system reacted to the penetration of the pathogen.

A false positive result in the diagnosis of hepatitis C is a very rare but possible occurrence. The reasons may be a violation of the rules for the preparation and study of the material, a banal confusion with test tubes, or the patient deliberately donating blood that is not his own, which is possible with a remote sampling (taking blood outside the walls of the laboratory).

Microbiology, or microbiological diagnostics, is not carried out, since hepatitis C has a viral etiology, and simply does not grow on the nutrient medium used for bacteria.

Treatment

There is an opinion that hepatitis C is incurable. Is this so and how effective are the proposed pharmaceuticals then? Unfortunately, after infection, the virus really cannot be completely eradicated, but modern methods of therapy are able to suppress its replication so much that it will not be detected in the blood.

Positive hepatitis C must be treated, not to completely eliminate (remove) the virus from the body, but to prevent complications.
Cirrhosis in the absence of proper medical care is a threat of liver failure, the consequences of which are very severe in hepatitis C.

How is hepatitis C treated? There are several main groups of medicines used to fight the virus:

  1. Interferons (viferon, alfaferon).
  2. RNA polymerase inhibitors (ribavirin, sofosbuvir).
  3. Protease inhibitors (simeprevir, boceprevir, telaprevir).

The duration of medication is from 16 to 72 weeks, while these drugs are combined for a more effective effect on the virus.

To maintain the liver, hepatoprotectors are also prescribed - substances that stimulate regenerative abilities and help the body to resist the destructive effects of hepatitis C.

Alcohol and its substitutes are incompatible with treatment, the diet implies the rejection of fatty and fried foods, hot spices, synthetic flavors.

Patients complain of constant fatigue, therefore, it is necessary to rationalize the mode of work and rest, engage in strengthening physical exercises, but avoid excessive fatigue.

It is better to consult a doctor and replace or cancel completely hepatotoxic drugs - it is difficult for a weakened liver to cope with an increased load, and the risk of side effects increases tenfold.

There is also a risk for women after menopause.

The type of infection is important - genotype 1 recurs much more often, unlike other variants of the disease, behind this is its high resistance to treatment, which can lead to
insufficient effect on hepatitis C. This should be taken into account when planning the duration of the drug regimen.

Alcohol abuse seriously aggravates and accelerates the onset of the consequences of hepatitis C, since even in uninfected people it leads to the development of cirrhosis.

It cannot be denied that hepatitis C is a serious illness, but nevertheless it is not a death sentence. The main obstacles to quality treatment are its high cost and late diagnosis, when the pathogen is detected already at the stage of liver cirrhosis. The course of hepatitis C, detected in a timely manner, can be slowed down and even interrupted.

Prophylaxis

What to do to avoid getting hepatitis C? Strictly individual use of medical and cosmetic instruments or careful sterilization with proper quality control is required.

When performing procedures involving the risk of the patient's blood or other biological fluid getting on the skin and mucous membranes, medical workers wear gloves, masks and glasses.

Protective equipment must be disposable and destroyed after use according to the existing regulations.

Mandatory use of a condom during sexual intercourse is recommended. This also applies to a regular partner if he has a carrier or a confirmed hepatitis C infection. Pregnant women and women planning to conceive are screened for hepatitis C.

You can find out everything about the risk to a child by consulting an obstetrician-gynecologist.

Hepatitis C is an inflammatory liver disease, it develops under the influence of the hepatitis C virus. An effective vaccine that could protect against this virus simply does not exist in nature, and it will not appear soon.

It is of two types - acute and chronic. In 20% of cases, people with acute hepatitis have a good chance of recovery, and in 80% of cases, the patient's body is not able to overcome the virus itself and the disease becomes chronic.

The transmission of the virus occurs through infection through the blood. Today, there are 150 million people in the world who are carriers of chronic hepatitis C, and 350 thousand patients with hepatitis end in death each year.

Basically, the first symptoms of hepatitis C appear 30-90 days after infection. That is why if you feel unwell, apathy, fatigue and other phenomena that are unusual for your body, then you better consult a doctor. This is necessary in order for the doctor to make an accurate diagnosis, and based on it, choose the most effective treatment.

How is hepatitis C spread?

What it is? Infection occurs mainly through contact with the blood of an infected person. Hepatitis C is also transmitted during medical procedures: collection and transfusion of blood, surgical operations, manipulations at the dentist.

The source of infection can be manicure tools, tattoo devices, needles, scissors, razors, etc. If the skin or mucous membranes are broken, contact with the blood of an infected person can lead to infection.

In rare cases, hepatitis C is transmitted through sexual intercourse. Infected pregnant women have a risk that the baby will also be infected with the virus during childbirth.

The most difficult to tolerate the course of the virus:

  • alcohol abusers.
  • persons suffering from other chronic liver diseases, including others.
  • older people and children.

The disease hepatitis C is not transmitted in everyday contacts through hugs, handshakes; in this disease, you can use shared dishes and towels, but you cannot use shared personal hygiene items (razors, nail scissors, toothbrushes). The disease transmission mechanism is only hematogenous.

Symptoms of hepatitis C

In most situations, viral hepatitis C proceeds slowly, without severe symptoms, remaining undiagnosed for years and already manifesting itself with significant destruction of liver tissue. Often the first time a patient is diagnosed with hepatitis C, when hepatocellular liver cancer is already taking place.

The incubation period for hepatitis lasts from 1 to 3 months. Even after this period, the virus may not manifest itself in any way until the liver lesions become too obvious.

After infection in 10-15% of patients self-healing occurs, the remaining 85-90% develop primarily chronic hepatitis C without any specific symptoms (such as pain, jaundice, etc.). And only in rare cases, patients develop an acute form with jaundice and severe clinical manifestations, which, with adequate therapy, leads to a complete cure of the patient from hepatitis C.

The first signs of hepatitis C in women and men

For a long time, the symptoms practically do not bother patients. In the acute period, the disease manifests itself only as weakness, fatigue, sometimes proceeds under the guise of a respiratory viral infection with pain in muscles and joints. These may be the first signs of hepatitis C in women or men.

Jaundice and any clinical manifestations of hepatitis develop in a very small percentage of those infected (the so-called icteric form of the disease). And this is actually excellent - patients immediately turn to specialists, and the disease has time to be cured.

However, the bulk of the infected carry hepatitis C on their feet: with an anicteric form, they either do not notice anything at all, or blame the malaise on a cold.

Chronic hepatitis

A feature of chronic hepatitis C is a latent or low-symptom course for many years, usually without jaundice. , detection of anti-HCV and HCV RNA in blood serum for at least 6 months are the main signs of chronic hepatitis C. Most often, this category of patients is discovered by chance, during examination before surgery, during medical examination, etc.

The course of chronic hepatitis C can be accompanied by such immune-mediated extrahepatic manifestations as mixed cryoglobulinemia, mesangiocapillary glomerulonephritis, porphyria cutaneous tarda,.

Photo

In the photo, liver damage with prolonged course of hepatitis.

Forms

According to the presence of jaundice in the acute phase of the disease:

  1. Icteric.
  2. Anicteric.

By the duration of the course.

  1. Acute (up to 3 months).
  2. Prolonged (more than 3 months).
  3. Chronic (more than 6 months).

By severity.

  1. Lightweight.
  2. Moderately heavy.
  3. Heavy.
  4. Fulminant.

Complications.

  1. Hepatic coma.
  1. Recovery.
  2. Chronic hepatitis C.
  3. Cirrhosis of the liver.
  4. Hepatocellular carcinoma.

By the nature of the clinical manifestations of the acute phase of the disease, typical and atypical hepatitis C are distinguished. All cases of the disease accompanied by clinically visible jaundice are classified as typical, and anicteric and subclinical forms are atypical.

Stages

The disease is divided into several stages, depending on which treatment is prescribed.

  1. Acute - it is characterized by an asymptomatic course. A person often does not even suspect that he is the carrier of the virus and the source of infection.
  2. Chronic - in the overwhelming majority of cases (about 85%), after the acute stage, a chronic course of the disease begins.
  3. Liver cirrhosis - develops with further progression of pathology. This is a serious disease that threatens the patient's life both in and of itself, and the fact that if it is present, the risk of developing other complications, in particular, liver cancer, increases significantly.

A distinctive feature of the virus is the ability to genetic mutations, due to which approximately 40 HCV subspecies can be simultaneously detected in the human body (within one genotype).

Virus genotypes

The severity and course of the disease depend on the genotype of hepatitis C that infected the body. At the moment, there are six known genotypes with several subtypes. Most often, viruses of 1, 2 and 3 genotypes are found in the blood of patients. They are the ones that cause the most pronounced manifestations of the disease.

In Russia, genotype 1b is most common. Less commonly - 3, 2 and 1a. Hepatitis C caused by genotype 1b virus is characterized by a more severe course.

Diagnosis of hepatitis

The main method for diagnosing hepatitis is to determine the presence of antibodies to the hepatitis C virus (anti-HCV) and HCV-RNA. A positive result from both tests confirms the presence of infection. The presence of antibodies of the IgM class (anti-HCV IgM) makes it possible to distinguish active hepatitis from carriage (when there are no IgM antibodies and ALT is normal).

A PCR test for hepatitis C (polymerase chain reaction) allows you to determine the presence of hepatitis C RNA in the patient's blood. PCR is mandatory for all patients with suspected viral hepatitis. This method is effective from the first days of infection and plays an important role in early diagnosis.

When is hepatitis C more difficult to treat?

According to statistics, it is more difficult to treat hepatitis C in men, people over 40 years old, in patients with normal transaminase activity, with a high viral load, with 1 b virus genotype. Of course, the presence of cirrhosis of the liver at the time of the start of treatment worsens the prognosis.

The effectiveness of antiviral treatment depends on many factors. With a long course of hepatitis C, it is not easy to achieve complete eradication of the virus. The main task is to slow down the process of active multiplication of viruses.

This is possible in most cases with the use of modern antiviral therapy regimens. In the absence of active reproduction of viruses in the liver, the severity of inflammation is reliably reduced, and fibrosis does not progress.

Hepatitis C treatment

In the case of hepatitis C, combination therapy with interferon alpha and ribavirin is considered the standard of care. The first drug is available in the form of a solution for subcutaneous injection under the trademarks Pegasys®, PegIntron®. Peginterferons are taken once a week. Ribavirin is sold under various brand names and is taken as a tablet twice a day.

  1. Interferon alpha Is a protein that the body synthesizes on its own in response to a viral infection, i.e. it is actually a component of natural antiviral defense. In addition, interferon alpha has antitumor activity.
  2. Ribavirin as an independent treatment has low efficiency, however, when combined with interferon, it significantly increases its effectiveness.

The duration of therapy can be from 16 to 72 weeks, depending on the genotype of the hepatitis C virus, the response to treatment, which is largely associated with the individual characteristics of the patient, which are determined by his genome.

A course of antiviral therapy using the "gold standard" can cost a patient from $ 5,000 to $ 30,000, depending on the choice of drugs and treatment regimen. The main costs are for interferon preparations. Foreign-made pegylated interferons are more expensive than conventional interferons of any manufacturer.

In most regions of Russia, treatment is not covered by compulsory medical insurance and is carried out at the expense of regional programs. For example, in Moscow alone, up to 2,000,000,000 rubles are spent annually on the treatment of people with hepatitis C, treating up to 1,500 patients a year. At the same time, 70,000 patients were officially registered in Moscow alone. It turns out that it will take 50 years to cure all of them.

In addition to standard therapy, in 2018, patients with chronic hepatitis C who are not at high risk of death from other causes are recommended interferon-free therapy with direct-acting antiviral drugs (DAAs), for a period of 8 to 24 weeks. Patients at high risk of complications (assessed by the degree of liver damage) should be considered first. At the moment, inhibitors of replication of three non-structural HCV proteins are used in interferon-free AVT regimens: NS3 / 4A protease, NS5A interferon-resistant protein, NS5B polymerase.

The effectiveness of the treatment of hepatitis C is assessed by the biochemical parameters of the blood (decreased activity of transaminases) and the presence of HCV-RNA, by reducing the level of viral load.

New in hepatitis treatment

Despite the fact that AbbVie Inc., consisting of the second generation inhibitors of the viral NS3 and NS5A proteins glecaprevir / pibrentasvir, was registered with the FDA on August 3, 2017, the final, third phase of clinical trials of individual regimens based on Maviret is still ongoing and will last until 2019 In particular, the optimal duration of therapy with glecaprevir / pibrentasvir for acute hepatitis C is being established, and the combination of glecaprevir / pibrentasvir and sophosbuvir is being investigated as a "last resort" therapy for people with multidrug resistance.

The first pangenotypic representatives of the class of non-nucleoside inhibitors of NS5B polymerase GSK2878175 and CC-31244 are undergoing phase I-II clinical trials. Both inhibitors can potentially be used in combination therapy with both DAA classes of other classes and with indirect antiviral drugs.

Maviret was officially registered with the Ministry of Health of the Russian Federation on April 13, 2018, after which he appeared in pharmacies. The average cost of a Mavyret package exceeds 350 thousand rubles, and the price of a standard 8-week course of treatment reaches 600-700 thousand rubles or more.

It is worth noting that treatment standards for people with hepatitis C are changing rapidly. Sofosbuvir, daclatasvir and the combination sofosbuvir / ledipasvir are among the preferred regimens in WHO guidelines and can contribute to 95% cure rates.

Side effects of antiviral therapy

If treatment with interferons is indicated, then side effects cannot be avoided, but they are predictable.

After the first injections of interferon, most people experience the syndrome. After 2-3 hours, the temperature rises to 38-39 0 С, there may be chills, pain in muscles and joints, noticeable weakness. The duration of this condition can be from several hours to 2-3 days. Within 30 days, the body is able to get used to the introduction of interferon, so by this time the flu-like syndrome disappears. Weakness, fatigue persists, but we have to put up with this.

As for Ribavirin, it is usually well tolerated. But quite often in the general analysis of blood, the phenomena of mild hemolytic anemia are noted. There may be phenomena of mild dyspepsia, rarely headache, an increase in the level of uric acid in the blood, very rarely there is an intolerance to the drug.

How many people live with hepatitis C, if not treated

It is very difficult to say unequivocally how many people live with hepatitis C, as well as with HIV infection. In an average number of patients, cirrhosis of the liver may develop in about 20-30 years.

As a percentage, the ratio depending on the age of the person, cirrhosis develops:

  • in 2% of patients infected before the age of 20;
  • in 6% of those who received the virus at the age of 21-30;
  • in 10% of those infected at the age of 31-40;
  • in 37% of cases at 41-50 years old;
  • 63% of those infected are over 50 years old.

Also, most studies have proven that the development of fibrosis depends on gender. In men, this pathology develops much faster and in a more severe form, even if treated.