What You Need to Know about Hepatitis C

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What Is Hepatitis C?

A hepatitis C virus (HCV) causes an inflammatory state of the liver. The illness may be mild in heaviness and lasts few weeks (acute form), or it can last for the whole life (chronic form). Almost 3% of the population is infected with HCV. The disease can pass without any signs or manifest with serious disorders. The danger of the hep. C is that it is recognized quite late, since most of the affected people do not show any signs of illness at all.

How is hepatitis C transmitted?

The presence and proliferation of RNA virus in hepatocytes provoke the hepatic inflammation and the destruction of tissue and cells. HCV can be passed on in blood through:

  • reuse of syringes by IV drug addicts;
  • the multiple uses or imperfect sterilization of medical equipment and tools for making tattoos and piercing;
  • the transfusion of blood products;
  • the sexual intercourse;
  • from a pregnant woman to an infant.

One must remember that a virus cannot be disseminated through tears, milk, saliva and food. Hep. C does not spread through casual contacts, such as shaking hands, hugging or kissing. Usually, the exact source of contagion cannot be detected.

Symptoms of Hepatitis C

Up to 80% of those infected with HCV do not experience any symptoms. The incubation phase lasts 2-24 months. The common hepatitis C symptom is jaundice (when eyes, mucous membranes, and skin become yellow and the urine becomes dark) Fever, tiredness and exhaustion, low appetite, sickness and vomiting, joint ache indicate intoxication. Abdominal pain can be caused by an expanded liver and spleen; sometimes people may have spider-like blood vessels.

Hep. C is characterized by a high activity of liver transaminases even being subclinical. On rare occasions, it happens per acute hep. C in settings with hepatitis B, cirrhosis, and after immunosuppressive therapy in addition to liver transplantation.

How is Hepatitis C Recognized?

Taking into account the fact that the hep. C remains asymptomatic and masked, a significant percentage of incidents are discovered in acute stages. When a viral illness manifests itself and provokes complications, people seek medical help.

The validation of HCV infection includes:

  • Serological test for anti-HCV antibodies;
  • PCR for RNA of the HCV;
  • the recognition of the genotypes of HCV (there are six main types).

The standard anti-HCV test (ELISA) must be confirmed by the recombinant immunoblot test (RIBA) or the detection of the RNA (PCR). As RNA analysis can show false-negative results it should be repeated.

When hep. C is confirmed, tests to indicate the degree and type of liver injury are done. Such tests as Fib-4, Geno-FibroTest, FibroMax, and AST to Platelet Ratio Index, indicate the estimation of fibrosis. Biopsy, US, or magnetic resonance elastography assess the level of hepatic cirrhosis.

Anti-HCV IgM antibodies allow differing ongoing process from carriers.

The chance of getting infected and going through hepatitis C is about 10-20%. A person may become a carrier of the HCV. The virus reproduces itself in hepatic cells, but do not harm the host. There are no complaints and indications of deficiency even in laboratory tests and liver biopsy.

Medical cure

Therapy is not always needed, as 15-45% of infected patients recover without examination and treatment. The purposes of the therapy are to cure a patient, exclude spreading of the virus, normalize the hepatic function, and to avert fibroid induration (cirrhosis) and liver cell carcinoma, and increase the quality of life and chances of survival. Patients with a persistent form of hep. C must be examined for immune bodies to other types of hepatitis (practically A and B) and HIV.

Cure of hep. C infection involves:

  • lifestyle changes;
  • taking medicines.

Lifestyle changes include eating a healthy diet, regular exercises sport, avoiding smoking. The person should have his\her own personal accessories such as washing things, razors, hair removal unit, nail grooming kit and hair picks. Patients with hepatitis C should stop drinking alcohol as it advances the progress of liver insufficiency and may result in coma.

The selection of drugs and regime of treatment depend on the genotype. The answer to antiviral therapy is higher on acute stage. The protocols and regimes of care for hep. C are changing quickly: the most helpful combinations are to be discovered in the WHO protocols and guidelines. Antiviral cure is helpful in 50–90% of cases. It is best to discuss needed measures and drugs with a specialist.

Antiviral drugs can cure the illness, defeat the HCV, and avert cirrhosis or hepatic cancer. Medical cure lasts for 2 months to 2 years. The effectiveness of the drugs is assessed on the basis of the reduction of viral load and the level of hepatic enzymes. Transplantation is the option in case of life-threatening sequelae.

Prevention

The hepatitis C vaccine is not designed. Scientists fail to identify a stable protein, specific for all subspecies of the HCV, to synthesize preventive substances against it. The measures of warning include adhering to the directions for sterilizing/cleaning instruments in health-care settings, the use of barrier contraception sheath during sexual relation, checking of the blood supplies and regular medical checkups.

References:

  1. Manns, Michael P., et al. “Peginterferon alfa-2b plus ribavirin compared with interferon alfa-2b plus ribavirin for initial treatment of chronic hepatitis C: a randomised trial.” The Lancet 358.9286 (2001): 958-965.
  2. Poynard, Thierry, et al. “Randomised trial of interferon α2b plus ribavirin for 48 weeks or for 24 weeks versus interferon α2b plus placebo for 48 weeks for treatment of chronic infection with hepatitis C virus.” The Lancet 352.9138 (1998): 1426-1432.
  3. Knodell, Robert G., et al. “Formulation and application of a numerical scoring system for assessing histological activity in asymptomatic chronic active hepatitis.” Hepatology 1.5 (1981): 431-435.

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