Hepatitis C: routes of infection, prevalence, symptoms and treatment
Hepatitis C is a viral disease of the liver, a provoked inflammatory process.Until 1989, the virus of the disease in question was not identified, so in medicine the infection was called "neither A nor B".Hepatitis C often turns into a chronic form of the current, but with timely access to qualified medical help you can completely get rid of the virus.Table of contents: General information on hepatitis C How does hepatitis C virus infection Hepatitis C symptoms Hepatitis C treatment Possible side effects with combination therapy
General information on hepatitis C
The main feature of the virus of the disease under consideration is its unique genetic variability thatIs expressed in the ability to mutations.The science knows 6 major genotypes of the virus, but due to their ability to mutate in the human body, there may be about 40 subspecies of the virus.That is why there is a high incidence of chronic forms of hepatitis C - the human immune system is not able to control the production of the necessary antibodies and while it produces antibodies for some specific subspecies of the virus, their "offspring" with very different antigenic properties are actively formed.
More and more cases of hepatitis C are diagnosed every year, and this active prevalence of the virus is associated with a high level of drug addiction - according to statistics, 40% of people become infected with intravenous drug use.
How does hepatitis C virus infection occur?
Virus infection of the disease in question is possible in a variety of places:
- in salons for tattooing and piercing;
- in medical institutions - applies only to health workers who work with infected blood;
- with blood transfusion - the modern donor service tries to prevent this, but in 4% of cases of hepatitis C infection, infection has occurred in this way;
- during any medical manipulation if the instrument has not been sterilized in a manner to be sterilized.
But most often the infection with the hepatitis C virus occurs with the use of injecting drugs - they become infected due to the use of dirty syringes.
It is believed that the infection of the virus undergoing sexual intercourse is extremely rare, but in 3-5% of cases there is to be.If sexual relations are monogamous, the risk is reduced to almost zero, but with random sex, on the contrary, it rises sharply.There is no information about whether there is a risk of infection with the hepatitis C virus in oral sex.
Please note: infection with the hepatitis C virus never occurs by airborne droplets!If there was a transmission of the virus in the home, then it will necessarily take place the particles of blood from the patient / carrier into the blood of the infected.This can happen, for example, in a cut, open wound or even abrasion.
There are groups of people who have a high risk of contracting hepatitis C:
- injecting drug users;
- those who are on the machine "artificial kidney"( hemodialysis);
- patients with liver disease, unidentified etiology;
- newborns from an infected mother.
Symptoms of hepatitis C
The incubation period( from the moment of infection with the virus to the appearance of the first symptoms of the disease) can be about 14 days, but in some cases the same period lasts 26 weeks.It depends on the individual characteristics of the body - for example, in a person with strong immunity, which leads a healthy and active lifestyle, the incubation period will be longer, and the symptoms will be very poorly expressed.
Hepatitis C can be acute, and then its symptoms will be similar to those of another type of hepatitis( B):
- increased weakness and fatigue;
- indigestion - periodically arising intestinal colic, diarrhea( diarrhea);
- pain in the joints, "aches";
- nausea and vomiting.
Note: despite the similarity of symptoms, there is also a characteristic feature of hepatitis C - when it develops, the patient never has jaundice and hyperthermia( elevated body temperature).
The danger of the hepatitis C virus lies in the fact that in 80% of cases the acute form of hepatitis C becomes chronic, and this is fraught with the development of cirrhosis or liver cancer.The symptomatology of the acute period of the disease in question is usually lubricated, the inflammatory process is of a sluggish character and that is why it is almost never possible to diagnose hepatitis C in an acute form.In addition, there is still no effective vaccine against hepatitis C.But modern medicine can offer a specific course of treatment, which in 75% of cases leads to complete recovery.
Treatment of hepatitis C
Therapy aimed at the destruction of the disease in question has three objectives :
- Decreased intensity or complete elimination of the inflammatory process in the liver.
- Preventing the transformation of hepatitis C into cirrhosis or cancer.
- Significant reduction or complete elimination of the virus in the body.
Hepatitis C, in spite of all the danger, does not always require the initiation of immediate treatment - in 5% of cases, doctors note complete self-healing, which occurs only thanks to a strong / powerful immune system of the body. Only an expert can accurately determine how appropriate to conduct a specific treatment for hepatitis C, and in his choice he will be guided by the following factors:
- age and sex of the patient;
- how much time passed from the estimated time of infection;
- how common is the inflammatory process;
- is there a genetic predisposition to fibroid formation.
Of all the above, the most important factor is the propensity to fibroid - this indicator is the reason for the appointment of treatment or dynamic monitoring of the patient.
There is no single protocol for the treatment of hepatitis C, each case involves an individual approach, but of course there are general principles of therapy.Modern medicine considers the most effective therapy to carry out antiviral treatment of a complex type with Ribavirin and Interferon.These drugs are effective against all hepatitis viruses - they are commongenotypic.Complexity of such complex treatment lies in the fact that many patients do not tolerate Interferon, and the cost of the full course of treatment for hepatitis C, unfortunately, is too high.
Note : many patients who want to save break the course of treatment as soon as symptoms of hepatitis C disappear. But in this case there can be no recovery and no speech, and if the patient in the future makes another attempt to undergo antiviral therapy, thenSuch treatment will be ineffective.
Treatment regimen for patients with hepatitis C:
- daily, or once every three days, Interferon is administered short-acting;
- once a week, patients receive a long-acting dose of Interferon;
- daily the patient should take Ribavirin in the form of tablets.
The course of treatment is 24 or 48 weeks - it all depends on what specific genotype of the virus is in the human body.According to statistics, the success rate of hepatitis C treatment with such a combined therapy is on average 70%.
Note: if the patient has contraindications to the combination therapy, then he is prescribed monotherapy with the use of Alfa-interferon.In this case, the course of treatment will be 12-18 months.
Contraindications to combined treatment of hepatitis C:
- patients of children's age( up to 3 years);
- women in pregnancy;
- Individual intolerance or hypersensitivity to interferon and ribavirin;
- previously diagnosed decompensated diabetes mellitus;
- patients with transplanted organs;
- ischemic heart disease;
- is a chronic obstructive pulmonary disease;
- heart failure;
- increased activity of the thyroid gland( hyperthyroidism).
Possible side effects with combination therapy
This type of treatment for hepatitis C is considered to be the most effective, but at the same time, it is against a background of combination therapy that there may be side effects.
The level of hemoglobin fall is directly related to the dosage of Ribavirin, but at the same time to correct the amount of medication used in a smaller direction is absolutely impossible - the effect of treatment will be low or completely absent.Therefore, when taking combined therapy for hepatitis C, doctors must prescribe to patients the intake of iron preparations.
This side effect is due to the inclusion of pegylated interferon in combination therapy against hepatitis C - this drug can provoke both an increase and a decrease in the activity of the thyroid gland.Throughout the treatment of hepatitis C, physicians must monitor the patient's thyroid gland, the same control is carried out and within 6 months after the end of the course of therapy.Antiviral therapy can lead to irreversible thyroid dysfunction.
This side effect is temporary - once the treatment of hepatitis C is over, the health of the hair is restored.Therefore, doctors do not focus on this moment of attention.
Symptoms identical to influenza
A patient at the beginning of therapy may complain of headache, fever, weakness and "aching" in the muscles.Typically, these symptoms occur within the first 24 hours after the administration of interferon.By the middle of treatment, the symptoms disappear, but you can alleviate the patient's condition in the first few weeks - just enter interferon in the evening( at night).
Difficulty in breathing
With the simultaneous administration of ribavirin and interferon, abnormalities in the respiratory system may occur, which is manifested by difficulties in breathing.As soon as a patient appears on combined antiviral therapy, a cough appears, the doctors immediately perform examinations, thereby excluding pneumonia and fibrosis.Often, labored breathing develops against anemia, which is also a side effect.
Every third patient undergoing therapy for hepatitis C is in a depressed state.He is worried about apathy, insomnia, decreased libido, feelings of hopelessness, irritability, loss of appetite, and even thoughts of suicide.Only a specialist will be able to notice the impending depression in time and prescribe medications that stabilize the patient's condition.Against the backdrop of therapy for hepatitis C, Paxil, Zoloft, Prozac are appointed.
Depression in the patient may not be, but insomnia is considered a frequent side effect in combination antiviral treatment.The patient should immediately report problems with sleep, so that the doctor can adjust his state of health.As a rule, for this it is enough to normalize the regime of the day, eat right, lead an active lifestyle, but in some cases it may be necessary to prescribe medications with hypnotics.
Note: for side effects in combination antiviral therapy for hepatitis C also includes rhinopathy.But such a visual impairment can occur only in the presence of disposable factors - for example, diabetes mellitus or hypertension in an anamnesis.
Several features of hepatitis C treatment:
- Simultaneously with the course of combined antiviral therapy, patients are assigned to receive hepatoprotectors.These drugs protect and repair liver cells( hepatocytes), improve their regeneration.
- During pregnancy, no application of antiviral therapy is out of the question - it is fraught with serious consequences for the pregnant woman and the fetus.Women are assigned only hepatoprotectors and a specially designed diet.If hepatitis C was diagnosed during the period of pregnancy planning, the woman not only undergo a full-fledged treatment, but also recommend postponeing conception - from the moment of full recovery to pregnancy should pass at least 6 months.
- Children under the age of 3 years do not take combined antiviral therapy.They are prescribed hepatoprotectors and diet.
Diet for hepatitis C
In general, there is no special diet for patients with the disease under consideration, but doctors insist on compliance with diet number 5, which is prescribed for pathologies of the gallbladder, biliary tract and liver. The basic principles of nutrition for hepatitis C include:
- You must consume a sufficient amount of fluid - at least 6-8 glasses of water per day.
- From the diet you need to completely eliminate alcoholic beverages, fast foods, canned foods and sweet pastries.
- Do not consume large quantities of foods high in sugar and saturated fat( red meat, whole milk, fried foods).
- The diet should be enriched with cellulose, vegetable oils, nuts.
- To exclude from the menu you need meat broths, spices and condiments, fatty grades of fish and meat, cocoa in any manifestation, sorrel, butter dough, smoked meat.
- To eat better in small portions, but often - a minimum of 5 meals per day.
- The diet should be varied and full.
- You should never go hungry, even just feel hungry.
In addition, doctors insist on getting sick moderate physical exertion - this will help to fight insomnia and depression.You can start with hiking outdoors and daily morning exercises.
To avoid infection with the hepatitis C virus, you must follow the recommendations of specialists:
- Never use other personal care items on which( theoretically) blood may remain( for example, shaving accessories, towels, toothbrushes andetc.
- If you have to undergo some kind of medical manipulation, then be sure to control what tools the doctor is working with - for example, the dentist before the reception can simply ask whether he uses disposable instruments and how the sterilization is going.
- Manicure and tattoo / piercing services should be performed by specialists in equipped offices.Be sure to check that the wizard washed his hands before work and used only sterile / disposable tools.
- When using sexual intercourse, it is advisable to use a condom - this applies only to those who do not have a regular sexual partner.
Hepatitis C is one of quite serious diseases.But it is quite amenable to treatment, in most cases, doctors make favorable predictions.Vaccines from this disease does not exist, but it is only necessary to follow the recommendations for preventive measures to avoid infection with the virus.
Tsygankova Yana Aleksandrovna, medical reviewer, therapist of the highest qualification category