What is hepatitis C and how does it affect the liver. How is hepatitis C transmitted and who is at risk. What are the differences between acute and chronic hepatitis C. How common is hepatitis C in the United States. What are the long-term health consequences of chronic hepatitis C.

Understanding Hepatitis C: An Overview of Liver Inflammation

Hepatitis C is a specific type of liver inflammation caused by the hepatitis C virus (HCV). To fully grasp the nature of this condition, it’s essential to understand what hepatitis means in general.

Hepatitis refers to inflammation of the liver, which can be triggered by various factors, including:

• Excessive alcohol consumption
• Exposure to certain toxins
• Some medications
• Specific medical conditions
• Viral infections

While multiple factors can lead to hepatitis, viral infections are among the most common causes in the United States. The three primary hepatitis viruses are:

1. Hepatitis A virus (HAV)
2. Hepatitis B virus (HBV)
3. Hepatitis C virus (HCV)

Each of these viruses can cause liver inflammation, but they differ in transmission methods, disease progression, and long-term effects on liver health.

How does hepatitis C differ from other forms of viral hepatitis?

Hepatitis C has several distinguishing features when compared to hepatitis A and B:

• Duration: While hepatitis A is typically a short-term infection, hepatitis C can become chronic in many cases.
• Vaccination: Vaccines are available for hepatitis A and B, but there is currently no vaccine for hepatitis C.
• Transmission: Hepatitis C is primarily spread through blood-to-blood contact, whereas hepatitis A is often transmitted through contaminated food or water, and hepatitis B can be spread through various bodily fluids.

The Nature of Hepatitis C: Acute vs. Chronic Infection

Hepatitis C infections are categorized into two main types: acute and chronic. Understanding the difference between these two forms is crucial for proper diagnosis and treatment.

What characterizes acute hepatitis C?

Acute hepatitis C refers to the initial stage of infection, occurring within the first six months after exposure to the virus. During this phase, some individuals may experience mild symptoms or no symptoms at all, making detection challenging.

How often does acute hepatitis C progress to chronic infection?

Unfortunately, more than half of those infected with HCV will develop a chronic infection. This means that the virus persists in the body beyond the six-month mark, potentially leading to long-term liver damage if left untreated.

Can hepatitis C resolve without treatment?

While it is possible for the body to clear the hepatitis C virus without medical intervention, this occurs in less than half of infected individuals. The reasons why some people naturally eliminate the virus while others develop chronic infections are not fully understood by medical experts.

The Prevalence of Hepatitis C in the United States

Understanding the prevalence of hepatitis C is crucial for public health efforts and individual awareness. Let’s examine the current statistics for both acute and chronic cases in the United States.

How common are new hepatitis C infections in the US?

In 2018, 3,621 cases of acute hepatitis C were reported to the Centers for Disease Control and Prevention (CDC). However, this number likely underestimates the true incidence of new infections. Due to the often asymptomatic nature of acute hepatitis C, many cases go undiagnosed and unreported. The CDC estimates that the actual number of acute hepatitis C cases in 2018 was closer to 50,300.

What is the estimated prevalence of chronic hepatitis C in the US?

As of 2016, an estimated 2.4 million people were living with chronic hepatitis C in the United States. This significant number underscores the importance of awareness, prevention, and access to treatment for this potentially serious condition.

Transmission Routes: How Hepatitis C Spreads

Understanding how hepatitis C is transmitted is crucial for prevention efforts and identifying at-risk populations. The hepatitis C virus is primarily spread through blood-to-blood contact with an infected individual.

What are the most common ways hepatitis C is transmitted?

The following are the primary routes of hepatitis C transmission:

1. Sharing drug injection equipment: This is currently the most common mode of transmission in the United States.
2. Mother-to-child transmission: Approximately 6% of infants born to infected mothers contract hepatitis C.
3. Healthcare exposures: While uncommon, infections can occur when proper infection control procedures are not followed.
4. Sexual contact: Although less common, hepatitis C can spread during sexual activity, particularly among men who have sex with men.
5. Unregulated tattoos or body piercings: Using non-sterile equipment in unlicensed facilities can lead to transmission.
6. Sharing personal items: Objects like razors, nail clippers, or toothbrushes that may have come into contact with infected blood can potentially spread the virus.

Is hepatitis C transmitted through casual contact?

It’s important to note that hepatitis C is not spread through casual contact such as hugging, sharing eating utensils, or breastfeeding. This knowledge can help reduce stigma and unnecessary fear surrounding the condition.

Historical Context: Blood Transfusions and Organ Transplants

Prior to 1992, blood transfusions and organ transplants posed a significant risk for hepatitis C transmission. However, the implementation of widespread screening of the blood supply has dramatically reduced this risk.

How has the risk of hepatitis C transmission through blood products changed over time?

Today, the risk of contracting hepatitis C through blood transfusions or organ transplants is extremely low due to rigorous screening protocols. This development represents a major advancement in preventing the spread of the virus through medical procedures.

The Serious Nature of Chronic Hepatitis C

While acute hepatitis C can resolve on its own in some cases, chronic hepatitis C poses significant health risks if left untreated. Understanding these potential complications is crucial for emphasizing the importance of early detection and treatment.

What are the potential long-term consequences of chronic hepatitis C?

Chronic hepatitis C can lead to several serious health issues, including:

• Liver damage
• Cirrhosis (scarring of the liver)
• Liver cancer
• Liver failure
• Death

In fact, hepatitis C is the most common reason for liver transplantation in the United States, highlighting the severe impact it can have on liver function.

How many deaths are attributed to hepatitis C annually?

In 2018, the CDC reported 15,713 deaths related to hepatitis C virus. However, this figure is believed to be an underestimate of the true impact of the disease. The potential for underreporting emphasizes the need for improved surveillance and awareness of hepatitis C-related mortality.

Prevention and Treatment: Addressing Hepatitis C

Given the serious nature of chronic hepatitis C, prevention and early treatment are crucial. While there is currently no vaccine available for hepatitis C, there are effective treatments that can cure the infection in most cases.

What are the key strategies for preventing hepatitis C transmission?

Prevention strategies for hepatitis C include:

• Avoiding sharing needles or other drug injection equipment
• Ensuring proper infection control practices in healthcare settings
• Using protection during sexual activity, particularly for high-risk groups
• Only getting tattoos or piercings from licensed facilities using sterile equipment
• Avoiding sharing personal items that may come into contact with blood

How effective are current treatments for hepatitis C?

Modern antiviral treatments for hepatitis C are highly effective, with cure rates exceeding 95% for most genotypes of the virus. These treatments typically involve a course of oral medications taken over 8-12 weeks, with minimal side effects compared to older interferon-based therapies.

The Importance of Testing and Early Detection

Given that many people with hepatitis C may not experience symptoms, especially in the acute phase, regular testing for at-risk individuals is crucial for early detection and treatment.

Who should be tested for hepatitis C?

The CDC recommends hepatitis C testing for:

• All adults aged 18 years and older, at least once in their lifetime
• All pregnant women during each pregnancy
• People who inject drugs or have ever injected drugs
• People with HIV
• People who receive maintenance hemodialysis
• People with persistently abnormal liver enzyme levels

By promoting widespread testing and early detection, public health efforts aim to reduce the burden of chronic hepatitis C and its associated complications.

What is Hepatitis C – FAQ

Overview and Statistics

What is hepatitis?

Hepatitis means inflammation of the liver. When the liver is inflamed or damaged, its function can be affected. Heavy alcohol use, toxins, some medications, and certain medical conditions can all cause hepatitis. However, hepatitis is often caused by a virus. In the United States, the most common hepatitis viruses are hepatitis A virus, hepatitis B virus, and hepatitis C virus.

What is the difference between hepatitis A, hepatitis B, and hepatitis C?

Hepatitis A, hepatitis B, and hepatitis C are liver infections caused by three different viruses. Although each can cause similar symptoms, they are spread in different ways and can affect the liver differently. Hepatitis A is usually a short-term infection. Hepatitis B and hepatitis C can also begin as short-term infections, but in some people, the virus remains in the body and causes chronic (long-term) infection. There are vaccines to prevent hepatitis A and hepatitis B; however, there is no vaccine for hepatitis C.

The page “What is viral hepatitis?” explains in detail the differences between hepatitis A, hepatitis B, and hepatitis C.

What is hepatitis C?

Hepatitis C is a liver infection caused by the hepatitis C virus. Hepatitis C can range from a mild illness lasting a few weeks to a serious, long-term illness. Hepatitis C is often described as “acute,” meaning a new infection, or “chronic,” meaning long-term infection.

• Acute hepatitis C occurs within the first 6 months after someone is exposed to the hepatitis C virus. Hepatitis C can be a short-term illness, but for most people, acute infection leads to chronic infection.
• Chronic hepatitis C can be a lifelong infection if left untreated. Chronic hepatitis C can cause serious health problems, including liver damage, cirrhosis (scarring of the liver), liver cancer, and even death.

How serious is chronic hepatitis C?

Chronic hepatitis C can be a serious disease resulting in long-term health problems, including liver damage, liver failure, cirrhosis, liver cancer, and even death. It is the most common reason for liver transplantation in the United States. There were 15,713 deaths related to hepatitis C virus reported to CDC in 2018, but this is believed to be an underestimate.

How likely is it that someone with acute hepatitis C will become chronically infected?

More than half of people who become infected with hepatitis C virus will develop a chronic infection.

Is it possible for someone with hepatitis C to get better without treatment

Yes. However, less than half of people who are infected with the hepatitis C virus clear it from their bodies without treatment. Experts do not fully understand why this happens for some people.

How common is acute hepatitis C in the United States?

In 2018, a total of 3,621 cases of acute hepatitis C were reported to CDC. Since many people do not have symptoms, they don’t seek care from a health provider and don’t get diagnosed with this infection. These cases aren’t reported to public health authorities and aren’t counted in yearly totals. CDC believes the actual number of acute hepatitis C cases in 2018 was probably closer to 50,300.

How common is chronic hepatitis C in the United States?

In 2016, an estimated 2.4 million people were living with hepatitis C in the United States.

Transmission / Exposure

How is hepatitis C spread?

The hepatitis C virus is usually spread when someone comes into contact with blood from an infected person. This can happen through:

►Sharing drug-injection equipment.

Today, most people become infected with hepatitis C by sharing needles, syringes, or any other equipment used to prepare and inject drugs.

►Birth.

Approximately 6% of infants born to infected mothers will get hepatitis C.

►Health care exposures.

Although uncommon, people can become infected when health-care professionals do not follow the proper steps needed to prevent the spread of bloodborne infections.

►Sex with an infected person.

While uncommon, hepatitis C can spread during sex, though it has been reported more often among men who have sex with men.

►Unregulated tattoos or body piercings.

Hepatitis C can spread when getting tattoos or body piercings in unlicensed facilities, informal settings, or with
non-sterile instruments.

►Sharing personal items.

People can get infected from sharing glucose monitors, razors, nail clippers, toothbrushes, and other items that may have come into contact with infected blood, even in amounts too small to see.

►Blood transfusions and organ transplants.

Before widespread screening of the blood supply in 1992, hepatitis C was also spread through blood transfusions and organ transplants. Now, the risk of transmission to recipients of blood or blood products is extremely low.

Hepatitis C is not spread by sharing eating utensils, breastfeeding, hugging, kissing, holding hands, coughing, or sneezing. It is also not spread through food or water.

Can you get hepatitis C more than once?

Yes. You can be infected again even if you have cleared the virus or were successfully treated and cured. This is why people who currently inject and share needles, syringes, or other drug preparation equipment, along with those who receive maintenance hemodialysis, should be tested for hepatitis C on a regular basis.

Can hepatitis C virus be spread through sexual contact?

Yes, but the risk of transmission from sexual contact is believed to be low. The risk increases for men who have sex with men and for people who have multiple sex partners, have a sexually transmitted disease, engage in rough sex, or are infected with HIV.

Can you get hepatitis C by getting a tattoo or piercing?

Research has not shown that hepatitis C is spread within licensed, commercial tattooing facilities. However, transmission of hepatitis C (and other infectious diseases) is possible at facilities that don’t take the necessary measures to control infections during tattooing or piercing. Unregulated tattooing and piercing occurring in prisons and other informal settings may put a person at risk of infection.

Can hepatitis C be spread within a household?

Yes, but this does not occur very often. If hepatitis C virus is spread within a household, it is most likely a result of direct, through-the-skin exposure to the blood of an infected household member.

Who is at risk for hepatitis C?

The following people are at increased risk for hepatitis C:

• People who use injection drugs or did so in the past, even those who injected only once many years ago
• People with HIV infection
• People with certain medical conditions, including those who ever received maintenance hemodialysis and those with persistently abnormal alanine aminotransferase (ALT) levels (an enzyme found within liver cells).
• People who have received transfusions or organ transplants, including those who
  • received clotting factor concentrates produced before 1987
  • received a transfusion of blood or blood components before July 1992
  • received an organ transplant before July 1992
  • were notified that they received blood from a donor who later tested positive for hepatitis C virus infection
• Health care, emergency medical, and public safety personnel who have been exposed to the blood of someone who has hepatitis C (through needle sticks, sharps, or mucosal exposures)
• Children born to mothers who have hepatitis C

Can a person be infected with both HIV and the hepatitis C virus?

Yes. A person can be “coinfected” with both HIV and the hepatitis C virus. People who are coinfected are more likely to get cirrhosis as a result of their chronic hepatitis C infection. To learn more about coinfection, read HIV and Viral Hepatitis.

What is the risk of a pregnant woman passing hepatitis C to her baby?

Of every 100 infants born to mothers with hepatitis C, about six will become infected with the hepatitis C virus. However, the risk is greater if the mother has both HIV and hepatitis C.

Can women with hepatitis C breastfeed their babies?

Yes. There is no evidence that breastfeeding spreads hepatitis C, so infected women can safely breastfeed their babies. However, women with cracked or bleeding nipples should stop nursing temporarily until their nipples have healed. Hepatitis C is spread through contact with blood, and not enough is known about whether this practice is safe.

Can I get hepatitis C from a mosquito or other insect bite?

No. The hepatitis C virus has not been shown to be transmitted by mosquitoes or other insects.

Can I donate blood if I have tested positive for hepatitis C?

The American Red Crossexternal icon does not accept blood donations from anyone who has ever tested positive for hepatitis C or from anyone with current signs or symptoms of hepatitis.

Can someone with hepatitis C donate organs?

According to the U.S. Department of Health & Human Service’s online information on organ donation and transplantationexternal icon, very few conditions would prevent someone from being an organ, eye, or tissue donor. Even with acute or chronic hepatitis C, you may be able to donate your organs or tissues. The transplant team will determine what organs or tissue can be used based on a clinical evaluation, medical history, and other factors.

Symptoms

What are the symptoms of acute (new) hepatitis C?

Many people newly infected with the hepatitis C virus don’t have symptoms, don’t look or feel sick, and therefore don’t know they are infected. For people who develop symptoms, they usually happen 2–12 weeks after exposure to the hepatitis C virus and can include yellow skin or eyes, not wanting to eat, upset stomach, throwing up, stomach pain, fever, dark urine, light-colored stool, joint pain, and feeling tired.

What are the symptoms of chronic (long-term) hepatitis C?

Most people with chronic hepatitis C don’t have any symptoms or have only general symptoms like chronic fatigue and depression. Many people eventually develop chronic liver disease, which can range from mild to severe and include cirrhosis (scarring of the liver) and liver cancer. Chronic liver disease in people with hepatitis C usually happens slowly, without any signs or symptoms, over several decades. Chronic hepatitis C virus infection is often not recognized until people are screened for blood donation or from an abnormal blood test found during a routine doctor’s visit.

Can a person spread hepatitis C without having symptoms?

Yes. If you are infected with the hepatitis C virus, you can spread it to others even if you have no symptoms.

Tests

Who should get tested for hepatitis C?

CDC recommends hepatitis C testing for:

• Are 18 years of age and older (get tested at least once in your lifetime)
• Are pregnant (get tested during each pregnancy)
• Currently inject drugs (get tested regularly)
• Have ever injected drugs, even if it was just once or many years ago
• Have HIV
• Have abnormal liver tests or liver disease
• Are on hemodialysis
• Received donated blood or organs before July 1992
• Received clotting factor concentrates before 1987
• Have been exposed to blood from a person who has hepatitis C
• Were born to a mother with hepatitis C

Should anyone be tested for hepatitis C more than once?

Yes. Regular testing is recommended for people who currently inject and share needles, syringes, or other drug preparation equipment and for those currently getting maintenance hemodialysis.

If I am pregnant, should I be tested for hepatitis C?

Yes, hepatitis C testing is recommended during every pregnancy.

What tests are used to diagnose someone with hepatitis C?

A blood test, called an HCV antibody test, is used to find out if someone has ever been infected with the hepatitis C virus. This test, sometimes called the anti-HCV test, looks for antibodies, which are proteins released into the bloodstream when someone gets infected with the virus that causes hepatitis C. People who have positive HCV antibody tests are given a follow-up HCV RNA test to learn whether they have active infection.

When should I expect to get my test results?

Test results can take anywhere from a few days to a few weeks to come back. Rapid anti-HCV tests are available in some health clinics, and the results of these tests are available in 20–30 minutes.

How are hepatitis C test results interpreted?

Your doctor will help interpret the results from your HCV antibody test and help guide you through next steps. The test can be “non-reactive,” or “negative,” meaning that you are not currently infected with the hepatitis C virus.  The test can also be “reactive,” or “positive,” which means you have been infected with the hepatitis C virus at some point in time. It is important to know that

• Once you have been infected, you will always have antibodies in your blood. This is true if you have cleared the virus, have been cured, or still have the virus in your blood.
• A reactive, or positive, antibody test does not necessarily mean that you currently have hepatitis C, so a follow-up test is needed.

What should I do if the HCV antibody test is reactive?

• If the antibody test is reactive or positive, you need an additional test to see if you currently have hepatitis C. This test is called a nucleic acid test (NAT) for HCV RNA, but it can also be called a PCR test.
• If the nucleic acid test for HCV RNA (or PCR test) is:
  • Negative – this means you were infected with hepatitis C virus, but the virus is no longer in your body because you were cured or cleared the virus naturally.
  • Positive – this means you currently have the virus in your blood and are infectious, meaning you can spread the virus to others.
• If you have a reactive antibody test and a positive NAT for HCV RNA, you need to talk to a doctor about treatment. Treatments are available that can cure most people with hepatitis C in 8–12 weeks.

How soon after exposure to the hepatitis C virus can a test tell if someone is infected?

After exposure to the hepatitis C virus, it can take 8–11 weeks for an HCV antibody test to be positive. For most people who are infected, the anti-HCV blood test will become positive by 6 months after exposure. A special kind of blood test called a nucleic acid test (NAT) that detects HCV RNA (also called a PCR test) can tell if a person is infected within 1–2 weeks of exposure.

Can a person have normal liver enzyme level and still have hepatitis C?

Yes. For people with hepatitis C, it is common for liver enzyme levels to go up and down, sometimes returning to normal or near normal. Some people with hepatitis C have liver enzyme levels that are normal for over a year even though they have chronic liver disease.

Treatment

What is the treatment for hepatitis C?

Treatment is recommended for all people, including non-pregnant women, with acute or chronic hepatitis C (including children aged ≥3 years and adolescents). Current treatments usually involve just 8–12 weeks of oral therapy (pills) and cure over 90% with few side effects. The FDA has a list of currently approved FDA treatments for hepatitis C.external icon

 What can people with chronic hepatitis C do to protect the liver?

People with chronic hepatitis C and those with cirrhosis (even if they have been cured of their hepatitis C infection) should be monitored regularly by a doctor, because these people have a continued risk of complications of advanced liver disease, including liver cancer. In addition, people living with hepatitis C should

• be vaccinated against hepatitis A and hepatitis B
• avoid alcohol because it can cause additional damage to the liver
• check with their doctor before taking any prescription pills, herbs, supplements, or over-the-counter medications, as these can potentially damage the liver
• be tested for HIV, because people who have both infections are more likely to get cirrhosis

Prevention

Is there a vaccine that can prevent hepatitis C?

No. Currently, there is no vaccine to prevent hepatitis C.

Hepatitis C and Employment

Should a person infected with the hepatitis C virus be restricted from working in certain jobs or settings?

CDC’s recommendations for prevention and control of the hepatitis C virus infection state that people should not be excluded from work, school, play, child care, or other settings because they have hepatitis C virus infection. There is no evidence that people can get hepatitis C from food handlers, teachers, or other service providers without blood-to-blood contact.

Why isn’t there a hepatitis C vaccine?

My children received vaccines for hepatitis A and B. Why isn’t there a vaccine for hepatitis C?

Answer From Stacey A. Rizza, M.D.

Efforts to develop a hepatitis C vaccine started more than 30 years ago, when the hepatitis C virus was identified. Since then, researchers have studied several potential vaccines in animals. Some of these vaccines, developed mainly in the past decade, have undergone limited testing in people.

One ongoing clinical trial includes:

• A therapeutic vaccine trial. Researchers are testing a vaccine therapy on people who already have chronic hepatitis C. The purpose is to determine if the vaccine can help the body build an immune response and thereby treat the hepatitis C infection. It will also determine if the vaccine is safe and able to protect against future infection.

  If this trial has good results, larger trials will be necessary to verify this effect and determine the best way to deploy the vaccine.

Progress on developing a successful vaccine has been slow for a number of reasons, including:

The unique characteristics of the virus

The hepatitis C virus is more variable than hepatitis A and hepatitis B viruses. Hepatitis C occurs in at least seven genetically distinct forms (genotypes) with multiple subtypes. About 60 subtypes have been identified.

Different genotypes cause infections in different parts of the world. A global vaccine would have to protect against all variants of the virus.

Limited animal models of hepatitis C infection

A hepatitis C infection in chimpanzees is similar to an infection in humans. However, ethical and cost concerns limit medical research with these animals.

Although researchers are still working to develop an effective vaccine, new medications can cure nearly everyone who is infected with hepatitis C.

With

Stacey A. Rizza, M.D.

• Acute hepatitis C infection
• Early hepatitis C infection: How often does it become chronic?

Oct. 28, 2020

Show references

1. Chopra S. Characteristics of the hepatitis C virus. https://www.uptodate.com/contents/search. Accessed Oct. 7, 2020.
2. Sepulveda-Crespo D, et al. Hepatitis C virus vaccine design: Focus on the humoral immune response. Journal of Biomedical Science. 2020; doi:10.1186/s12929-020-00669-4.
3. Bailey JR, et al. Approaches, progress and challenges to hepatitis C vaccine development. Gastroenterology. 2019; doi:10.1053/j.gastro.2018.08.060.
4. Lombardi A, et al. Hepatitis C: Is eradication possible? Liver International: Official Journal of the International Association for the Study of the Liver. 2019; doi:10.1111/liv.14011.
5. Hepatitis disease-specific research. National Institute of Allergy and Infectious Diseases. https://www.niaid.nih.gov/diseases-conditions/hepatitis-research. Accessed Oct. 16, 2020.
6. DNA vaccine therapy in treating patients with chronic hepatitis C virus infection. ClinicalTrials.gov. https://clinicaltrials.gov/ct2/show/NCT02772003?term=Inovio&cond=Hepatitis+C&draw=2&rank=4. Accessed Oct. 16, 2020.

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Hepatitis C | HCV | MedlinePlus

What is hepatitis C?

Hepatitis is inflammation of the liver. Inflammation is swelling that happens when tissues of the body are injured or infected. Inflammation can damage organs.

There are different types of hepatitis. One type, hepatitis C, is caused by the hepatitis C virus (HCV). Hepatitis C can range from a mild illness lasting a few weeks to a serious, lifelong illness.

Hepatitis C can be acute or chronic:

• Acute hepatitis C is a short-term infection. The symptoms can last up to 6 months. Sometimes your body is able to fight off the infection and the virus goes away. But for most people, an acute infection leads to chronic infection.
• Chronic hepatitis C is a long-lasting infection. If it is not treated, it can last for a lifetime and cause serious health problems, including liver damage, cirrhosis (scarring of the liver), liver cancer, and even death.

How is hepatitis C spread?

Hepatitis C spreads through contact with the blood of someone who has HCV. This contact may be through

• Sharing drug needles or other drug materials with someone who has HCV. In the United States, this is the most common way that people get hepatitis C.
• Getting an accidental stick with a needle that was used on someone who has HCV. This can happen in health care settings.
• Being tattooed or pierced with tools or inks that were not sterilized after being used on someone who has HCV
• Having contact with the blood or open sores of someone who has HCV
• Sharing personal care items that may have come in contact with another person’s blood, such as razors or toothbrushes
• Being born to a mother with HCV
• Having unprotected sex with someone who has HCV

Before 1992, hepatitis C was also commonly spread through blood transfusions and organ transplants. Since then, there has been routine testing of the U.S. blood supply for HCV. It is now very rare for someone to get HCV this way.

Who is at risk for hepatitis C?

You are more likely to get hepatitis C if you

If you are at high risk for hepatitis C, your health care provider will likely recommend that you get tested for it.

What are the symptoms of hepatitis C?

Most people with hepatitis C have no symptoms. Some people with acute hepatitis C do have symptoms within 1 to 3 months after they are exposed to the virus. These symptoms may include

If you have chronic hepatitis C, you probably will not have symptoms until it causes complications. This can happen decades after you were infected. For this reason, hepatitis C screening is important, even if you have no symptoms.

What other problems can hepatitis C cause?

Without treatment, hepatitis C may lead to cirrhosis, liver failure, and liver cancer. Early diagnosis and treatment of hepatitis C can prevent these complications.

How is hepatitis C diagnosed?

Health care providers diagnose hepatitis C based on your medical history, a physical exam, and blood tests.

If you do have hepatitis C, you may need additional tests to check for liver damage. These tests may include other blood tests, an ultrasound of the liver, and a liver biopsy.

What are the treatments for hepatitis C?

Treatment for hepatitis C is with antiviral medicines. They can cure the disease in most cases.

If you have acute hepatitis C, your health care provider may wait to see if your infection becomes chronic before starting treatment.

If your hepatitis C causes cirrhosis, you should see a doctor who specializes in liver diseases. Treatments for health problems related to cirrhosis include medicines, surgery, and other medical procedures. If your hepatitis C leads to liver failure or liver cancer, you may need a liver transplant.

Can hepatitis C be prevented?

There is no vaccine for hepatitis C. But you can help protect yourself from hepatitis C infection by

• Not sharing drug needles or other drug materials
• Wearing gloves if you have to touch another person’s blood or open sores
• Making sure your tattoo artist or body piercer uses sterile tools and unopened ink
• Not sharing personal items such toothbrushes, razors, or nail clippers
• Using a latex condom during sex. If your or your partner is allergic to latex, you can use polyurethane condoms.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

About the hepatitis C virus

Hepatitis C is a blood-borne virus that predominantly infects the cells of the liver. This can result in inflammation and significant damage to the liver. It can also affect the liver’s ability to perform its essential functions. Although it has always been regarded as a liver disease – ‘hepatitis’ means ‘inflammation of the liver’ – recent research has shown that the hepatitis C virus (HCV) affects a number of other areas of the body. These can include the digestive system, the lymphatic system, the immune system and the brain.

Hepatitis C was first discovered in the 1980s when it became apparent that there was a new virus (not hepatitis A or B) causing liver damage. Before being properly identified in 1989 it was originally known as non-A non-B hepatitis. In 1991 a screening process was developed making it possible to detect HCV in blood samples. As a relatively new disease there are still many aspects of hepatitis C which are yet to be fully understood.

There are an estimated 150 million people worldwide chronically infected with hepatitis C. The level of infection, known as prevalence, varies widely from country to country. In some countries, such as Egypt, it is as high as15%. In the United States it is believed to be 1% and in the UK it is believed to be around 0.5%. The virus can only be transmitted by infected blood.

Hepatitis C is an RNA virus. RNA viruses mutate much more than DNA viruses. This ability to mutate makes the RNA virus much harder for the body’s immune system to locate and destroy it. In hepatitis C there are 6 major variations of the virus, labelled 1 to 6. These are known as ‘genotypes’. Different genotypes predominate in different parts of the world. One genotype cannot change into another. However, it is possible, although rare, to be infected with more than one genotype at the same time.

A hepatitis C infection can be categorised into two stages. The first stage is acute infection (following initial infection). The second stage is chronic infection. The acute stage refers to the first 6 months of infection and does not necessarily result in any noticeable symptoms. Approximately 20% of those infected with hepatitis C will naturally clear the virus from their body within the first six months. For the remaining 80% a chronic (long-term) infection will develop.

The course of a chronic hepatitis C infection is extremely varied and unpredictable. Some people experience very few symptoms for as long as a decade. Others can suffer symptoms almost from the start. Some will progress to develop fibrosis and cirrhosis (scarring) of the liver, liver cancer or end stage liver disease, while others experience very little liver damage, even after many years. In cases where there is an absence of symptoms many people do not discover that they have HCV until some time after they have been infected.

Another reason that hepatitis C goes undiagnosed for many years is that its symptoms can often be put down to other illnesses. For example, depression, fatigue, skin problems, insomnia, pain and digestive disorders could all have other causes. For these reasons hepatitis C is often referred to as the ‘Silent Epidemic’.

Drug treatment to eradicate the virus has advanced greatly in the last few years. Treatments for all genotypes have a high success rate, are shorter in duration in most cases and much more tolerable in terms of side effects. A vaccine remains some time off.

Hepatitis C symptoms & treatment

FAST FACTS:

• Hepatitis C is found in infected blood. It is also rarely found in semen (cum) and vaginal fluids.

• Hepatitis C is mainly passed on through using contaminated needles and syringes or sharing other items with infected blood on them. It can also be passed on through unprotected sex, especially when blood is present.

• You can prevent hepatitis C by never sharing needles and syringes, practising safer sex, and avoiding unlicensed tattoo parlours and acupuncturists.

• Hepatitis C will often not have any noticeable symptoms, but a simple blood test carried out by a healthcare professional will show whether you have hepatitis C.

• In the early stages, some people’s bodies can clear a hepatitis C infection on their own, others may develop chronic hepatitis C and will need to take antiviral treatment to cure the infection. 

• Without treatment, chronic hepatitis C can lead to permanent liver damage.

Hepatitis C (also known as hep C or HCV) is part of a group of hepatitis viruses that attack the liver.

It’s mainly passed on through contaminated needles, either from injecting drugs or from needle stick injuries in healthcare settings. It can also be transmitted sexually, especially during anal sex or other types of sex that may involve blood.

Some groups are more at risk of getting hepatitis C than others, including people who use drugs, people in prisons, men who have sex with men, health workers and people living with HIV.

Chronic hepatitis C can be serious and without appropriate treatment and care, can cause liver disease and liver cancer leading to death. Treatment, where available, can cure hepatitis C in most cases.

How do you get and prevent hepatitis C?

Hepatitis C is passed on when infected blood gets into another person’s body. It is very infectious and the virus can stay alive outside the body for up to several weeks.

Contaminated needles and infected blood

You can get hepatitis C from sharing contaminated needles, syringes and other injecting equipment during recreational drug use. Banknotes and straws used for snorting may also pass the virus on.

Being exposed to unsterilised tattoo and body piercing equipment can also pass hepatitis C on. Occasionally, you can get it from sharing a towel, razor blades or a toothbrush if there is infected blood on them.

Hepatitis C infection is also passed on in healthcare settings, from needle stick injuries or from medical and dental equipment that has not been properly sterilised. In countries where blood products are not routinely screened, you can also get hepatitis C by receiving a transfusion of unscreened blood and blood products.

You can prevent hepatitis C by:

• never sharing needles and syringes or other items that may be contaminated with infected blood (even old or dried blood can contain the virus)
• only having tattoos, body piercings or acupuncture in a professional setting, where new, sterile needles are used
• following the standard infection control precautions, if you’re working in a healthcare setting.

Sex

Hepatitis C can be passed on via sex without a condom or dental dam with someone who has the virus, even if they don’t have symptoms. Hepatitis C has been detected in semen and vaginal fluids, but infection via these routes is thought to be unlikely.

Sex which leads to blood exposure is the main way hepatitis C is passed on sexually. These types of sexual activities include anal sex, fisting, when a woman is on her period and rough sex which leads to tearing or cuts. Sharing of uncovered or unwashed sex toys can also pass it on.

Because of this, sexual transmission of hepatitis C is more common among populations that practise anal sex, such as men who have sex with men. Sexual transmission during vaginal sex is thought to be very rare.

The risk of hepatitis C infection is increased when you have another STI – especially one that causes sores. People living with HIV are also more likely to get hepatitis C.

How do I protect myself from getting hepatitis C during sex?

• Test for hepatitis C and know the status of your sexual partners.
• Use condoms, especially during anal sex, rough sex or if you’re menstruating. If you’re having sex with a new partner or if you have multiple partners, it’s a good idea to use condoms consistently.
• Use dental dams and latex gloves for rimming, fingering and fisting.
• Test regularly for STIs.

If you’re living with HIV, taking your antiretroviral treatment for HIV keeps your immune system strong so you’re less likely to get other infections, including hepatitis C.  

from condoms, other types of contraception such as the contraceptive pill and pre-exposure prophylaxis (PrEP) for HIV offer no protection against hepatitis C or other sexually transmitted infections.

If you’ve been diagnosed with hepatitis C, it’s advised that you avoid sex until you have finished your treatment and a health care professional says it’s safe.

Mother to child

Hepatitis C can be passed on from a pregnant woman to her child during pregnancy and birth, although this is rare. The risk of passing hepatitis on is slightly higher for mothers living with both HIV and hepatitis C (called co-infection).  

Antivirals used to treat hepatitis are not currently recommended for pregnant women because there isn’t enough information to know if the drugs are safe for your unborn baby.

If you have hepatitis C and are pregnant speak to your doctor. They will be able to give you advice on how to keep yourself and your baby safe during pregnancy and birth.

If you’re planning to have a baby, your doctor may recommend that you treat the hepatitis C before you get pregnant.

Breastfeeding with hepatitis C is considered safe. But if you have cracked or bleeding nipples, it’s generally recommended to stop breastfeeding until they have healed.

What do hepatitis C symptoms look like?

Hepatitis C infection can go through two stages: acute and chronic. In the early, or ‘acute’ stage, most people don’t have symptoms. If they do develop symptoms, these can include:

• flu-like symptoms, tiredness, high temperature and aches and pains
• loss of appetite
• tummy (abdominal) pain
• jaundice, meaning your skin and the whites of your eyes turn yellow

While for some people, the infection will clear without treatment, in most cases, acute infection will develop into long-term ‘chronic’ infection. Chronic infection may not become apparent for a number of years until the liver displays signs of damage. These symptoms can include:

• mental confusion (often called ‘brain fog’) and depression – these are specific to hepatitis C
• constantly feeling tired
• nausea, vomiting or tummy pain
• dark urine (pee)
• pale faeces (poo)
• jaundice
• itchy skin
• feeling bloated
• joint and muscle pain

Without treatment, chronic hepatitis C can cause scarring of the liver (cirrhosis), which can cause the liver to stop working properly. A small number of people with cirrhosis develop liver cancer and these complications can lead to death. Other than a liver transplant, there’s no cure for cirrhosis. However, treatments can help relieve some of the symptoms.

How do you test for hepatitis C?

A simple blood test carried out by a healthcare professional will show whether you have the virus. You may also be given an extra test to see if your liver is damaged.

If you’ve got hepatitis C you should be tested for other STIs. It’s important that you tell your recent sexual partner/s so they can also get tested and treated. Many people who have hepatitis C do not notice anything wrong, and by telling them you can help to stop the virus being passed on. It can also stop you from getting the infection again.

How do you treat hepatitis C?

People with acute infection do not always need treatment, because their immune system may clear hepatitis C on its own. If you test positive during the acute stage, your doctor may ask you to come back after a few months to re-test and to see if you need any treatment.

If people develop chronic infection, they will need treatment to help clear the virus. Where available, treatment with drugs called direct-acting antivirals (DAAs) can cure hepatitis in most cases. These are usually taken for 8-12 weeks. Your doctor will also check your liver for any damage.  

If you’ve had hepatitis C in the past, you’re not immune to future infections – which means you can get it again. You can also still get other types of hepatitis, and having hepatitis C together with another type is more serious.

If you’ve already had hepatitis C, it’s advisable to have the vaccination against hepatitis A and B to protect your liver from further damage.

Whether you have symptoms or not, don’t have sex until your healthcare professional says you can.

Hepatitis C and HIV

Co-infection with hepatitis C and HIV is common because they are both transmitted in similar ways. While both infections can be treated, it can complicate things, so it’s important that your doctor is fully aware of your infections.

That’s because if you’re living with HIV and become infected with hepatitis C, you’re more likely to develop chronic hepatitis C. The infection is also more likely to progress quickly and become serious. This is even true when you are taking your antiretroviral treatment for HIV and your viral load is low.

If you think you’ve been exposed to hepatitis C, it’s important to get tested and treated with DAAs if necessary. In some cases, your doctor may make changes to your antiretroviral treatment while they are treating your hepatitis C infection.

Hepatitis C Fact Sheet | PeaceHealth

The following is from the Centers for Disease Control and Prevention (CDC) hepatitis C website.

What is hepatitis?

Hepatitis means inflammation of the liver. Toxins, certain drugs, some diseases, heavy alcohol use, and bacterial and viral infections can all cause hepatitis. Hepatitis is also the name of a family of viral infections that affect the liver; the most common types are hepatitis A, hepatitis B, and hepatitis C.

What is hepatitis C?

Hepatitis C is a contagious liver disease that ranges in severity from a mild illness lasting a few weeks to a serious, lifelong illness that attacks the liver. It results from infection with the hepatitis C virus (HCV), which is spread primarily through contact with the blood of an infected person.

Acute hepatitis C virus infection is a short-term illness that occurs within the first 6 months after someone is exposed to the hepatitis C virus. For most people, acute infection leads to chronic infection.

Chronic hepatitis C virus infection is a long-term illness that occurs when the hepatitis C virus remains in a person’s body. Hepatitis C virus infection can last a lifetime and lead to serious liver problems, including cirrhosis (scarring of the liver) or liver cancer.

How common is hepatitis C?

In 2009, there were an estimated 16,000 new hepatitis C virus infections reported in the United States. An estimated 3.2 million persons in the United States have chronic hepatitis C virus infection. Many with hepatitis C do not know they are infected because they don’t look or feel sick.

How is hepatitis C spread?

Hepatitis C is usually spread when blood from a person infected with the hepatitis C virus enters the body of someone who is not infected. Today, most people become infected with the hepatitis C virus by sharing needles or other equipment to inject drugs. Before 1992, when widespread screening of the blood supply began in the United States, hepatitis C was also commonly spread through blood transfusions and organ transplants.

People can become infected with the hepatitis C virus during such activities as

     • Sharing needles, syringes, or other equipment to inject drugs
     • Needlestick injuries in health care settings 
     • Being born to a mother who has hepatitis C

Less commonly, a person can also get hepatitis C virus infection through

     • Sharing personal care items that may have come in contact with another person’s blood, such as razors or toothbrushes 
     • Having sexual contact with a person infected with the hepatitis C virus

Can hepatitis C be spread through sexual contact?

Yes, but the risk of transmission from sexual contact is believed to be low. The risk increases for those who have multiple sex partners, have a sexually transmitted disease, engage in rough sex, or are infected with HIV. More research is needed to better understand how and when hepatitis C can be spread through sexual contact.

Should a person with the hepatitis C virus be restricted from working in certain jobs or settings?

The U.S. Centers for Disease Control and Prevention recommendations for prevention and control of the hepatitis C virus infection state that people should not be excluded from work, school, play, child care, or other settings because they have hepatitis C. There is no evidence that people can get hepatitis C from food handlers, teachers, or other service providers without blood-to-blood contact.  

Can hepatitis C be spread within a household?

Yes, but this does not occur very often. If hepatitis C virus is spread within a household, it is most likely a result of direct, through-the-skin exposure to the blood of an infected household member.

What is the risk of a pregnant woman passing hepatitis C to her baby?

Hepatitis C is rarely passed from a pregnant woman to her baby. About 4 of every 100 infants born to mothers with hepatitis C become infected with the virus. However, the risk becomes greater if the mother has both HIV infection and hepatitis C.

What are the symptoms of acute hepatitis C?

Approximately 70%-80% of people with acute hepatitis C do not have any symptoms. Some people, however, can have mild to severe symptoms soon after being infected, including: fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, clay-colored bowel movements, joint pain, and jaundice (yellow color in the skin or eyes).

Is it possible to have hepatitis C and not know it?

Yes. Many people who are infected with the hepatitis C virus do not know they are infected because they do not look or feel sick.

What are the symptoms of chronic hepatitis C?

Most people with chronic hepatitis C do not have any symptoms. However, if a person has been infected for many years, his or her liver may be damaged. In many cases, there are no symptoms of the disease until liver problems have developed. In persons without symptoms, hepatitis C is often detected during routine blood tests to measure liver function and liver enzyme (protein produced by the liver) level.

How serious is chronic hepatitis C?

Chronic hepatitis C is a serious disease that can result in long-term health problems, including liver damage, liver failure, liver cancer, or even death. It is the leading cause of cirrhosis and liver cancer and the most common reason for liver transplantation in the United States. Approximately 15,000 people die every year from hepatitis C related liver disease.

What are the long-term effects of hepatitis C?

Of every 100 people infected with the hepatitis C virus, about

     • 75-85 people will develop chronic hepatitis C virus infection; of those,
     • 60-70 people will go on to develop chronic liver disease 
     • 5-20 people will go on to develop cirrhosis over a period of 20-30 years 
     • 1-5 people will die from cirrhosis or liver cancer

Can acute hepatitis C be treated?

Yes, acute hepatitis C can be treated. Acute infection can clear on its own without treatment in about 25% of people. If acute hepatitis C is diagnosed, treatment does reduce the risk that acute hepatitis C will become a chronic infection. Acute hepatitis C is treated with the same medications used to treat chronic hepatitis C. However, the optimal treatment and when it should be started remains uncertain.

Can chronic hepatitis C be treated?

Yes. There are several medications available to treat chronic hepatitis C, including new treatments that appear to be more effective and have fewer side effects than previous options.

Is it possible to get over hepatitis C?

Yes. Approximately 15%-25% of people who get hepatitis C will clear the virus from their bodies without treatment and will not develop chronic infection. Experts do not fully understand why this happens for some people.

What can a person with chronic hepatitis C do to take care of his or her liver?

People with chronic hepatitis C should be monitored regularly by an experienced doctor. They should avoid alcohol because it can cause additional liver damage. They also should check with a health professional before taking any prescription pills, supplements, or over-the-counter medications, as these can potentially damage the liver. If liver damage is present, a person should check with his or her doctor about getting vaccinated against hepatitis A and hepatitis B.

For more information about hepatitis C, please visit http://www.cdc.gov/hepatitis/C/.

What is Hepatitis C? | Hepatitis C Symptoms, Treatment, Transmission

Of all the chronic liver diseases, chronic hepatitis C is the most common.  Between 8,000 and 13,000 deaths a year are associated with chronic hepatitis C. Most liver transplants in the United States are performed on people with chronic hepatitis C.

Chronic Hepatitis C

About 70 to 80 percent of people with hepatitis C will have a long-term infection.  This is called chronic hepatitis C. The infection could be lifelong unless treatment is provided that results in a cure.

Hepatitis C Symptoms

Most people with hepatitis C will not have symptoms, even if they have significant liver damage as a result.  Among those who develop symptoms from hepatitis C, fatigue is the most common.

Symptoms of hepatitis C include:

• Fatigue
• Bleeding or bruising easily
• Yellow discoloration of the body (jaundice)
• Nausea
• Lack of appetite
• Muscle / joint aches
• Weakness
• Weightloss

Chronic hepatitis C starts as acute hepatitis C, which often goes undiagnosed because symptoms are rare. Acute hepatitis C symptoms typically appear one to three months after exposure.  If symptoms appear at all, they can last from a couple weeks to a few months.

Acute hepatitis C doesn’t always become chronic. Some people experience a spontaneous clearing of the virus.  If diagnosed, acute hepatitis C can be treated with antiviral therapy.

Hepatitis C Causes

Hepatitis C is caused by the hepatitis C virus entering the bloodstream in an uninfected person.  Blood can be transmitted a number of different ways.

Hepatitis C Risk Factors

The risk of exposure to hepatitis C increases if you:

• Work in a healthcare environment with exposure to infected blood, including a needle piercing the skin.
• Have ever inhaled or injected illicit drugs
• Have HIV
• Received a tattoo or piercing using unsterile equipment.
• Received a transplant or blood transfusion before 1992
• Received a clotting factor concentrate prior to 1987
• Were born to a mother with hepatitis C
• Spent any time in prison
• Were born between 1945 and 1965

Hepatitis C Complications

Chronic hepatitis C (lasting years) can cause significant complications.

• Cirrhosis – Scarring of the liver (cirrhosis) can occur over long periods of time; 20 to 30 years of having a hepatitis C infection. Cirrhosis makes it difficult for the liver to function properly.
• Liver Cancer – Around 1 in 50 people with Cirrhosis and a hepatitis C infection will develop hepatocellular carcinoma, a type of liver cancer.  The majority of people with cirrhosis and hepatitis C will not develop cancer.
• Liver Failure – Advanced cirrhosis could cause the liver to stop functioning.

Hepatitis C Diagnosis

Blood tests

Experts recommend anyone with an increased risk of hepatitis C to get a blood test to check for hepatitis C.

If the screening test is positive, further blood testing will be done to confirm the diagnosis of hepatitis C. This will include genotype testing, which helps determine the type of hepatitis C virus and the best treatment plan. Most people in the United States have type 1 hepatitis C.

Liver Biopsy

A liver biopsy is not required for the diagnosis of hepatitis C, but may be performed when treatment is being considered.  A biopsy can help determine the long-term prognosis and stage of the disease.

Hepatitis C Treatment

The goal of hepatitis C treatment is to stop the progression of liver disease. However, treatment isn’t recommended for everyone.  Other health conditions, lifestyle choices, and the current level of liver damage will be reviewed before your doctor makes a treatment recommendation.

Antiviral Medications – Hepatitis C can be treated with antiviral medications which will help clear the virus from the body.  After 8 to 12 weeks, you may be tested again for the hepatitis C virus.

Cure is defined as a negative test for hepatitis C more than six months after stopping treatment. The cure-rate of type 1 hepatitis C virus is around 40% to 50% and types 2 and 3 are around 80%.

Recurrence happens in about 25% to 35% of hepatitis C patients.

Liver Transplant – Because hepatitis C can cause serious liver complications, a liver transplant may be an option.  Transplanted organs often come from deceased donors, but some come from living donors when only a portion of a healthy liver is transplanted.

Vaccines  – There are no vaccines for hepatitis C, but your doctor may recommend vaccines for hepatitis A and B.  Although these are separate viruses, they also affect the liver and can further complicate treating chronic hepatitis C.

Long Term Management of Hepatitis C

Do not drink alcohol – Alcohol can damage the liver and speed the progression of liver disease.

Screening for cancer – People with hepatitis C and cirrhosis should get regular screening tests every year or every other year.  Testing for hepatocellular carcinoma usually includes a visual examination with ultrasound and a blood test to look evaluate the alpha-fetoprotein level.

Diet – There is no recommended diet for those with hepatitis C.

Avoid Liver-Damaging Medications – Some medications could cause liver damage.  Talk to your doctor about all medications you take, including over-the-counter medications, herbal supplements, or dietary supplements.

Prevent Spreading hepatitis C – You can help others not come in contact with your blood by taking precautions.

• Don’t donate blood, organs, or semen
• Don’t share toothbrushes or razors
• Tell healthcare workers you have the virus
• Tell your sexual partner prior to sex and use condoms during intercourse

Support Groups – There are many helpful support groups for people with hepatitis C.  Visit the American Liver Foundation for a complete list.

Hepatitis C Clinical Trials

Research is always being conducted for hepatitis C – for more information on clinical trials for hepatitis C, patients can search the NIH Clinical Trials database for current studies.

Patients exhale into a bag and the doctor uses a device that detects the presence of carbon. Some acid-suppressing medications (PPIs), antibiotics, and bismuth subsalicylate (Pepto-Bismol) can affect the results and accuracy of this test. Your doctor will ask you to stop taking these medications one to two weeks before your breath test.”
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90,000 Where does hepatitis come from and how to cure it – Wonderzine

What is hepatitis

The name of the disease is collective and denotes inflammation of the liver, as a result of which normal liver cells (hepatocytes) die. And when there are more dead hepatocytes than new normal cells, the process of tissue scarring (fibrosis) begins, which over time can lead to cirrhosis or liver cancer. The disease can occur in both acute and chronic forms.

The popular belief about hepatitis is rooted in the myth that only those who put themselves at additional risks, such as neglecting protected sex or using intravenous drugs, face the problem. According to this logic, if you lead a “pious” lifestyle, nothing will happen, and hepatitis will bypass. These judgments are only partially justified, but in reality everything is much more complicated: there are a lot of varieties of hepatitis, and the reasons for its occurrence are also very different.

Hepatitis can really be caused by a viral infection, and then we need to talk about viruses of types A, B, C (popularly nicknamed him “the affectionate killer”), D, E.Sometimes experts distinguish type G separately, despite the fact that it is almost identical to C and, as it is believed (this type is not well understood), spreads the same way. However, not only and not so much viruses can provoke the development of hepatitis. Sometimes non-alcoholic fatty disease is behind it all. In the United States alone, for example, up to 40% of the adult population is exposed to it; for comparison, in 2015, hepatitis B virus infection was recorded in 3.5% of the population. Non-alcoholic fatty disease can result in so-called non-alcoholic steatohepatitis (which affects 3 to 12% of Americans), in which case the excess fat accumulated in the liver cells leads to inflammation.This disease is associated with diabetes mellitus, lipid metabolism disorders or increased body weight, but other reasons are not excluded.

Since the liver acts as a filter, toxins can take particular damage. And here, first of all, you need to remember about alcohol – in one of the studies, alcoholic liver disease was found in 6.9% of 5,000 residents of Moscow. You should not write off medications (in 10% of cases of acute hepatitis, they should be blamed) and dietary supplements.

Several studies supplement the range with exposure to toxic chemicals at work (although it is difficult to judge whether these may actually be the root cause of toxic hepatitis).In addition, it makes sense to use energy drinks with caution: there is a case of acute hepatitis in a healthy fifty-year-old man who drank four to five cans daily for three weeks. Mayevskaya also says that sometimes toxic hepatitis occurs in people (most often young men) who are injected with testosterone-based drugs to accelerate muscle growth. Testosterone has a significant effect on the liver, and such patients come to a hepatologist with jaundice and itchy skin.

Hepatitis can also be autoimmune, when the body perceives liver cells as something foreign and tries to destroy them. This problem is more common in women; And although autoimmune hepatitis cannot be completely cured, it is successfully controlled with special therapy that inhibits the inflammatory process and even allows the liver to recover to some extent.

90,000 Where does hepatitis C come from and how to protect yourself from it

According to the World Health Organization, 130-150 million people worldwide suffer from chronic viral hepatitis C.A significant proportion of patients are faced with cirrhosis or liver cancer. It is also terrifying that 58,000 people die every month from liver disease caused by the hepatitis virus. Where does hepatitis C come from, what are the modes of transmission and how to protect yourself from this infection? In this article, you will get answers to all these questions.

Hepatitis refers to inflammation of the liver. The cause of the inflammatory process can be toxins, viruses and bacteria, some diseases, medication, alcoholism.

The most common forms of hepatitis are A, B and C. Although each causes the same symptoms, they are transmitted differently and can affect the liver in different ways. Hepatitis A manifests itself only as an acute or re-emerging infection that does not become chronic. In most cases, this virus “goes away” on its own – without treatment. Hepatitis C and B can appear as acute infections, but often the virus remains in the body and becomes chronic.In this case, the person has serious liver problems.

Hepatitis C is an infectious disease that, in severe forms, attacks the patient’s liver throughout life. It is usually transmitted by contact with the blood of an infected person. There are 2 forms of the disease:

• Acute Hepatitis C

The acute form is a short-term illness that occurs within the first 6 months after a person is exposed to the virus.Sometimes the patient’s body gets rid of the infection on its own. However, in 75-85% of people, the acute form becomes chronic.

• Chronic viral hepatitis C

This is a long-term illness that occurs if the infection does not leave the human body. It is this form of hepatitis that can haunt the patient all his life. It often leads to serious liver disease. Early detection and treatment of chronic hepatitis helps prevent liver damage and further complications.

How is hepatitis C transmitted ?

As mentioned, the virus spreads through contact with the blood of an infected person. This can happen under the following conditions:

• Using the same syringe with an infected person,
• Accidental needle sticking by a carrier of the infection,
• Piercing or tattooing with tools that have been used on an infected person and have not been properly sterilized,
• Infection in manicure salons, if the tools were used on a carrier of the virus,
• Contact with open wounds of a patient with hepatitis C,
• Using a razor, toothbrush or nail clipper of a carrier of the virus,
• Unprotected intercourse with an infected person.

Hepatitis C during pregnancy is rarely transmitted to the newborn. For every 100 infected pregnant women, there are 6 cases of transmission of the virus to a child. The infant is at increased risk of infection if the mother has HIV in addition to hepatitis C. A nursing baby can only become infected from mother’s milk if the nipples are cracked or bleeding.

A person is not infected:

• Sitting next to an infected person,
• From sharing food, sharing forks, spoons and other cutlery,
• From coughing or sneezing,
• Hugging or kissing a sick person,
• From handshakes.

What are the symptoms of hepatitis C?

Most carriers of the infection do not have any symptoms. Sometimes a person with an acute illness will experience symptoms within the first three months after infection. These signs of hepatitis C may include:

• Dark yellow urine,
• Feeling tired,
• Fever,
• Gray-colored or clay stool,
• Joint pain,
• Loss of appetite,
• Nausea,
• Abdominal pain,
• Vomiting,
• Yellowing of the skin and whites of the eyes.

If a person has chronic hepatitis C virus infection, they will almost certainly have no symptoms. The infection will not manifest until complications are found. The latter can appear even decades after a person has been infected with the virus. This is why screening for hepatitis C is very important even if there are no signs of infection.

Why is hepatitis C dangerous ?

If the infection is not diagnosed in time and the course of treatment is not completed, the patient has a high chance of facing serious consequences.

This is a condition in which the liver is slowly destroyed. Ultimately, the organ loses its ability to perform its functions. Scar tissue replaces healthy cells and partially blocks blood flow through the liver. In the early stages of the disease, the liver continues to perform its many functions. Further development of cirrhosis leads to liver failure.

• Liver failure

In the hepatitis C virus, the consequences can be life-threatening.It is not for nothing that liver failure is called the terminal (final) stage of liver disease. It develops gradually over several months, years or even decades. The disease is characterized by the inability of the liver to replace damaged cells. As a result, the organ refuses to perform the most important functions for the vital activity of the organism.

Chronic viral hepatitis C significantly increases a person’s chances of encountering liver cancer. If the chronic form of the disease leads to severe liver damage or cirrhosis, the chances of encountering cancer will be high even after undergoing treatment.

How not to get hepatitis C ?

Everyone can take protective measures against this dangerous virus:

• Never use needles or syringes that have been shared by another person.
• Wear medical gloves before touching a person’s blood or open wound.
• If you decide to get a tattoo, get pierced, or visit a nail salon, make sure the equipment is sterile.
• Do not share your toothbrush, razor, or manicure tools with other people.
• Use condoms.

Is there a vaccine for hepatitis C? To date, scientists have developed a vaccine only for hepatitis A and B. Research and experiments to develop vaccines against the class C virus are still ongoing.

How to define hepatitis C ?

Diagnosis is based on medical history analysis, patient examination and blood tests.

Analysis of medical history

The doctor will definitely ask about the symptoms and whether the person has received blood transfusions and whether he has had any experience of intravenous drug use.

Physical examination

During the examination, the doctor examines the patient’s body for signs of liver damage. What the doctor pays attention to:

• Yellowing of the skin, dryness, the appearance of spider veins.
• In advanced stages – an increase in the abdomen and swelling in the legs.

Hepatitis C Tests

Several blood tests may be required to diagnose an infection. Among the main ones:

• Test for antibodies to hepatitis C virus (anti-HCV)

This is the main test that shows whether antibodies to the virus have been developed in the human body. A positive result indicates that the patient has been exposed to the infection.

• Hepatitis C RNA test

If the previous test showed a positive result, an RNA test should be performed.It shows if the infection is currently in the blood and what type of virus it is. This information helps the doctor choose a treatment strategy and check whether the concentration of the virus in the patient’s blood is decreasing.

Often the doctor prescribes additional tests for hepatitis C, for example, sometimes the patient is referred for liver function tests.

For the diagnosis and treatment of hepatitis C, please contact our gastroenterologists. Persomed employs professionals in their field, whose goal is to recover the patient before complications appear.

Sources:

1. Hepatitis C Fact sheet, The World Health Organization (WHO),
2. Hepatitis C, The National Institute of Diabetes and Digestive and Kidney Diseases, Health Information Center,
3. Hepatitis C FAQs for the Public , Centers for Disease Control and Prevention,
4. Hepatitis C, Canadian Liver Foundation.

What you need to know about viral hepatitis C?

I have hepatitis C

What you need to know about viral hepatitis C?

Information prepared and kindly provided by Dr. Larisa Yurievna Bredneva.Contains 2011 updates.

The information is intended for educational purposes. It cannot be used as a substitute for consulting a doctor.

What is viral hepatitis C?

Hepatitis C virus (HCV) is an infectious disease that occurs as a result of infection with the hepatitis virus, and leads to damage to liver cells of varying severity. Viral hepatitis C can be acute or chronic.

How can you get infected with hepatitis C virus?

The hepatitis C virus is transmitted by direct contact with human blood.For example, you can become infected if:

• Have you ever used drugs and shared syringes or needles.
• You received blood transfusions, blood components or organ transplants from donors with hepatitis C virus.
• You have ever been on hemodialysis and may have contact with blood on the equipment.
• Have you ever worked in a health care setting and had frequent blood contact at your work, especially accidental needle sticks.
• Your mother was diagnosed with viral hepatitis C.
• You have had sex with an infected hepatitis C virus.
• You lived with a person infected with hepatitis C and used their personal hygiene items, such as shaving utensils, a toothbrush, on which blood particles may have remained.
• You have undergone any operations, including dental ones.

Is the hepatitis C virus sexually transmitted?

Yes, but this rarely happens.The likelihood of sexual transmission through unprotected sexual contact with a person infected with the hepatitis virus is 3-5%. To reduce your partner’s risk of infection, practice barrier protectors (latex condoms).

Can you get the hepatitis C virus from family members?

Yes, but this rarely happens. Family members are infected through direct contact with the blood of an infected person.

Can I get hepatitis C through tattooing?

There is no data on the transmission of the hepatitis C virus through tattooing.However, in the absence or poor infection control, there is the potential for transmission of the virus.

Is it possible to get infected with vinegars from mosquitoes or other blood-sucking insects?

Hepatitis C virus is not transmitted by bites of mosquitoes and other blood-sucking insects.

How often does chronic hepatitis C virus infection develop?

Approximately 75-85% of infected people develop chronic infection.

Is chronic viral hepatitis C serious?

Chronic viral hepatitis is the leading cause of cirrhosis, primary liver cancer and liver transplants. In the USA, according to statistics, 8-10 thousand patients die annually from complications of viral hepatitis C.

How long can hepatitis C virus survive in the environment and be infectious?

Hepatitis C virus can survive on surrounding surfaces at room temperature for at least 16 hours, but not more than 4 days.

How to disinfect? What should be used to disinfect hepatitis C virus on surrounding objects?

Clean up any blood spatter, including dried blood, using a solution containing one part household bleach, disinfectant and 10 parts water to disinfect the surface. Use gloves when cleaning surfaces containing blood.

How can people infected with the hepatitis C virus prevent the spread of the virus to others?

1. Do not donate blood, organs, other tissues, or sperm.
2. Do not share personal items such as toothbrushes, manicure kits or shaving accessories that may contain your blood.
3. Cover your wounds and cuts.
4. Practice safe sex.

How can a hepatitis C patient protect their liver?

1. Stop drinking alcohol.
2. See a doctor with experience in managing viral hepatitis regularly.
3. Do not start taking any new medications, over-the-counter forms, herbs, or other medications without your doctor’s advice.
4. Get vaccinated against hepatitis A and B.

What else should a hepatitis C patient know?

Hepatitis C virus is not spread by coughing, sneezing, hugging, through water or food, when using shared utensils, cups, casual contact. Those infected with the hepatitis C virus should not be suspended from work at school, caring for children, etc.Involvement in a support group can help patients cope with viral hepatitis C.

Can viral hepatitis C manifest itself in other organs and systems (other than the liver)?

A small percentage of patients with chronic hepatitis C virus infection may develop other organ damage. This is due to a violation of the immune system, the occurrence of autoimmune reactions directed against the body’s own cells. These lesions include glomerulonephritis, mixed essential cryoglobulinemia, porphyria, and several others.

Is there a vaccine to prevent Hepatitis C virus infection?

No.

What tests are used to diagnose hapatitis C?

The most accessible diagnostic method is the determination of Anti-HCV (antibodies to the hepatitis C virus). This test is the primary screening test. If it is positive, it should be confirmed. The presence of Anti-HCV establishes the fact of infection in the past or present. For an accurate diagnosis of hepatitis C, the next step is performed, PCR diagnostics (polyserase chain reaction), which allows you to determine the RNA of the hepatitis C virus in the blood.A qualitative test for detecting the presence or absence of hepatitis C virus confirms both the presence of infection and the fact of replication (multiplication) of viruses in the body. Negative PCR does not prove that the subject is not infected: the virus may be present in the blood in an insignificant amount and cannot be detected by the PCR method. A negative result can be in those infected in the past, as well as in convalescents. If a diagnosis of viral hepatitis C is assumed and the PCR is negative, the analysis should be repeated. A quantitative test for detecting the amount of hepatitis C virus makes it possible to judge about
activity or the rate of reproduction of viruses.The higher the tier load, the more active the replication of viruses. High viral load is a factor that reduces the effectiveness of antiviral therapy.

Can liver enzyme levels, including ALT, be normal in chronic hepatitis C?

Chronic hepatitis C is characterized by periodic fluctuations in liver enzymes. ALT activity can rise and fall towards normal values. In some patients, normal liver enzyme levels are recorded for more than a year, but the development of chronic liver disease continues.If the liver enzymes are within the normal range, the patient should be monitored several times over a period of 6-12 months. If the indicators remain normal, they should be monitored at least once a year.

How long after infection with viral hepatitis C is it possible to determine the RNA of the pathogen by PCR?

By PCR, hepatitis C virus can be detected 1-2 weeks after infection.

What does the term “genotype” mean?

The term “genotype” refers to the genetic makeup of a virus or organism.At least 6 genotypes of the hepatitis C virus are known, in Ukraine most often 1 genotype is registered
.

Why is it necessary to determine the genotype of the virus?

Knowledge of the C genotype is necessary for the preparation of recommendations and treatment tactics. Patients with genotypes 2 and 3 respond better to antiviral therapy, for these patients a 24 week course of combination therapy is sufficient, while patients with genotype 1 require a longer, 48 week course of therapy.

Can a patient be infected with different genotypes of the virus?

Yes, due to an unproductive immune response. Previous infection does not protect against reinfection with the same and other genotypes of the virus. For these reasons, there is no effective pre- and post-exposure prophylaxis (eg, immunoglobulin).

What is a liver biopsy for?

Liver biopsy is taking a small piece of liver tissue with a special needle and examining it under a microscope.A liver biopsy is necessary to assess the extent of liver damage, especially in asymptomatic patients. This study allows you to identify the degree of damage, monitor the course of the disease and the effectiveness of treatment.

Diagnostics of the state of liver tissue without biopsy

Currently, there are absolutely safe and fairly reliable diagnostic tests that can detect fibrosis from the very beginning of its formation. These are Fibrotest and Fibroscan.

What is Fibrotest?

This is data obtained using a patented algorithm based on the determination of specific biomarkers of fibrosis in the venous blood of a patient, taking into account his age, sex, height and body weight. There are several types of tests, which for the convenience of assessing their clinical significance are grouped into two complexes: Fibro / Acti Test and Fibro Max.

What is Fibroscan?

This is a pulse elastometry of the liver (measurement of the elasticity of the liver tissue).The principle of the method is that the density of the liver is directly proportional to the stage of fibrosis.

How fibrotest and fibroscan differ from liver biopsy?

These are minimally invasive methods that provide higher accuracy in identifying the early stages of fibrosis. Fibrotest allows you to detect the smallest functional changes in the liver, when these changes have not yet led to anatomical defects. Also, these methods are indispensable when there are contraindications for liver biopsy, for example, with blood clotting disorders.

Pregnancy and breastfeeding

Does a pregnant woman need to be tested for anti-HCV?

No. The risk of infection with the hepatitis C virus in a pregnant woman is not higher than in a non-pregnant woman. However, if a pregnant woman has risk factors for hepatitis C virus infection, she should be screened for anti-HCV.

What is the risk of transmission from a woman infected with the hepatitis C virus to a child?

Infection is possible only during childbirth and it is not possible to prevent it today.According to statistics, during childbirth, 4 out of 100 newborns from HCV infected mothers become infected, most of them do not have symptoms of the disease.

What is the risk of perinatal transmission of hepatitis C virus if the mother is also infected with human immunodeficiency virus (HIV)?

If the mother is diagnosed with hepatitis C virus and HIV co-infection, the probability of infection of the fetus can reach 19%.

Should a woman with viral hepatitis C refuse to breastfeed?

No.There is no evidence of transmission of hepatitis C virus through feeding. Mothers infected with hepatitis C virus should consider not breastfeeding if they have cracked or bleeding nipples.

When should a baby born to a mother with hepatitis C virus be tested for possible infection at birth?

Children under 18 months of age should not be screened as maternal anti-HCV may persist until this age. If it is desirable to establish the diagnosis before 18 months, a PCR study should be performed on the child at the age of 1-2 months.PCR should be repeated at the next visit, regardless of the result of the initial examination.

Treatment of chronic viral hepatitis C

Treatment of viral hepatitis should be started as early as possible!
The earlier therapy is started, the more chances for a complete cure are!

To date, treatment with a combination of pegylated interferon and ribavirin is recognized as the most effective worldwide. The use of this scheme allows achieving a persistent virological response in 60-95% of patients (up to 60% in patients infected with the most common genotype 1, and up to 95% in patients infected with genotypes 2 and 3).Interferon alone is a treatment option for patients for whom ribavirin is contraindicated. Ribavirin is ineffective when used alone.

When is hepatitis C more difficult to treat?

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

What happens if after the course of treatment the patient is not among those who have been cured?

Courses and special re-therapy regimens are provided for people in whom the result of treatment was not achieved or was incomplete (there was a relapse of infection
immediately after treatment).

The drugs and treatment protocols for hepatitis C are constantly being improved, their effectiveness is increasing and may turn out to be higher than the previous treatment regimen, which did not give the desired result.

Even in the absence of a persistent virological response, interferon therapy reduces the severity of fibrosis in the liver and can significantly extend the time before the onset of such formidable complications of viral hepatitis C as liver cirrhosis and hepatocellular carcinoma.

Is it possible to get infected and get sick with hepatitis C again?

Yes, you can get infected and get sick again. Even if the treatment was successful, immunity to the hepatitis C virus is not developed, therefore, re-infection (including with another type of HCV) causes the disease.

What are the contraindications for antiviral therapy?

• Clinically significant concomitant diseases (malignant tumors, unstable angina pectoris, severe obstructive pulmonary disease).
• Clinically decompensated liver disease *.
• Uncontrolled autoimmune diseases.
• Pregnancy or planned pregnancy in the patient or patient’s sexual partner, or unwillingness to use adequate pregnancy control.
• Documented lack of patient adherence to previous treatment or inability to complete prescribed examinations.
• Severe uncontrolled psychiatric illnesses, in particular depression with a risk of suicide.
• Current injecting drug use.
• Current alcohol abuse.
• Age under 3 years old.
• Individuals with individual intolerance to any drug for the treatment of hepatitis C.

What research needs to be done before starting therapy?

You need monthly consultations with your attending physician to examine and evaluate the results of laboratory tests, as well as to ensure that side effects of treatment or complications are recognized and corrected in time, and serious adverse events do not develop at all.

Mandatory examinations

1. Screening for depression and alcohol intake.
2. Biochemical markers of liver damage and assessment of liver function, including determination of ALT, albumin, bilirubin (in particular direct), prothrombin time.
3. Leukocyte count, hemoglobin level, hematocrit, platelets.
4. Determination of thyroid function.
5. Serum creatinine.
6. Serum glucose or glycosylated hemoglobin (HbA1C) in patients with diabetes mellitus.
7. Pregnancy test (for women of childbearing age).
8. Definition of HIV infection.
9. HBsAg, Anti-HBc, anti-HBs, anti-HAV (total).
10. Quantification of HCV RNA.
11. HCV genotype.
12. ECG.

Desirable

1. Liver biopsy to determine the severity of liver disease (in particular with HCV genotype 1), fibrotest, fibroscan.
2. Examination of the fundus to detect retinopathy in patients with diabetes mellitus and arterial hypertension.
3. Serum ferritin, iron saturation, antinuclear antibodies.
4. Toxicological study of urine for the presence of opiates, cocaine, amphetamines.

Can children with chronic viral hepatitis receive interferon therapy?

FDA approved a combination of antiviral drugs for the treatment of viral hepatitis C starting at age 3.

What is co-infection?

The term co-infection refers to the simultaneous presence of two or more viruses.Since the modes of transmission in viral hepatitis B, C and HIV are similar, it is possible to simultaneously become infected with two or even three viruses.

Hepatitis B / Hepatitis C coinfection

Like hepatitis C, hepatitis B can cause severe liver damage, including cirrhosis and primary liver cancer. HBV / HCV coinfection is poorly understood, but studies have shown that coinfection can lead to more severe liver damage than infection with only one of the viruses.

What is the prevalence of HCV infection among injecting drug users?

The most recent surveys show that one third of young people who inject drugs (aged 18-30) are infected with HCV. Infection rates among the elderly and former injecting drug users are generally higher, ranging from 70% to 90%.

What is the risk of contracting viral hepatitis C from cocaine use?

There is limited epidemiological data indicating an additional risk associated with cocaine use.

What are the features of viral hepatitis C in HIV-infected people?

Most research suggests that HIV infection leads to more aggressive hepatitis C.

There is no consensus on when to start HIV treatment. According to the latest data, patients with a CD4 count below 350 cells in 1 mm3 and a viral load exceeding 55,000 copies in 1 ml need treatment. The standard treatment for HIV infection is the combined use of several antiretroviral drugs.

HIV infection can be effectively treated in most patients with viral hepatitis C. Some drugs used in the treatment of HIV infection, such as protease inhibitors, can cause a temporary increase in ALT and other liver biochemical parameters. Most patients with hepatitis C virus infection can take drugs for the treatment of HIV infection if liver parameters are closely monitored.

General rules for the treatment of HCV infection can be applied to HIV-infected patients.Treatment of hepatitis C in these patients is more demanding and should be longer. HIV-infected patients with a CD4 count of less than 200 cells / mm3 are not considered good candidates for HCV infection and are in primary need of antiretroviral therapy
.

The importance of deciding on antiviral therapy

In the long term, treatment is your best chance to stay as healthy as possible and for as long as possible.

The condition of untreated patients is not getting better: the virus continues to damage the liver.Patients who start antiviral therapy earlier respond better to treatment.

Whether or not to start taking antiviral therapy is one of the most significant decisions you have made in your life. For many, treatment helps to reduce the viral load in the blood to undetectable levels, and has a positive effect on the structure of the liver.

The course of antiviral therapy for many seems to be a difficult and lengthy task, and it always seems easier to do nothing at all, but to wait for a better or more convenient case in the future.This is very tempting: constantly, under some pretext, to postpone treatment. Six months or 1 year of treatment is not as long as it seems right away if you want to maintain your quality of life and health.

Be honest with yourself and answer the following questions:
Was antiviral therapy more successful and effective than it is now?
Will I ever be stronger, healthier, more ready to make a decision than I am now?

The answer to the first question is simple.We have learned a lot about hepatitis C and some progress has been made in treatment.

You can form the answer to the second question by communicating with your doctor.

By making an informed decision about therapy, you can end up with a good result and feel better. Many patients completed their treatment successfully. Just completing the treatment is a success in itself. Dealing with stress is an important control factor during therapy. Living with a chronic illness is stressful.Try to maintain a realistic view of your health and a positive outlook on life.

It is necessary to know that during the therapy of chronic hepatitis C there may be side effects associated with the intake of antiviral drugs. Side effects are different for each patient. Some patients do not notice side effects, while others pay attention to poor drug tolerance.

If you are receiving antiviral therapy:

It is necessary to correctly recognize the side effects you are experiencing.How to deal with side effects should be learned, including situations where it is necessary to seek the help of a doctor.

You should know which side effects are serious and that if they develop, you should immediately consult a doctor.

Side effects of treatment should always be evaluated and monitored by a physician.

An important component of successfully managing side effects is establishing a pre-treatment support group that can include your family and friends.

Maintaining a positive attitude during treatment is a very difficult and important task. There is no scientific evidence on how the general attitude of the patient affects the treatment process. However, many patients report the importance of maintaining a positive mindset. A positive attitude is a process, not an ultimate goal. Don’t program yourself to fail. Be attentive to yourself.

How to maintain a positive attitude during treatment?

Before starting treatment, make a list of the reasons why you started treatment, constantly re-read it when it is difficult for you.The reasons that prompted you to start treatment may be different:
To improve your health.
To live longer.
To make you feel like you have done everything that you can do.
To live for your children, grandchildren, loved ones.
In order to simply get rid of the virus.
To reduce symptoms of hepatitis and improve quality of life.
For the prevention of cirrhosis and liver cancer.
In order not to become a burden to others.

When you wake up in the morning, think gratefully of the people who support you during your treatment and that you have the opportunity to receive treatment. Remind yourself each night that another day of treatment is over and you are one day closer to your goal of completing your treatment. Keeping in a good mood is much easier if you look after yourself constantly. If you look good, you generally feel better.

Try to follow these tips:

• Take a shower or bath daily.
• Listen to soothing music.
• Take care of the beauty of your hands and nails.
• Moisturize skin constantly.
• Take care of your hairstyle, it should be attractive and easy to maintain.
• Men do not forget about shaving.
• Women, if you regularly used makeup before starting therapy, do not forget to do so during treatment.
• Get dressed, even if you spend all day on the couch, choose comfortable clothes.
• Wear colors that make you feel your best.

Moderate exercise is strongly recommended for all HCV-infected patients, except those with acute hepatitis. Physical activity will improve your overall well-being and help you stay positive and motivated. Exercise can relieve stress and help you stay fit. However, excessive exercise can exacerbate the disease.Choose light types of exercise such as walking, hula hoop, swimming, dancing, gardening, yoga, qigong practice.

Slowly increase the load until the desired level is reached. Talk to your doctor before embarking on any exercise program.

Regular exercise contributes to:

• Increased muscle mass, strength and endurance.
• Energy potential improvement.
• Reduce stress.
• Increased bone strength.
• Reducing cholesterol and triglyceride levels.
• Increased appetite.
• Improve sleep.
• Stabilization or prevention of CD4 cell decline in HIV-infected individuals.

However, don’t overdo it! Exercising for 20 minutes, at least 3 times a week, will lead to a significant improvement in your physical condition and you can feel better. Choose activities that you enjoy.

Several dietary guidelines for viral hepatitis C:
Eat a healthy and balanced diet with lots of vegetables and fruits.
Try to refrain from excess sugar, salt and fatty foods.
Read all labels to familiarize yourself with the ingredients of the food you purchase.
Proteins from meat, poultry, fish, and plant sources may be most beneficial.
Do not eat raw or undercooked shellfish. they are harmful to patients with hepatitis C.
Avoid taking large doses of vitamins A and D.
Do not take vitamins and herbs without consulting your doctor.

What symptoms should I call a doctor immediately?
Severe depression.
Thoughts to harm yourself or others.
Chest pain.
Persistent increase in body temperature, its increase.
Decreased vision, loss of vision.
Difficulty breathing (dyspnea on exertion with exertion is common with therapy).
Recurrence of psoriasis.
Bloody diarrhea.
Unusual bleeding or bruising.
Severe abdominal or back pain.
Pregnancy

What medications should not be taken while taking antiviral therapy?

You should not take didanosine while you are taking ribavirin. Talk to your doctor about any medications you are taking.

Antiviral Therapy Side Effects Guide

Almost all patients taking pegylated interferons experience flu-like symptoms during treatment, such as muscle and joint pain, headache, chills, and fever.Most often, these symptoms occur 2-24 hours after the injection. Fortunately, they are usually most pronounced at the beginning of treatment. Flu-like symptoms are unpleasant, but you can manage them.

Temperature

The appearance of temperature is associated with the intake of pegylated interferon. The rise in temperature is usually more pronounced after the first few injections and usually occurs on the first or second day after the administration of interferon.

Seek help immediately if:
Temperature is over 38 ° C and lasts more than a day;
When chills or severe weakness appear;

In this case, the temperature may be associated with an infection, and you need specific treatment.Your Doctor will find out what your situation is related to.

Recommendations

Talk to your doctor about taking paracetamol or ibuprofen * half an hour before your pegillated interferon, or after an injection when you have a fever. This can reduce the temperature associated with the injection. Drink enough fluids, with a weight of 70 kg, you should drink at least 8 glasses of water per day. Visit your doctor if your temperature:
is above 38 ° C, if this does not follow after an interferon injection.
above 38 ° C: repetitive or lasting more than 24-48 hours.

* Caution: high doses of paracetamol cause severe irreversible changes in the liver, aggravated by the simultaneous intake of alcohol. Taking Ibuprofen increases the risk of gastrointestinal bleeding in patients taking anticoagulants and steroids, the risk increases with the simultaneous intake of alcohol.

Muscle pains

Muscle pains are the result of inflammation in the muscles that occurs while taking pegylated interferon.Ribavirin can also cause muscle inflammation and loss of fluid in your blood vessels, which can lead to muscle pain (dehydration is partly responsible for muscle soreness after prolonged exercise).

Recommendations
Talk with your doctor about taking paracetamol, or ibuprofen, to relieve muscle pain.
Do moderate-intensity exercises.
Use a warm, damp washcloth to rub over painful areas.
Take warm baths.
Drink plenty of fluids.

Headache

About 60% of patients taking antiviral therapy have headaches. Stress, insomnia, unhealthy diet can be the cause of headache. Headache can also be directly related to interferon, as well as anemia (low red blood cell count) caused by ribavirin.

Recommendations
Drink plenty of fluids.
Sleep more.
Take warm, soothing baths.
Relax in a quiet, dark room.
Try to reduce your stress levels.
If you have persistent headache for more than 24 hours, contact your doctor immediately.
Discuss paracetamol or ibuprofen * with your doctor
If you have had migraine attacks (a certain type of headache often with visual disturbances), talk with your doctor about taking medication
Avoid loud sounds, bright lights, alcohol, caffeine and foods containing tyramine (such as cheese and chocolate) and phenylalanine (used as artificial sweeteners).

Mental health

Poor sleep

Many patients on antiviral therapy have trouble sleeping. This occurs due to the stimulation (arousal) of certain areas of the body. Lack of sleep can trigger other side effects, including weakness, irascibility, poor mood and headache, and make your overall condition much worse. Adequate sleep and rest are the keys to successful treatment.

Recommendations
Make eight hours of sleep a regular habit.
Avoid reading and watching TV in bed.
Turn off the TV and computer one hour before bed.
Try to go to bed and get up at the same time.
Try to get some sleep during the day.
Limit fluid intake in the evening to avoid going to the toilet at night.
If you feel anxious while taking ribavirin, take the tablets at 4 pm or 5 pm instead of just before bed.
Avoid eating large amounts of food, excess exercise, tobacco and caffeine before bed.
Do some light exercise regularly, but refrain from exercise at least 4 hours before bed.
Chamomile tea is one of the most widely used teas for improving sleep. For better relaxation, place small lavender herb pillows or cotton cloths dipped in lavender oil near the bed. Remember, however, if you are using herbs, be very careful.

Feelings of fear and anxiety

Many patients report anxiety during antiviral therapy.This is a side effect of drugs, especially interferon, and is difficult to prevent. You may feel anxious and nervous.

Recommendations
Use relaxation techniques (yoga, meditation, deep breathing)
Avoid stimulants such as caffeine (coffee and tea).
If you do not feel well, tell your doctor about your symptoms and he will recommend medications to improve your well-being.

Hot temper

Many patients on antiviral therapy are angry about things that normally do not cause them emotion.This can even happen to people who have never been irritated. You may find yourself yelling at people in transport, although this has never happened to you before. By being aware of your temper, you can expect and control it better. If your family and friends know that you are taking medication that may be causing your reckless behavior, it will be easier for them to understand you.

Recommendations
Use relaxing technologies (yoga, meditation, deep breathing).
Breathe deeply, count to 10.
Share your feelings with friends and family.
Join a support group.
If you are tired, depressed, or sleepy, find ways to deal with these side effects.
Try to make your work less stressful.
For example, discuss flexible working hours with your supervisor if this can help you.

Depression and discouragement

Let’s face it, any chronic illness can cause depressed mood.Therefore, it is not surprising that many patients feel worthless and guilty. Depression is a spectrum of different symptoms. Typical symptoms are:
Longing, sadness, anxiety, or irritability.
Difficulty falling asleep, repeated awakening at night, or awakening too early.
Loss of interest in work, food, sex life.
Feelings of guilt and inferiority, hopelessness in relation to the future.
Difficulty concentrating and constant fatigue.
Weight loss or, conversely, weight gain.
Excessive concern for their own health.
Thoughts about suicide and death.

Antiviral therapy can increase the symptoms of depression, and symptoms usually appear within the first four weeks of starting treatment, although depression can start at any time during therapy. If you suffered from depression before starting therapy, tell your doctor about it – they will help you cope with this condition.

Taking pegylated interferon usually causes feelings of powerlessness.If you find your condition more than slightly exhausted – perhaps you feel
worthless, useless, or driven to complete despair, having lost interest in your hobby – you are depressed. This condition can be corrected
by changing the dose of interferon or prescribing antidepressants. After the end of therapy, these sensations will disappear within 1-2 weeks. Be sure to discuss your condition with your doctor. It is important for you to have a social circle with which you can share your feelings and doubts during treatment.Your family and friends can be a source of support for you and help you cope with your worries.

Recommendations
If you feel you are capable of harming yourself or are thinking about suicide, seek help immediately.
Do what brings you pleasure, for example, read books, visit your favorite cafes, performances, museums.
Learn to manage your emotions.
Develop habits: eat, go to bed, take medicine at the same time.
Avoid eating large amounts of sugar.
Keep a journal of any negative thoughts and feelings that affect your mood; this will help you and your doctor know how you are feeling on a daily basis.
It is important for you to have a social circle with which you can share your feelings and doubts during treatment. Your family and friends can be a source of support for you and help you cope with your worries. Spend time with people who can support you.
Join support groups.
Discuss with your doctor the options for treating depression.
Remember that depression is a controlled condition.
If you are taking medication for depression, make sure you follow your doctor’s instructions correctly.
Increase your intake of omega-3 acids.

Fatigue

Patients with hepatitis usually feel tired and weak.

Fatigue is one of the first side effects of antiviral therapy. This is partly due to the fact that interferon stimulates your immune system, and ribavirin has a toxic effect on red blood cells, reducing them (this condition is called “anemia”).Dysfunction of the thyroid gland, accompanied by a decrease in the level of thyroid hormones, can also cause fatigue.

Recommendations
Explore your limits and don’t overwork yourself. Do only those activities that really need to be done.
Try to go to bed and get up at the same time every day.
When planning any activity, take breaks for rest or short naps.
Get regular little exercise, but refrain from exercise at least 4 hours before bed.
Watch your posture.
Eat healthy foods to maintain your weight.
Remember to drink plenty of water throughout the day, especially after taking the pills.
If fatigue is significant within 1–2 days after injection of interferon, take 325 to 1000 mg of paracetamol * prior to injection. (Talk to your doctor about this.
Remember that health is the most important thing. Learn to say no to your friends and family who overestimate your strength, ask them to help you.

Loss of concentration, memory and ability to think clearly

Tips for improving memory:
Keep a regular diary of medication and side effects.
Do not forget to take medicines with you, put them in a special container.
Use the timer settings on your wristwatch, alarm, electronic organizer, or computer to remind you of your medication.
Get into the habit of planning your day the night before.
Perform one task at a time, not several tasks at the same time.
Notice what you want to remember, repeat several times.
Use sticky notes to remind you of your plans.

Oral cavity, stomach, digestion

Antiviral therapy can lead to decreased appetite. It is important to adhere to a complete diet during and after therapy. Your body needs good nutrition and healthy food to fight the hepatitis C virus and repair the damage caused by it.

Recommendations
Take a walk or exercise to relax before eating.It can boost your appetite.
Eat small meals 5-6 times a day instead of three meals a day. For example, 8:30 for breakfast, 10:00 for a light snack, 12:30 for lunch, 15:00 for a light snack, 17:30 for dinner, and 19:30 for a light snack.
Eat your favorite food, even if you eat little.
Drink freshly prepared homemade drinks with food additives instead of meals. Drink drinks through a straw if you find them less appetizing.
Store snacks such as boiled eggs, cheese, and butter wherever you can.Store snacks that don’t need to be refrigerated by your bed or TV.
Stock up on small portions of frozen food, it’s easy and simple to prepare.
Try to use different types of food to prepare the most interesting dishes.
Watch television on cooking.
Make your meal enjoyable – eat with others, eat in a pleasant place with candles.
If possible, do not drink liquids at the same time as meals.This will make you full sooner.

Bad taste in the mouth, change in taste

Pegylated interferon can cause a bitter or metallic taste in the mouth. Ribavirin can cause mouth inflammation and dehydration, which can create a dry and unpleasant taste in your mouth.

Recommendations
Drink plenty of water.
Sour foods can mask metallic taste. Drink orange, cranberry, pineapple juice, and lemon drink. Add apple cider vinegar, lemon juice, pickle, or seasonings to your meals.
Marinate meat, chicken, fish or turkey in apple cider vinegar, wine, mayonnaise, soy sauce. Add fresh and dry herbs or condiments to (such as onion, garlic, chili, rosemary, cumin, basil, oregano (mint), thyme, mustard, horseradish, ketchup).
Avoid canned foods. Eat fresh or frozen foods.
Eat cold foods such as popsicles, sorbet, fruit yogurt, frozen yogurt to freeze the taste buds. Eat frozen grapes, orange slices, or melon and watermelon slices.Use lemon lozenges to help reduce or eliminate bad taste in your mouth that does not go away after eating.
Do not eat citrus fruits or drink citrus juices immediately before or after brushing your teeth.
Eat dark chocolate.
Rinse your mouth with tea, salt water, or water and baking soda before meals. This will help freshen up the palate.
Use glass, china, plastic wrap instead of metal.
Observe oral hygiene.
Remember that your palatability will recover after the end of therapy.

Dry mouth and thick saliva

Ribavirin destroys red blood cells, resulting in dehydration. This causes dry mouth or thickened saliva.

Recommendations
Use sugar-free candy, ice cubes, chewing gum to moisturize the mouth.
Start and end your day with a glass of water.
Add sauces, juices, yoghurts to food.
Dip bread, crackers, biscuits in soup, milk, juice or hot chocolate.
Keep a glass of liquid near your bed in case you come in for a drink at night.
Rinse your mouth with a mild saline solution.
Drink plenty of fluids, water with lemon juice, lemon tea.
Talk to your doctor about other oral moisturizers for dry mouth.

Inflammation of the mouth and throat

All patients are recommended to be examined and treated by a dentist before starting treatment.During treatment, inflammation of the mouth and throat is possible. If you usually have sores in your mouth, your condition may worsen during treatment as a result of decreased immunity. Talk to your doctor: many factors can cause stomatitis and aphthous lesions in the mouth.

Recommendations
Observe oral hygiene.
Use a soft toothbrush.
Do not use toothpastes containing sodium lauryl sulfate.
Drink plenty of water.Adequate hydration is important to maintain health, especially during hepatitis B treatment. Eat chopped foods or mashed potatoes. Baby food can be a great substitute for other foods.
Drink nectars instead of juices.
Drink instant drinks or milkshakes instead of solid foods.
Use a straw.
Eat warm or cold food, not hot food.
Rinse your mouth with warm, salted water.
Consult your doctor regarding the use of lidocaine for oral care.This can relieve the discomfort of oral inflammation.
Keep a food diary to identify possible causes of inflammation and eliminate foods that cause inflammation from your diet.
Use high tannin teas and herbs (chamomile, sage, peppermint) for mouthwash.
Talk to your doctor about taking probiotics containing Lactobacillus.
Echinacea may speed up the healing process of aphthae, however, in patients with HIV, echinacea is contraindicated.

Refrain from:
Salty, sour, spicy foods.
Coarse food like dry toast, muesli.
Chili powder, hot sauce, pepper, curry, cloves, nutmeg.
Beverages containing carbonate salts (cola).
Citrus fruits (oranges or grapefruits).

Nausea and vomiting

Nausea is a common side effect and can be caused by both interferon and ribavirin. Repeated vomiting can lead to dehydration and chemical imbalance in the body.If you experience frequent vomiting or nausea, consult your doctor.

Recommendations

Try:
Eating a diet containing bananas, rice, applesauce, tea, and toast.
Eat small, snack meals every 2-4 hours instead of 2 or 3 meals a day.
Take ribavirin with meals.
Eat food that is cool or chilled to room temperature. Fruit or chilled cheese sandwiches are good. Hot food can contribute to nausea and vomiting.
When vomiting, support yourself with soups, juices, frozen fruits.

Foods to help with nausea and vomiting:
Salty foods such as crackers, pretzels.
Mint, chamomile, ginger tea will calm your stomach.
Cold mineral water with gas.
Talk to your doctor about the use of medicines that reduce nausea.

What to avoid:
Do not lie down for an hour after eating.
Avoid odors and foods that cause nausea.Open windows to reduce the smell of food being cooked.
Do not eat during severe nausea.
Avoid very sweet, hot, fatty, spicy, strong-smelling foods.

Diarrhea

Diarrhea (diarrhea) may occur during therapy. In some patients, diarrhea is a manifestation of side effects. Diarrhea can cause dehydration and weakness, so it is very important to make up for lost fluid loss.

Recommendations
Eat a diet containing bananas, rice, applesauce, tea and toast.Eat small meals often.
To replenish lost fluids, drink a variety of drinks (water, herbal teas) at room temperature throughout the day.
Eat foods high in soluble fiber: oatmeal, rice, bananas, applesauce, fruit jelly.
Drink and eat foods that contain a high percentage of potassium carbonate, a substance that is lost in diarrhea. It contains bananas, peeled tomatoes, fish, chicken, meat, apricot, orange, mango and peach juices.
Eliminate spicy, fried, fatty foods.
Drink a glass of liquid after each bowel movement.
Talk to your doctor about taking medicines for diarrhea.

What to avoid:
Avoid fatty, fried, spicy and overly sweet foods.
Limit caffeinated beverages such as coffee and cola.
Avoid dairy products for three days after symptoms have subsided.
Avoid foods and drinks that can cause cramps and bloating, such as beans, cabbage, broccoli, Brussels sprouts, fresh peppers, sodas, and onions.
Limit the use of sugar-free chewing gum, sorbitol candies.

Weight loss

Excessive weight loss can be a serious problem with treatment. A well-balanced diet is an important part of maintaining overall health during treatment. Most patients notice weight changes during treatment. Unfortunately, weight loss can be associated with side effects of therapy and muscle loss. Exercise, like a balanced diet, is important because it increases muscle mass, stimulates appetite, and reduces depression and anxiety.

Causes of weight loss must be identified and corrected by your doctor.

Tips for preventing weight loss:

• Consult a dietitian regarding food choices.
• Choose foods that are high in calories and protein.
• Drink juices in addition to water.
• Add to your diet regular consumption of milk, milkshakes, milk soups, eggs, mashed potatoes, baked goods.

Skin and Hair

Antiviral therapy can lead to excessive hair loss (baldness) as well as changes in hair texture. Such changes can occur throughout the body, not just on the head. One in three patients taking antiviral therapy is worried about brittle hair and hair loss, hair color becomes dull.

Hair loss can also be a symptom of a malfunctioning thyroid gland, and all patients who complain of this symptom should have a thyroid function test. Major hair loss / changes in hair structure occur more frequently after 3-4 months of treatment.Hair usually falls out little by little, rather than profusely as with chemotherapy. After the end of the therapy, your hair will begin to grow slowly and will regain its original thickness. It is important to know that minoxidil (contained in VICHI shampoos) does not have the desired effect on interferon-induced hair loss. In fact, minoxidil can cause irritation and dryness of the skin, which are undesirable during therapy.

Recommendations

• Do not wash your hair too often.
• Wear a hat.
• Use a wide-toothed combs or soft brush, do not brush your hair too often.
• Do not blow dry your hair, tie your hair tightly, and avoid chemical dyes and perm.
• Use less gels, sprays, hair sprays, hair mousses, especially those containing alcohol.
  Use a mild shampoo.
• Sleep on a satin pillowcase to reduce hair friction.
• Do not use medicines for hair loss – they are not effective for hair loss associated with taking interferon

Changes to nails

Antiviral therapy can affect the structure of your nails, they can become dry and brittle.

Tips for nail care:
Keep your feet short.
Use hand lotions and creams as often as possible, especially after your hands have been in water.
Wear gloves to protect your hands when washing dishes, cleaning, gardening, doing laundry, or working with chemicals.
Before going to bed, grease your hands with greasy cream, wear special cotton gloves.
Use custom manicure supplies.
If you use the services of nail salons, remember not only about your own safety, but also about the safety of other clients.

Skin rashes

Skin rashes, especially on the limbs and trunk, are often the result of taking ribavirin. This rash tends to come and go during the treatment period.

Recommendations:

• Take a cool bath, use moisturizing soaps and lotions.
• For dry skin, use a shampoo containing selenium.
• Protect your skin from sun damage, which can exacerbate rashes.
• Avoid taking hot showers, baths.
• If the use of lotions and creams does not improve the condition, consult your doctor.

Local reactions in the area of ​​injection

Redness and spots may appear at the injection sites. Your condition will improve a few days after the end of your treatment.

Recommendations
If you are self-administering the drug, follow the rules for administering the drug.
If you experience pain, swelling, or irritation at the injection sites, consult your doctor immediately.

Tips for safe injections:
Wash hands with soap and water before injecting to prevent infection.
Check that the drug is at room temperature.
Treat the injection site, the skin must be dry.
Change injection sites constantly.
Do not massage the injection site.
Apply cold to problem areas.
Talk to your doctor about using hydrocortisone cream for itching.
Clothing may irritate the skin at the injection site; therefore, it is advisable to wear clothing and linen made from natural materials.
Needles and syringes should not be reused.
The use of cosmetic creams may help with minor irritations.

Chest pain

Chest pain is a common side effect of therapy. The hepatitis C virus affects the entire body – from muscles to joints, lungs and digestive system. Your esophagus, lungs, chest muscles, ribs, and heart can trigger a variety of chest symptoms that feel like chest pain.But if the pain appeared during therapy, especially if it is significant, differs from the pain that was previously present, or appears during the ascent or descent of stairs, you should seek medical help, because perhaps the pain is associated with problems of the cardiovascular system and requires special therapy.

Recommendations

Seek medical help, as only a doctor can decide what your problem is.

Shortness of breath

During treatment, many patients notice the appearance of shortness of breath.This phenomenon is associated with a decrease in red blood cells (anemia) while taking ribavirin. Seek medical attention immediately if shortness of breath occurs. Shortness of breath can make you feel anxious. A doctor can help rule out bronchial asthma or another lung disease that requires special treatment.

Recommendations

Pay attention, after which shortness of breath occurs, inform your doctor about it. It is necessary to undergo additional examinations to exclude heart and lung diseases.

Visual impairment

Visual impairment may be associated with impairment of visual clarity. If they do occur, you should see an ophthalmologist to rule out other causes of visual impairment.

Recommendations
Visit your ophthalmologist prior to treatment to know your baseline values ​​for vision.
Describe to the doctor the time of the onset of visual impairments (night, in bright light, the usual time of day), how they appear (blurred objects, inability to look with one or two eyes, pain).
For noticeable visual impairment (sudden loss of vision, sudden change in vision in one eye), seek medical attention within 24 hours.

Thyroid problems

The thyroid gland is located on the front of the neck and is the size of an apricot. It controls many functions of the body: it affects appetite, weight, concentration. Pegillated interferon can decrease and increase the activity of the thyroid gland.Thyroid function should be checked carefully before treatment, and then checked every three months of treatment. In most patients, interferon does not cause thyroid dysfunction. If any changes occur, they should be discussed with your doctor.

Recommendations

Tell your doctor about the changes that worry you, the doctor will prescribe you additional blood tests.

Anemia

Before starting antiviral therapy and during treatment, it is necessary to regularly, at least once every two weeks, monitor the indicators of a general blood test, including indicators of erythrocytes, platelets and leukocytes.

Taking ribavirin often leads to anemia (a decrease in the number of red blood cells), which leads to chronic fatigue and can cause heart pain, shortness of breath, or even a heart attack. Anemia is diagnosed using two tests: determining the amount of hemoglobin and hematocrit.

There are two approaches to the treatment of ribavirin-induced anemia: dose reduction of ribavirin and the use of erythropoietin-beta, which stimulates red blood cell production. Some medical experts believe that ribavirin dose reduction should be avoided, especially during the first 12 weeks of treatment, as adequate doses of ribavirin help prevent relapse and increase the chances of achieving a sustained virologic response (SVR).

Neutropenia

The main function of leukocytes is to fight infection. There are several types of white blood cells: neutrophils, lymphocytes, monocytes, eosinophils, and basophils. Neutropenia is characterized by an abnormally low number of neutrophils. Neutropenia is a common side effect of both conventional and pegylated interferons. Clinical studies have shown that in more than 95% of patients with antiviral therapy, there was a decrease in the number of neutrophils.The vast majority of patients who develop interferon-induced neutropenia do not develop serious infections. However, despite this, it is very important that patients are timely (at least once every 14 days) monitored blood counts in order to prevent serious complications of neutropenia. Neutropenia is usually corrected by dose reduction

Source: http://www.hvstop.org/page.php?id=22

90,000 Hepatitis C Virus: Where Does It Come From?

May 2, 2013

Signs to the photo,

This infection affects 150 million people in the world

Virologists, epidemiologists and geneticists have been struggling for decades with the question of where the hepatitis C virus came from.One recent study showed that it could come to humans from bats. But that theory may not be true, says Professor Jonathan Ball of the University of Nottingham.

The ubiquitous bats, which make up one-fifth of all mammalian species, are enigmatic creatures.

They “gave” people a lot of viral infections, in particular SARS and Ebola. And according to a recent study published in the journal PNAS, bats are also a giant natural reservoir for viruses related to those that cause hepatitis C.

This dangerous infection affects 150 million people worldwide. And scientists have been trying to figure out its origin for many years.

Phoenix-Lan Quan from Columbia University in New York, along with colleagues analyzed the blood of hundreds of bats from South America, Africa and Asia.

These animals are carriers of dozens of infections. To find all of them, scientists used highly efficient sequencing, which examines the nucleic acids present in the subjects’ blood.

And in the DNA of 5% of the examined bats, the researchers found genetic sequences similar to the nucleic acids of viruses from the genus of pegiviruses and hepatoviruses. The human hepatitis C virus (HCV) also belongs to the hepatovirus genus.

To determine the evolutionary history and relationship of the viruses of bats with HCV, scientists drew the so-called phylogenetic tree of the viruses found.

Unlike the human family tree, which is built on the basis of archival data, historical data recorded in the information sequences of nucleic acids is used to reconstruct the phylogenetic tree.

During replication, the genetic material of the virus may change or mutate; over time, these mutations accumulate, allowing the virus to evolve.

If you determine the genetic differences between viruses, you can understand whether they are related and how much: the fewer the differences, the more closely they are related.

In other words, viruses located on adjacent branches are relatives, and the shorter the branches, the closer these relatives are.

In Dr. Quan’s experiments, the branches leading to the bat viruses are long and branched.This means that bats have long been infected with a large number of strains – significantly more than humans.

In addition, the phylogenetic tree told scientists something about the origin of the hepatitis C virus.

If it came to us from bats, then somewhere in the branches of a segment of bats of the tree, the HCV sequence must also be hidden. At first glance, it is.

But before declaring the bat an enemy of humanity, one should answer the question: did the hepatitis virus really come to us from these peaceful mammals?

Horses, dogs or bats?

Sign up to photo,

Bats could have transmitted the hepatitis C virus to us.But recently, scientists have appeared and other suspects

The method of transmission of diseases from animals to humans is called zoonosis.

The method of phylogenetic trees allowed scientists to find the source of many infections.

For example, in 2005 in the journal Science there was information that the Sars virus, which causes SARS, came to people from vivere cats, and they contracted it from bats. And in the Royal Society Journal in 2010, it was finally proved that HIV came to humans from African primates.

The evidence is very solid.

For example, in the trees of viruses obtained from a wide sample of wild primates, it is clearly visible that the human immunodeficiency virus is more similar to the chimpanzee immunodeficiency virus. Therefore, it is most likely that HIV came to us from them.

According to a study published in Emerging Infections Diseases, the human hepatitis virus is more similar to viruses from horses and dogs than from bats. On the other hand, the branches leading to human HCV are very long, which means that this virus has undergone significant genetic changes, that is, it has evolved for a long time.

It could be concluded that the hepatitis virus was transmitted to humans millennia ago, but this is unlikely.

A much larger sample is required for a final verdict.

Just as the identification procedure only makes sense when a criminal is present among the innocent, phylogenetic analysis can identify viruses most closely related to HCV only when they are present in the subjects’ blood.

Although Dr. Quan’s research was based on very broad – unprecedentedly broad – material, there were not enough “suspects” among the hepato- and pegiviruses she found.

“Our work has shed light on the evolutionary history of the viruses that ultimately formed HCV,” explains Dr. Quan. bat blood. That is, the evolutionary history of these viruses in bats is longer than in primates, horses or dogs. ”

Although Dr. Quan believes that bats have a wide range of these important viruses, she is hesitant to claim that bats are the source of HCV.

“The current evidence does not make it clear that bats are the ‘ultimate’ reservoir of hepato- and pegiviruses, or that HCV is transmitted to humans from bats,” she says. “Much larger research needs to be done to answer this question. than ours. ”

About mice and people

Signs to the photo,

It may turn out that the hepatitis virus came to us from rodents

This theory is also confirmed by the work of Amit Kapoor, a researcher at the same Columbia University.In an article published in the journal Mbio, he reported that many rodent species are also carriers of hepato- and pegiviruses.

Mouse viruses, like bat viruses, are also extremely genetically diverse, which means that mice have lived with them for a long time.

None of the rodent viruses were closer to human HCV than equine hepatoviruses. But one of the co-authors of the study, Professor Peter Simmonds of the University of Edinburgh, considers the very fact of the diversity of hepatoviruses in rodents to be important.

“It appears that both bats and rodents carry a wide variety of HCV-like viruses,” he says. “We have only found viruses quite different from HCV now, but it is possible that we will find close relatives of it in the future.”

Professor Simmonds does not exclude that the hepatitis virus could have come to humans and from other animals, but predicts that scientists will nevertheless “find in Africa or South Asia, where HCV most likely originated, species of bats and / or rodents who transmitted the virus to humans. “Although “knowing what these species are, and how and when they infected humans is quite difficult.”

Thus, despite recent advances, the phylogeny of hepato- and pegiviruses is more of a seedling than an adult tree.

Further large-scale research will add new branches to it and bring us even closer to understanding where the hepatitis C virus came from.

Bats and rodents have existed for more than 50 million years, so it is not surprising that during this time they picked up a couple of viruses.

Some of them inevitably passed on to people – through the general habitat or human activity.

But who gave us HCV – bats, rodents and other animals – remains to be seen.

Non-viral hepatitis

Hepatitis is an inflammation of the liver. If the inflammatory process lasts less than 6 months, hepatitis is acute, if more than 6 months – chronic.

Various factors can cause hepatitis. There are infectious and non-infectious hepatitis.Among infectious, the most common are viral, but there are hepatitis caused by bacteria and parasites. Non-infectious substances can be caused by toxic substances, including alcohol, diseases of other organs and systems of the body. Chronic alcoholism is one of the main causes of non-infectious hepatitis: approximately 20% of patients suffering from alcoholism for 5-6 years develop alcoholic liver damage.

As a rule, acute hepatitis results in complete recovery.Sometimes the disease becomes chronic, which can last for months or years, and in some cases leads to cirrhosis or liver cancer.

Russian synonyms

Non-infectious hepatitis, alcoholic hepatitis, non-alcoholic steatohepatitis, fatty hepatosis, drug hepatitis, toxic hepatitis, toxic-allergic hepatitis, idiopathic hepatitis, autoimmune hepatitis, reactive hepatitis, chronic persistent hepatitis, chronic necrotic hepatitis, non-active hepatitis acute hepatitis, chronic hepatitis.

Synonyms English

Acutehepatitis, chronichepatitis, nonviral hepatitis, noninfectious hepatitis, non-alcoholic hepatitis, non-alcoholic steatohepatitis, NASH, toxic hepatitis, autoimmune hepatitis, neonatal hepatitis, d-induced hepatitis, alcoholic hepatitis.

Symptoms

In the initial stages, hepatitis can go unnoticed. The first signs of the disease are usually nonspecific. The intensity of symptoms depends on the cause of hepatitis, the activity and duration of the pathological process.The main symptoms of hepatitis are:

• weakness, malaise;
• yellowness of the skin, sclera;

90,027 muscle and joint pain;

• loss of appetite;
• nausea, vomiting, heaviness in the abdomen;
• fever.

General disease information

The liver is one of the most important human organs. It is located in the upper right part of the abdominal cavity, bordered by the diaphragm, right kidney, intestinal loops, stomach and consists of two main lobes (right and left), which are formed by thousands of lobules.The lobules are made up of hepatocytes, the cells responsible for the basic functions of the liver. The hepatic artery, through which oxygen-rich blood flows, and the portal vein, which carries blood from the organs of the gastrointestinal tract, go to the liver. The outflow of blood is carried out through the hepatic vein. There is also a complex system of bile ducts, through which synthesized bile enters the gallbladder, where it accumulates, and into the intestines.

The liver performs a number of vital functions: synthesizes proteins (albumins, clotting factors), cholesterol, enzymes, hormones, bile, cleans the blood from excess hormones, metabolic products, toxins and microorganisms that enter the bloodstream through the digestive system, participates in the metabolism of carbohydrates , vitamins, microelements.

Exposure to a number of factors can lead to liver damage and malfunction. With hepatitis, the liver tissue becomes inflamed, leukocytes accumulate in it, zones of necrosis (necrosis) may appear, and a small amount of connective fibrous tissue appears. However, in general, unlike cirrhosis, the structure of the liver lobules is not disturbed. Inflammation is accompanied by stagnation of bile and dysfunction of hepatocytes.

Depending on the cause, the following types of non-infectious hepatitis are distinguished.

• Alcoholic hepatitis. It is formed as a result of many years of alcohol abuse, which disrupts the metabolism in hepatocytes, leading to their destruction.
• Non-alcoholic steatohepatitis. This is a condition in which changes in the liver resemble alcoholic hepatitis, but are not associated with alcohol intake. Non-alcoholic steatohepatitis can be combined with metabolic diseases: obesity, diabetes mellitus. In some cases, it occurs in people without concomitant diseases and even in children.
• Medicinal hepatitis. Taking a number of medications – antibiotics, anti-tuberculosis drugs, oral contraceptives – sometimes leads to hepatitis. The likelihood of a toxic effect of drugs on the liver is determined by the individual tolerance of the drugs.
• Toxic hepatitis. It is caused by poisonous mushrooms, alcohol substitutes, arsenic compounds, toluene, benzene, lead and other substances that have a direct destructive effect on liver cells.
• Autoimmune hepatitis. With this disease, the immune system is disrupted, which begins to destroy its own, normal liver cells. The mechanism of development of autoimmune hepatitis is not fully understood.
• Metabolic hepatitis. It is caused by hereditary metabolic diseases, for example, hemochromatosis (increased absorption of iron in the intestine with its deposition in the tissues of the body) or Wilson’s disease (a violation of copper metabolism with its deposition in the liver and other organs).
• Reactive hepatitis. It can be formed as a result of exposure to toxins and metabolic products that enter the bloodstream in diseases of other organs (with stomach ulcers, pancreatitis, endocrine and autoimmune diseases).
• Primary biliary hepatitis. It is associated with a violation of the patency of the bile ducts, a violation of the outflow of bile, which leads to damage to the liver tissue.

Liver cells in hepatitis can be damaged not only as a result of direct exposure to toxic substances, but also due to the pathological activity of cells of the body’s own immune system.As a result, the liver is disrupted, which leads to the characteristic symptoms of hepatitis: the liver increases in size, there is a feeling of heaviness in the abdomen, the outflow of bile necessary for the digestion of fats slows down, which causes nausea, vomiting, flatulence, stool disorders (diarrhea or constipation ). Disruption of protein (albumin) synthesis leads to a decrease in the osmotic pressure of the blood and the release of fluid into the tissues, which causes edema. A decrease in the number of clotting factors leads to increased bleeding.The purification of the blood from toxic substances is impaired, which is manifested by weakness, malaise, and fever. The yellowness of the skin and mucous membranes is due to an increase in the level of bilirubin. It is formed when erythrocytes are destroyed, binds in the liver with glucuronic acid (direct, bound bilirubin is formed) and is excreted in the bile. With hepatitis, this process is disrupted and direct bilirubin enters the bloodstream.

Who is at risk?

• Alcohol abusers.

• Obese.
• Patients with chronic autoimmune, endocrine diseases.
• Patients who need long-term use of drugs that have a toxic effect on the liver.
• Contact with high doses of toxic chemicals.

Diagnostics

The manifestation of hepatitis depends on the immediate cause of the liver damage. In some cases, hepatitis may have nonspecific symptoms or even be asymptomatic.Careful questioning and examination of the patient helps the doctor to suspect hepatitis, but more research is needed to make a definitive diagnosis.

Laboratory diagnostics

• Complete blood count. An increased level of leukocytes is a sign of the infectious nature of hepatitis.
• Prothrombin index. This is the ratio of the clotting time of a healthy person to the time of the patient’s clotting. Prothrombin is a precursor of thrombin and is involved in blood coagulation.The test is used to assess the rate of blood clotting. In the initial stages of hepatitis, the prothrombin index is normal; in severe cases of the disease, it can be reduced.
• Fibrinogen. A blood clotting factor that is synthesized by liver cells. When liver tissue is damaged, fibrinogen is reduced.
• AST (aspartate aminotransferase), ALT (alanine aminotransferase). Liver enzymes that enter the bloodstream when liver tissue is damaged.With hepatitis, it can be increased.
• Gamma Glutamyl Transpeptidase (Gamma GT). Hepatic enzyme, the amount of which increases with damage to the liver and biliary tract.
• Alkaline Phosphatase. An enzyme that is found in all tissues of the body, but in greatest quantities in bones, kidneys and liver. With hepatitis, it can be increased.
• Total bilirubin. Bilirubin in hepatitis is increased mainly due to the direct (bound) fraction.
• Total whey protein. In hepatitis, the level of total protein can be reduced by reducing the amount of albumin.
• Total cholesterol. This substance is synthesized in the liver and is an element of cell membranes, a precursor of bile acids and some hormones. With hepatitis, it can be lowered, which indicates a violation of the synthetic function of the liver.
• Tests for hepatitis B, C, D. The presence of hepatitis viruses in the body as a possible cause of the disease is determined.
• Ferritin, transferrin. Ferritin is a protein that binds iron in the liver, and transferrin is a protein that transports iron from the intestine to the liver. Their level can be increased with hemochromatosis.
• Copper, ceruloplasmin. The level of these substances is measured when Wilson’s disease is suspected, in which the concentration of ceruloplasmin decreases and the concentration of copper increases.
• Screening test for the presence of narcotic, psychotropic and potent substances.Identification of compounds that could cause hepatitis.

Additional research

• Ultrasound of the abdominal organs. Used to determine the size and structure of the liver. With hepatitis, the liver may be enlarged.
• X-ray, CT, MRI. Helps to determine the size, structure of the liver, to exclude other diseases.
• Retrograde cholangiography. This is an X-ray examination, which is carried out after the injection of a contrast agent visible in the picture into the biliary tract.Used to assess the patency of the biliary tract.
• Liver biopsy. Taking a sample of liver tissue using a thin hollow needle, which is inserted through the skin of the abdominal wall after preliminary anesthesia. It is carried out under the control of ultrasound. Microscopy of the taken sample determines the inflammation of the liver tissue, the accumulation of leukocytes, a small amount of connective tissue while maintaining the structure of the liver lobules.

Treatment

Treatment of acute hepatitis is based, first of all, on the cessation of the effect of the pathological factor on the liver and is aimed at preventing the transition of the disease into a chronic form.Most of the acute hepatitis is completely cured. Chronic hepatitis, depending on the cause and activity of the process, can last from 6 months to several years. A long course implies regular examinations, strict adherence to the doctor’s recommendations, changing the patient’s lifestyle – this is necessary for the prevention of liver cirrhosis, liver failure, liver cancer.

Prevention

• Refusal from alcohol and drugs.
• Following the instructions and recommendations of the doctor when taking medications.
• Use of protective equipment when working with toxic chemicals.
• Fighting excess weight.

Recommended analyzes

90,000 Where Does Hepatitis C Come From – Symptoms and Treatment

Hepatitis C is a viral inflammatory disease that leads to complete liver dysfunction. Pathology develops asymptomatically for a long time, so it is rather difficult to identify it at an early stage. Because of this, the risk of complications increases significantly.Most often, the patient’s history is supplemented by cirrhosis and liver cancer. The sooner treatment is started, the sooner a positive result will appear. Today, you can buy medications through which you can get rid of the disease forever. Unfortunately, few people know the whole truth about hepatitis C. At the same time, the standard course is often not enough for a complete recovery.

Contents of the article:

Does hepatitis C exist

Hepatitis C has not been fully studied to date.Many myths have arisen on this basis. There is an opinion that this pathology was invented in order to obtain additional benefits from the sale of medicines. The reason for the emergence of such fictions are the following circumstances:

• Hepatitis C is diagnosed by chance in most cases. Most often this happens during a medical board appointed before a blood transfusion or during pregnancy. In this case, pathological changes in the liver progress without noticeable symptoms.
• The most reliable diagnostic method is considered to be an immunological test for antibodies formed in hepatitis C and HIV. It remains unclear why it is impossible to detect the virus through other clinical trials.
• Diagnostic examination, prescribed for suspected hepatitis C, takes place in several stages. Each of them is necessary for the detection of proteins resulting from an infectious infection, and not the pathogens themselves.
• The hepatitis C virus can be active or inactive.In the latter case, it does not harm the host, but at the same time it is transmitted to other people.
• Representatives of the younger generations (up to 30 years old) most often suffer from this disease.
• The consequences of treatment with ribavirin and interferon are not always positive. There is a high likelihood of developing serious side effects that greatly worsen the general condition of the patient.
• The disease is often diagnosed in people who do not belong to any risk group.This means that not all factors are known that can provoke pathological changes in the body.

Hepatitis C

Hepatitis is a serious illness that has several varieties. Viruses labeled A and B are considered common. Hepatitis C was detected in 1987, specific antibodies were found in people who abused alcohol, took drugs, and underwent a blood transfusion.

As a result of full-scale research, it has been proven that people with this diagnosis can live as long as others.According to doctors, this is due to the long latency period. They prove the existence of the hepatitis C virus using the results of clinical studies.

Main symptoms

Clinical signs vary depending on the type of disease. In the acute form of hepatitis C, symptoms such as:

• Painful sensations in the joints;
• changes in color and consistency of urine;
• sleep problems;
• decrease (loss) of appetite;
• weakness in the whole body;
• yellowing of the skin and sclera of the eyes;
• heaviness in the right hypochondrium and lower back;
• dyspeptic disorder (nausea and vomiting).

In chronic hepatitis C, the clinical picture is supplemented:

General weakness

• general malaise;
• discoloration of feces;

90,027 rashes on the body;

• hyperthermia;
• aversion to food.

Ignoring them is fraught with serious exacerbations. Their appearance is indicated by weight loss, bloating, scars on the liver, venous veins and asterisks on the body. Modern medicine can save the patient from this ailment.The duration of drug therapy largely depends on the type and stage of the pathology. As a last resort, a liver transplant is performed. The need for it appears if lesions are found in the liver, the development of which is fraught with irreversible pathological changes.

Causes of the disease

Infection with hepatitis occurs through direct contact of the blood of a healthy and sick person. This can happen when using a single needle (when injecting a drug), applying a tattoo, visiting a nail salon, or dental procedures.

There is a small chance of contracting hepatitis through unprotected sex with an infected partner. It is impossible to determine the diagnosis based only on external symptoms. The virus is not transmitted by the transplacental method, infection can occur with complicated childbirth (if the integrity of the placenta is violated). It should be noted that hepatitis C vaccines have not yet been developed. People with a history of this disease do not need to be isolated from society.The virus is not transmitted by airborne droplets and by household.

Diagnostics

If the doctor suspects hepatitis C, then the patient is prescribed a referral for the following clinical trials:

Blood test

• KLA – through it, you can detect a decrease in platelet levels and an increase in the concentration of leukocytes. This indicates the presence of foci of inflammation in the body.
• Biochemical blood test – it is prescribed together with the KLA.
• ALT and AST test – alanine aminotransferase and aspartate aminotransferase are found in liver cells. Deviations associated with the level of these enzymes indicate the proliferation of connective tissue in the parenchymal organ. The analysis allows you to detect hepatitis C at an early stage.
• Immunological study – determination of the amount of specific antibodies. Analyzing the information obtained through the analysis, the doctor finds out the body’s resistance to the hepatitis C virus.
• Coagulogram – a set of tests used to study blood clotting.A decrease in this indicator is due to a decrease in the production of prothrombin. This is the name of the protein, for the formation of which the liver is responsible. It is needed to stop the blood.
• PCR is a blood test that detects the hepatitis C virus and particles of its RNA chain. Thus, the genotype of the disease is determined.

This list is supplemented by biopsy and ultrasound examination of the liver. The diagnosis is made on the basis of a comprehensive examination. If a false positive result is obtained, the analysis is repeated.In this case, it is dangerous to question the existence of the hepatitis C virus.

Hepatitis C treatment

Doctor’s consultation

The therapeutic regimen is prescribed depending on the identified diagnosis (genotype, stage), general condition and individual characteristics of the patient. Of great importance is the genetic predisposition to the formation of fibrous tissue. Hepatitis C does not always require immediate treatment. In 5% of cases, the body’s defense system copes with the virus on its own.The result is lifelong immunity against hepatitis C.

If the virus is found in the patient’s blood, he should not panic. In the early stages, hepatitis C is curable. There are chances for a complete recovery even with a chronic course of pathology. The effectiveness of treatment for hepatitis C directly depends on the choice of therapy methods. To determine the likelihood of developing cirrhosis and liver cancer, the patient is prescribed a referral for an immunogenetic study. Doctors analyze the results of exposure to markers, they include immunoregulatory proteins and cytokines.

It should be noted that the treatment of hepatitis C is quite expensive. It is especially difficult for those patients with a history of the 1b genotype. With this type, relapses often occur. The European Association has approved a protocol according to which therapy for each patient must be selected individually.

When prescribing a treatment regimen for hepatitis C, take into account:

• the degree of damage to the parenchymal tissue;
• the patient’s readiness to undergo therapy;
• existing complications;
• risk of negative consequences;
• the expected impact of the actions taken.

Interferon

The complex antiviral therapy is considered the most effective. It is carried out with the help of Interferon and Ribavirin. These medicines can help with any type of hepatitis C. There are also negative aspects of such treatment. Interferon has a high cost, it provokes the occurrence of adverse reactions. When resistance to antiviral drugs appears, the therapeutic regimen is corrected, before that, the patient must undergo laboratory tests. This is necessary to assess the effectiveness of treatment.

Hepatitis C therapy lasts from 6 to 12 months, the patient can stay at home throughout its duration. When prescribing a drug regimen, contraindications must be taken into account. Combination treatment is not prescribed for patients from the following categories:

90,026 90,027 children under 3 years old;

90,027 women in position;

90,027 people who have undergone internal organ transplant surgery;

90,027 patients with a history of individual intolerance to these medications.

Treatment is contraindicated in those suffering from hyperthyroidism, heart failure, ischemia, obstructive respiratory system damage, diabetes mellitus.

The diet is of great importance. The diet includes food products that do not provoke a strong load on the liver. The total calorie content of food should not exceed the prescribed norms, especially for those who have a genetic predisposition or weakened immunity. A person who has already become ill with hepatitis C needs to reduce the amount of animal products.With an exacerbation, the patient is prescribed a strict diet; during remission, the doctor makes indulgences.

Steamed fish and fresh vegetables

Dishes that are minimally irritating to the liver are prepared from milk (low-fat cottage cheese is useful), fish, and fresh vegetables. The condition of the parenchymal organ is improved with the help of freshly squeezed fruit juices, decoctions made on the basis of medicinal plants. The salt intake will have to be limited. Food is steamed or cooked in the oven. Fried and spicy foods, marinades, canned food, baked goods, sweets and alcohol are strictly prohibited.

The therapeutic regimen for hepatitis C is often based on inhibitors. When using them, there is no need to prescribe ancillary drugs. Among the effective ones there are:

• Incivo.
• Sovriad.
• Insevec.
• Sovaldi.
• Simeprevir.
• Ledipasvir.

To reduce the risk of adverse reactions, the doctor prescribes hepatoprotectors to support the liver. Supplements are often included in the treatment regimen; they are required to strengthen the immune system.In the implementation of therapy for hepatitis C, it is allowed to use drugs made on the basis of the gifts of nature.

Preventive measures

To avoid infection with hepatitis C, you must lead a healthy lifestyle. We’ll have to give up alcoholic beverages, smoking and drugs. People who often come into contact with sick people should take precautions. For example, get vaccinated against hepatitis A and B viruses. Also, one should not forget about contraception, annual medical examination and proper nutrition.

Healthy lifestyle

It is necessary to get tattoos and manicure in salons whose employees follow all hygienic rules. The foreman should not work without gloves, the instruments must be disinfected after each client. Otherwise, hepatitis C infection is difficult to avoid. The same goes for medical professionals.

When the first symptoms of hepatitis C appear, do not jump to conclusions. Self-medication is strictly prohibited, the patient must visit a doctor.

Source: medgepatit.com

Read also

90,000 Antibodies to hepatitis C virus, sum. (Anti-HCV)

Hepatitis C is a disease caused by an RNA virus. The virus can be transmitted through blood, through non-sterile medical instruments, through organ and tissue transplantation, through sexual intercourse, from mother to child during pregnancy and childbirth. It multiplies in liver cells and causes acute or chronic hepatitis.The hepatitis C virus has several genotypes, due to frequent mutations, it is resistant to the effects of human immune defense mechanisms.

Viral hepatitis C is most often asymptomatic. Only in 15% of cases of acute illness, nausea, signs of intoxication, lack of appetite, and jaundice are rare. A minority of patients suffer hepatitis C as an acute illness and recover completely, while the majority of those infected develop chronic hepatitis C. A long-term chronic illness can lead to cirrhosis or liver cancer.

At the onset of the disease, antibodies to the components of the virus begin to form, first immunoglobulins M, later immunoglobulins G. Specific antibodies to the hepatitis C virus can be detected in the blood 3-8 weeks after the virus enters the body, but in some cases they may be absent during several months. In this case, the infection can be confirmed by a blood test for RNA of the hepatitis C virus. After infection in recovered patients, specific antibodies persist for many years with a gradually decreasing concentration and can be detected in low amounts throughout life.Antibodies to hepatitis C do not protect against reinfection when they encounter the virus again.

The risk group for hepatitis C includes doctors and nurses, people who use medical and cosmetic services, drug addicts, patients who have received blood or organ transfusions, children born to infected mothers who are carriers of the hepatitis C virus.

Analysis for antibodies to hepatitis C virus (HCV), total, allows you to identify specific immunoglobulins, the presence of which indicates a possible infection or a previous illness.The test is a screening test, it must be taken during hospitalization, before planned operations and during pregnancy.

In what cases the study is usually prescribed

• when examining patients preparing for planned hospitalization or surgery;
• for professional examinations and medical examinations;
• for suspected contact with infected blood or non-sterile medical instruments;
• when symptoms of liver damage appear;
• when examining pregnant women.

What exactly is determined during the analysis

The presence of specific total antibodies to the hepatitis C virus is detected by the IHLA method – a modification of the enzyme-linked immunosorbent assay.

What the test results mean

Result “Not detected” means that there are no specific antibodies to hepatitis C in the patient’s blood serum. This can be if the patient is healthy and has never met the hepatitis C virus. The absence of antibodies is possible for a short period at the onset of the disease, when the virus has entered the body, and the immune system has not yet developed antibodies to the hepatitis C virus (the so-called “serological window” period).

Result “Detected” means that antibodies to the virus in the blood have been detected. A positive result is always given with the results of a confirmatory test. The confirmatory test determines antibodies to structural and non-structural proteins of the hepatitis C virus.

Research result (example):

Antibodies can be detected in patients in several cases:

• the patient is currently suffering from acute or chronic hepatitis C;
• the patient once suffered from hepatitis C as an acute disease and is now healthy, the antibodies remained as an immunological memory of contact with the virus;
• the patient has a rare case of nonspecific serum reaction with the test system used.

Detection of antibodies to hepatitis C virus does not mean the presence of the disease and requires additional examination of the patient . In case of a positive answer, it is necessary to consult a doctor or an infectious disease doctor and prescribe additional tests. A PCR test for HCV (detection of RNA of the hepatitis C virus in the patient’s blood), biochemical markers – ALT, AST, GGT, alkaline phosphatase, bilirubin, a general blood test with a leukocyte formula, coagulogram may be prescribed.