Why is hepatitis C dangerous? Why is hepatitis C dangerous?
Hepatitis C is an infectious disease liver caused by the blood-borne hepatitis C virus. Hepatitis can be acute or chronic, and is dangerous due to its complications in the form of cirrhosis and liver cancer. Chronic hepatitis C has a long course and may not manifest itself in any way for many years.
Some statistics!
The problem of viral hepatitis C among the world population is becoming more and more urgent every year. Thus, the World Health Organization (WHO) estimates that about 500 million people in the world are infected with hepatitis C, which is 10 times more than the number of HIV-positive individuals. Of the total, 150 million suffer from a chronic form of hepatitis C, with an annual increase in patients of more than 3 million people, and about half a million people die per year.
But, as you know, official statistics lag behind reality; there is still no specific count of cases of viral hepatitis detected in the world, and not everyone seeks medical help. So, according to some data, the official figure for the incidence of hepatitis C can be multiplied by 5-10 times.
A little history!
The hepatitis C virus was discovered relatively recently, in 1989, which is even later than HIV infection. Before this, hepatitis A and B viruses were already known, and their clinical picture was described in detail. But doctors identified patients who had symptoms of hepatitis, but the hepatitis A and B viruses were not detected, and even for 2 decades this pathology was called “neither A nor B” hepatitis. Considering the relatively short period of observation of this pathology, doctors have not yet fully studied the hepatitis C virus, especially with regard to effective treatment, but scientists around the world are conducting intensive research in this direction.
July 28 is World Hepatitis Day.
Interesting Facts!
- Hepatitis C is called the "gentle killer." This is due to the fact that the disease can be asymptomatic or minimally symptomatic, but irreversible changes occur in the patient’s liver, leading to the death of the person.
- Hepatitis C is the most common blood-borne disease.
- Prevention of hepatitis C – prevention is easier than cure. So preventing this disease is a priority all over the world.
- More than half of cases of hepatitis C lead to the development of chronic hepatitis, which in 15-50% ends in liver cirrhosis.
- Chronic hepatitis C is diagnosed in 75% of patients with liver cancer.
- Modern antiviral drugs can cure hepatitis C.
- Despite the fact that doctors combine hepatitis A, B, C, D, E and others into one group of diseases, all these viruses differ significantly in their structure and belong to different genera and families, the only thing they have in common is the ability to damage the liver.
- Hepatitis C can be infected in a hospital, beauty salon or dental office, so few people are 100% insured against this disease.
The causative agent is hepatitis C virus (HCV or HCV)
Place of the hepatitis C virus in the kingdom of living organisms: - Kingdom: RNA virus;
- Family: Flaviviruses (Flaviviridae), from Latin "yellow";
- Genus: Hepavirus (Hepacivirus);
- Type: Hepatitis C virus.
Characteristics of the hepatitis C virus
| Characteristic | Hepatitis C virus |
| Dimensions | 30-60*10 -9 m |
| Where does the virus multiply? | In liver cells - hepatocytes. |
| Genotypes – types of viruses that differ in the set of certain genes. Each genotype has its own subtypes - quasi-species, which are constantly subject to mutation. |
In Russia, genotypes of the virus C 1a and b are more common, less often 2 and 3. Genotypes 4, 5, 6 are often found in African and Asian countries. |
| Who is affected? | Only human. |
| Antigens or proteins of the virus – protein molecules that make up the virus. |
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| Antibodies or immunoglobulins – specialized immune cells that are produced in the body in response to the introduction of a virus. | The body produces antibodies to each of the proteins (antigens) of the virus. In laboratory diagnostics, the total amount of antibodies is determined. |
| How long does the virus live on the surfaces of objects? | The virus can survive exclusively in drops of blood, including dried ones. At room temperature and moderate lighting, the virus lives from 16 to 96 hours, meaning it is relatively stable in the environment. Freezing blood does not kill HCV. |
| Under what conditions does the hepatitis C virus die? |
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| How much blood infected with hepatitis C must enter the body of a healthy person to infect him? | 1/100 – 1/10000 ml, this is less than 1 drop. |
Routes of transmission of hepatitis C virus
Parenteral route - through the blood
This is the main route of transmission of hepatitis C. This does not always require an infusion of infected blood; a drop of blood on various objects, including household ones, is enough.Conventionally, several risk groups for hepatitis C infection can be distinguished:
1. People who inject drugs drugs are the main group of people infected with hepatitis C, which is why it is also called “drug addicts’ hepatitis”. This is due to the fact that the drug addict does not always use individual syringes. In addition, some “drug chemists,” when preparing a drug, add their own blood to it to cleanse the resulting solution from sediment. That is, a drug addict, buying a dose of the solution, can receive hepatitis viruses or even HIV as a “bonus”.
2. Clients of beauty salons. Unfortunately, beauty salon technicians do not always conscientiously disinfect their tools, spreading blood-borne diseases, especially hepatitis B, which can live on objects for months and even years.
Procedures during which you can become infected with hepatitis C:
- manicure and pedicure for cuts;
- tattoo;
- shaving;
- haircut for damaged skin;
- some cosmetic procedures that can lead to damage to the integrity of the skin.
- Transfusion of donor blood products that have not undergone proper testing, including from a donor who at the time of blood donation had the hepatitis C virus, but has not yet developed antibodies to it (seronegative window). For your information, donated blood was not tested for hepatitis C until 1992, so people who received a blood transfusion before this period are considered high risk for hepatitis C (unless the person is tested).
- Treatment at the dentist, unfortunately, often causes infection with hepatitis, especially hepatitis B.
- People on hemodialysis have an average risk of contracting hepatitis.
- Surgical operations and dental treatment cause the transmission of hepatitis C quite rarely, but this route of infection is possible, especially in underdeveloped countries and among unscrupulous medical workers.
4. People providing health services(medical workers) – have a relatively low risk of infection. The most common patients with hepatitis C are surgeons, pathologists, dentists, laboratory assistants and nursing staff. Accordingly, the risk group includes manicurists and pedicurists and other beauty salon workers.
5. Other persons at risk of becoming infected with hepatitis C through blood:
- Police officers, prison staff, military personnel who may become infected during the detention of criminals, providing first aid for injuries and in other situations.
- In everyday life: if there are patients with hepatitis C in the family. Household transmission is possible in rare cases, with non-individual use of a toothbrush, blades, razors and other hygiene products.
Sexual tract
Transmission of the hepatitis C virus through unprotected sexual contact is possible, but in practice this occurs quite rarely, only in 1-3% of contacts, in the presence of injuries to the vaginal and penile mucosa. Such conditions can arise from rough sexual intercourse, anal sex, or the presence of inflammatory diseases of the external genitalia, which contribute to the formation of ulcers, cracks, and microtraumas. Can you get hepatitis C through semen?
The hepatitis C virus lives only in the blood. The virus may be present in other biological fluids, but in a very small concentration, which is not enough for infection. That is, semen and vaginal discharge cannot cause transmission of the virus.
Can you get hepatitis C through sex during your period?
Menstruation is the release of blood from the vessels of the uterus, which can be infected with hepatitis C, so a woman during menstruation can easily infect her sexual partner with hepatitis, but only if there are injuries to the penis or skin in contact with menstrual blood.
Also during menstruation, the risk of hepatitis infection increases in women.
Is it possible to get hepatitis C through oral sex?
Oral sex, like vaginal sex, can cause the transmission of hepatitis C, but subject to the simultaneous presence of microtraumas or cracks in the mucous membranes.
Transplacental route - from mother to child
Transmission of the hepatitis C virus can occur during childbirth and while caring for the baby. But this risk is regarded as low, since infection of a baby is possible on average only in 5% of cases. The risk of mother-to-child transmission of hepatitis C increases significantly if the mother has HIV infection, if she acquires the virus during pregnancy, or if the mother has a high viral load during childbirth.How is hepatitis C not transmitted?
- By airborne droplets;
- by everyday means;
- when communicating;
- through saliva and kisses;
- with hugs and handshakes;
- when using shared utensils;
- through toys;
- when using shared towels;
- other contacts that do not involve contact with blood.
Pathogenesis of the disease
Much in the mechanism of development of disease and liver damage by the hepatitis C virus has not yet been studied. The problem is that the virus is constantly mutating, and it is currently impossible to trace all stages of pathogenesis under such conditions. Perhaps, by discovering all the development processes of this infection, the world will open up new opportunities in the treatment of the disease and the possibility of creating an effective vaccine for prevention.
What happens with viral hepatitis C?
1. Incubation period– from 14 days to six months or more, on average 49-50 days.- The virus enters the blood and is delivered with it to liver cells - hepatocytes.
- In the hepatocyte, the virus multiplies - RNA replication.
- The virus releases toxin proteins (antigens) into the blood, including those that destroy the cell wall of the hepatocyte (cytotoxic proteins).
- Hepatitis sets in and liver cells are gradually destroyed.
- The immune system begins to respond to the virus only after 1 month or even more. First, lymphocytes, macrophages, NK killers and other cellular immune cells come to the liver cells. Antibodies to the hepatitis C virus are not yet detected at this stage.
- Liver enzymes are released from damaged liver cells, which further destroy hepatocytes.
- In response to proteins and the reaction of cellular immunity, the body produces immunoglobulins (antibodies) specific to hepatitis C. As a result, the amount of virus in the blood decreases sharply.
- The process involves autoimmune reactions, that is, when the immune system perceives its own cells as foreign. In this case, immunoglobulins to hepatitis C destroy the hepatocyte along with the virus, aggravating the course of hepatitis.
- Spontaneous cure of hepatitis C may occur, while HCV RNA in the blood is not detected, but whether the virus persists in the human body or not has not yet been established. It is believed that it remains inactive throughout a person’s life. Recovery occurs only if there is a good immune response.
- When hepatitis C becomes chronic, the virus constantly mutates, changes and multiplies unhindered, and the produced immunoglobulins do not have time to respond to new mutations. The immune response ceases to be effective.
- In chronic hepatitis C, the death of liver cells occurs slowly and gradually, sometimes several decades may pass before cirrhosis of the liver occurs.
- Against the background of hepatitis, fat metabolism in the liver is disrupted, which can lead to the development of fatty hepatosis (steatosis), that is, when normal liver tissue is replaced by fatty tissue.
- Immunity is depleted and the liver is further destroyed. The cells that are primarily affected are T-lymphocytes. It is these cells that are damaged by HIV, so HIV and hepatitis C aggravate each other.
- Remission may occur with the risk of further relapses. The liver can partially recover (regenerate), but only if liver cirrhosis has not occurred.
What is hepatitis C carriage?
A person can be infected with the hepatitis C virus, but not get sick from it. That is, the virus multiplies in the body without destroying liver cells. A person lives with the virus for many years and even his whole life without harm to the body, but such carriage can also lead to the rapid development of cirrhosis at any time. Such people are dangerous because they can be a source of infection.What happens in the patient's liver?
- Acute course of hepatitis C. The liver slightly increases in size, fills with blood (bright purple color), the surface is smooth and even. A small number of foci of necrosis (destroyed tissue) are detected in the liver, and foci of fatty degeneration are identified. Blood flow in the liver is not impaired.
- For chronic hepatitis C the number of foci of necrosis increases, in place of the destroyed liver tissue, fibrosis is formed - the proliferation of connective tissue, which does not perform the function of hepatocytes. The liver continues to be enlarged. First, single fibrous cords are formed, then the connective tissue gradually replaces the liver tissue, that is, liver cirrhosis occurs. In this case, the liver decreases in size, shrinks, and becomes lumpy. A decrease in the number of normal hepatocytes leads to liver failure, the liver gradually or acutely ceases to perform its functions.
- For cirrhosis of the liver blood circulation through the hepatic vessels is disrupted, portal hypertension syndrome and varicose veins of the hepatic vessels occur. In this case, additional vessels (anastomoses) are formed through which part of the blood circulates, bypassing the liver. The lack of blood and oxygen in the liver lobule contributes to further liver destruction, worsening liver failure.
- Hepatitis C virus affects the genetic material of liver cells, which can result in the formation of a cancerous tumor.
What does the liver of a hepatitis C patient look like (photo)?
Photo of the liver of a patient with hepatitis C who died of cirrhosis of the liver. The liver is reduced in size and has a mottled appearance. The capsule is thickened, light-colored, and gray-brown tubercles are visible underneath it. On section, the liver also has a spotted appearance (“spotted liver necrosis”). Bile ducts, blood and lymphatic vessels are fused.
Classification
Forms and types of hepatitis C
- Acute course of HCV– is diagnosed only in one case out of five, this is due to the fact that the disease may not manifest itself clinically. In more than 70% of cases, acute hepatitis C becomes chronic.
- Chronic course of HCV– the most common form of hepatitis C, characterized by slow and gradual destruction of the liver.
- Fulminant (malignant or fulminant) hepatitis C– a variant of the acute course of hepatitis, in which rapidly progressive destruction of the liver occurs; in this form, liver failure develops 10-15 days from the onset of the first symptoms. This variant of hepatitis C, fortunately, develops quite rarely, less than 1% of all cases. Among the predisposing factors to the development of malignant hepatitis are infancy, characteristics of the genotype of the virus, infection with several types of hepatitis viruses (A, B, D), alcohol, drugs and other liver damage. The mortality rate is about 70%.
Activity of chronic hepatitis C
Previously, the terms “active” and “inactive (persistent) hepatitis C” were used. At the moment, these definitions are not relevant, since it is believed that any chronic hepatitis C is always an active process, to a greater or lesser extent.Degrees of hepatitis C activity:
- "Minimal" chronic hepatitis C;
- “mild” (mild) chronic hepatitis C;
- chronic hepatitis C with moderate activity;
- severe chronic hepatitis C.
- the degree of liver damage according to the results of a histological examination of a liver biopsy;
- the presence of fibrosis (connective tissue);
- presence and severity of symptoms of the disease;
- laboratory parameters of liver tests (namely ALT - alanine transferase).
Stages of liver fibrosis in hepatitis C:
- liver fibrosis is absent;
- weakly expressed;
- moderately expressed;
- severe liver fibrosis;
- cirrhosis of the liver.
ICD-10 code
An ICD code is assigned to each type of disease, according to international classifications. Encryption of the diagnosis is necessary for easier processing of information and organization of medical and social care, for understanding the diagnosis by doctors around the world, as well as for hiding the pathology if the patient does not want to advertise it.- Acute viral hepatitis C: B 17.1.
- Chronic viral hepatitis C: B 18.2.
Periods and phases of hepatitis C
1. Incubation period – this is the time from the moment of infection to the appearance of the first signs of the disease. With hepatitis C, this period can last from 14 days to six months, but on average 49-50 days.2.
Acute phase– symptoms of the disease in most cases may be absent or there are symptoms to which the patient does not pay particular attention and does not consult a doctor. Acute hepatitis C lasts up to 6 months.
Options for the course of the acute phase of hepatitis C:
- Latent or hidden hepatitis - absence of symptoms or low symptoms - this is 8 out of 10 cases.
- Manifest hepatitis C – vivid clinical manifestations, severity of symptoms – occurs only in 20% of cases. We can separately distinguish the pre-icteric period (lasting on average 10 days) and the icteric period.
4. The period of reactivation and transition to the chronic stage of hepatitis C , occurs with or without clinical manifestations. For most people, this period lasts for decades and can result in the development of cirrhosis or liver cancer.
5. Remission period of chronic hepatitis C , which is achieved as a result of a course of therapy with antiviral drugs. We can talk about remission when liver test results are normalized and the HCV RNA test results are negative. Any remission can result in a relapse.
The duration of each period may differ in each individual case.
Symptoms of acute and chronic hepatitis C
There are no symptoms of hepatitis C in most cases. In this case, only laboratory changes are detected. But with the manifest course of viral hepatitis C, a number of symptoms can be identified that are associated with changes in the liver and other organs. Compared to other types of infectious hepatitis, the manifestations of hepatitis C are less pronounced.Possible symptoms and signs of viral hepatitis C
| Group of symptoms | Symptom | Mechanism of symptom development | How does the symptom appear? |
| Intoxication syndrome | Weakness and malaise | Intoxication can be severe in acute hepatitis C, especially in the pre-icteric period. With chronic hepatitis C, the symptoms of intoxication are less pronounced, but are permanently chronic. Intoxication is associated with the action of the toxins of the viruses themselves, as well as the decay products of destroyed liver tissue and unprocessed toxins produced in the body. Also a toxin is bilirubin, a bile pigment whose levels are elevated. Toxins affect the entire body, especially the central nervous system. | This is an early, almost constant and most common symptom of hepatitis C, both acute and chronic. The patient is constantly tired, wants to sleep, and has difficulty getting out of bed in the morning. |
| Decreased appetite | There is no appetite, up to a complete refusal to eat. Some patients develop an aversion to food. | ||
| Increased body temperature | In the acute period, the temperature can rise to high numbers, above 38 o C, and for the chronic course of hepatitis, periodic subfibrility (temperature up to 38 o C) is more typical. | ||
| Runny nose , cough | Reminds me of a regular ARVI. The cough is dry, infrequent, mucous discharge from the nose, nasal congestion. This symptom is mild and usually goes away quickly. |
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| Aches in joints, muscles, muscle weakness | Pain in the limbs can be aching or sharp. | ||
| Skin rashes | Skin rashes are a fairly common symptom of hepatitis C; it can appear in the pre-icteric period or against the background of jaundice. The rash can be different, most often in the form of red spots. But this rash is almost always accompanied by itchy skin. By the way, itchy skin can occur without rashes. | ||
| Sleep disturbance | More often observed with chronic HCV. Patients confuse day with night, during the day they want to sleep very much, and at night they experience insomnia. | ||
| Increased blood bilirubin levels | Yellowness of the skin and visible mucous membranes | Jaundice may appear in the acute period of the disease (rarely) or with the development of complications of hepatitis. Bilirubin is a bile pigment that is formed during the destruction of blood cells - red blood cells. Normally, this substance enters the liver, where reactions between bilirubin and glucoronic acid occur. With viral hepatitis, the binding process of bile pigment is disrupted, resulting in large quantities of unbound (direct) bilirubin entering the blood. It accumulates in all tissues and organs, giving them a yellow color; we see icteric mucous membranes and skin. Bilirubin normally colors stool and urine. With hepatitis, bile pigments do not reach the intestines, so the stool becomes light-colored. During this time, excess bilirubin is excreted by the kidneys, which leads to the formation of dark urine. | Jaundice with hepatitis C can vary in intensity. In most cases, jaundice is mild; at first, patients notice only staining of the sclera. With further damage to the liver, the skin also becomes stained; with hepatitis C, the color first has a yellow-brown tint; in severe cases, it becomes greenish or lemon-colored. |
| Darkening of urine | The color of urine in viral hepatitis is compared to the color of dark beer. | ||
| Light chair | The stool becomes lighter than usual or completely discolored. | ||
Complaints from the digestive system | Nausea, vomiting | These symptoms may be absent during the acute period of hepatitis or may be periodic. Disruption of digestive processes is associated with insufficient formation of bile and digestion of fats from food. As a result, the processes of fermentation, putrefaction and gas formation in the intestines intensify. | Nausea and vomiting may occur after eating food, especially fatty foods. |
| Stomach ache | Usually the pain is in the right hypochondrium or in the umbilical region. They can be acute or spasmodic in nature. | ||
| Belching | Belching of something rotten some time after eating. | ||
| Stool disorders | Constipation is the most common concern, although diarrhea is also possible. | ||
| Bloating | Feeling of fullness in the abdomen, increased release of gases. | ||
| Increased liver size | The liver enlarges as a result of the inflammatory process in it and stagnation of blood in the hepatic vessels. | Determined by the doctor during examination and ultrasound. | |
| Symptoms indicating fibrosis and cirrhosis of the liver, manifestations of liver failure | Fluid in the abdomen (ascites) | Varicose blood vessels of the portal vein compress the lymphatic ducts, which normally contribute to the drainage of fluid from organs and tissues. This causes water retention in the abdominal cavity. | The size of the abdomen increases significantly, like that of a pregnant woman. When puncturing the abdominal cavity with ascites, you can get 10 liters of fluid or more. |
| Spider veins | Spider veins are additional small vessels or anastomoses that pathologically form between larger vessels as a result of obstruction of blood circulation through the portal vessels. | Spider veins in such patients are detected to a greater extent on the abdomen and shoulders. | |
| Muscle weakness and weight loss | Muscles are formed from glycogen, which is formed from glucose in the liver. This function is impaired in liver fibrosis; the muscles lack building material. | There is flabbiness and weakness of the muscles, they decrease in size, the patient cannot cope even with small physical activities. | |
| Reduction in liver size | With complete replacement of liver tissue with connective tissue, the size of the organ decreases significantly. And given the fluid in the abdominal cavity, doctors describe such a liver as “floating.” | Changes in the size of the liver and spleen can be detected by a doctor when examining and palpating the abdomen, as well as when examining the abdominal organs using ultrasound, CT or MRI diagnostics. | |
| Enlarged spleen (splenomegaly) | The spleen deposits blood; when there is stagnation in the portal vessels, a larger amount of blood collects in it. Also, the spleen is loaded with additional work that the liver does not perform, namely, it participates in the processes of destruction of spent red blood cells and hemoglobin. | ||
| Increasing symptoms of intoxication, jaundice and digestive disorders | All symptoms that could be observed in a patient with chronic hepatitis are aggravated, which is associated with an increase in liver failure (“liver failure”). Symptoms of damage to the central nervous system by toxins that are not utilized by the liver appear. |
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| Impaired blood clotting, bleeding | The liver is involved in the formation of some blood clotting factors. As liver fibrosis increases, this function is impaired and the blood becomes too thin. The situation is aggravated by varicose veins of the portal vessels. | The patient develops bleeding from varicose veins of the esophagus, gastric, and intestinal bleeding. In addition, small hemorrhages and bruises (petechiae and hemorrhages) can be seen on the skin. | |
| "Liver palms" | This symptom also develops due to poor circulation and the formation of anastomoses. | The palms and feet become bright red. | |
| Atrophic glossitis (death of filiform papillae of the tongue) | Atrophy of the tongue papillae is a consequence of poor circulation and nutritional deficiency. | The tongue becomes bright red and shiny - “varnish tongue”. | |
| Pulmonary heart failure | Poor circulation in the portal vessels and swelling lead to changes in general blood circulation. At the same time, “excess” fluid also accumulates in the lungs, which can lead to pulmonary edema. Cardiac and respiratory failure develops. |
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The first signs of hepatitis C
In acute hepatitis C with a manifest course, the first signs are symptoms of intoxication (fever, weakness, joint pain, headaches, etc.), that is, a flu-like condition, against which jaundice appears after 7-10 days.
But in most cases, the first manifestations of hepatitis C are symptoms of liver cirrhosis and liver failure, that is, many years after the onset of the disease.
Signs of chronic hepatitis C:
- regular increase in body temperature to 37.5-38 o C;
- nagging pain in the right hypochondrium;
- periodic nausea, bloating after eating;
- spider veins on the skin of the body.
Features of the course of hepatitis C depending on the genotype of the virus
Scientists have proven the relationship between the course of hepatitis C and the genotype of the virus that affects the liver. Of course, there is still a lot of unknowns in this direction, but some data have already been obtained.HCV genotype 1, especially 1b – more often than other genotypes, it causes a severe and malignant course of the disease. Hepatitis caused by HCV genotype 1 requires longer treatment and higher doses of drugs. Genotype 1b carries a poor prognosis. It is this genotype that is most common in Russia.
HCV genotype 2– more often cause a mild or moderate course of hepatitis C, such hepatitis is easier to treat, in most cases there is a favorable outcome (recovery and restoration of the liver).
HCV genotype 3– this type of hepatitis also in most cases proceeds more easily and has a good prognosis, but most often it is this genotype that contributes to the development of fatty hepatosis.
The characteristics and patterns of other genotypes are still being studied.
However, there are cases when hepatitis C is caused not by one, but by several genotypes of the virus, then such a disease is much more severe and dangerous due to its complications.
What do people with hepatitis C look like?
Photo: eyes of a patient with hepatitis C, yellowness of the sclera.
Photo: jaundice.
Photo: dark urine with hepatitis C.
Photo: this is what a patient with cirrhosis of the liver may look like (increase in abdominal volume, dilation of blood vessels on the anterior abdominal wall, atrophy of the muscles of the upper shoulder girdle, yellowness of the skin).
Photo: liver palms.
Features of the course of hepatitis C in men and women
Scientists have proven that hepatitis C in women is much more favorable than in men. The fair half of humanity produces antibodies to HCV faster and has a lower risk of developing chronic hepatitis and liver cirrhosis. Just why this happens is still not known. Perhaps men lead a more irregular lifestyle, more often allow themselves to drink a glass or two with or without a reason, love to eat, work a lot, and listen less to their body.
What is the hepatitis C virus, how does it penetrate and multiply in liver cells - video
Diagnosis of the disease
Data from laboratory and instrumental studies are the main criteria for diagnosing hepatitis C, and sometimes the only signs of the disease.Blood test for antibodies (markers) to hepatitis C
Detection of antibodies refers to serological reactions. This is a blood test to determine the presence and state of immunity to the hepatitis C virus. To diagnose viral hepatitis C, the level of the following antibodies is determined:
- Total class G antibodies to HCV (Ig G anti HCV);
- Immunoglobulins M and G to HCV nuclear antigens (Ig M anti HCV core, Ig G anti HCV core);
- Antibodies to non-structural antigens (anti HCV NS).
Table. Interpretation of the results of a blood test to determine antibodies to hepatitis C.
| Diagnosis | Result | ||||
| Ig G anti HCV | Ig M anti HCV core | Ig G anti HCV core | anti HCV N.S. | RNA HCV | |
| Healthy (normal) | - | - | - | - | - |
| Carriage or previous history of hepatitis C | + | - | + | - | - |
| Acute hepatitis C | - or +* | + | - or + | - | + |
| Reactivation of chronic hepatitis C | + | + | + | + | + |
| Remission of chronic hepatitis C | + | - | + | + or - | + or -** |
| HCV + HIV at the AIDS stage (4 cell stage) | - | - | - | - | + |
* Class G immunoglobulins for hepatitis C appear only 2-4 months after infection.
** During remission of chronic hepatitis C, the virus can remain in the patient’s body or be eliminated (disappear).
"-" Negative result, that is, no antibodies or RNA of the virus were detected.
“+” Positive result, HCV antibodies or RNA detected.
PCR diagnostics (RNA determination) and hepatitis C viral load
Unlike the previous serological test for hepatitis C, PCR does not detect immunity, but the genetic material of the virus itself - RNA.There are two types of PCR diagnostics of hepatitis C:
1.
Qualitative determination of HCV RNA
– the hepatitis C virus is detected or not detected. For primary diagnosis, this type of PCR is used.
2.
Quantitative determination of HCV RNA, or viral load
– used to determine the concentration of the virus in the blood. The viral load allows us to assess the dynamics during treatment and indicates how infectious the patient is. The higher the viral load, the greater the likelihood of infection of a person in contact with his blood.
PCR is the most accurate method for diagnosing any infectious disease (over 98-99%), but only if it is carried out correctly.
In addition to identifying the virus itself, PCR can be used to determine the genotype of the virus, which affects the course of the disease and treatment tactics.
What does a questionable, false positive and false negative test result for hepatitis C mean?
About a false positive they say when, in the presence of class M immunoglobulins for hepatitis C, the hepatitis C virus is not detected by RNA PCR.
This result requires a retake of the analysis.
False negative test for hepatitis C usually obtained during the incubation period of the disease; doctors call this period the immunological window. During this period, a person is already infected with HCV, but does not yet have immunity to it, and there are no symptoms of the disease.
Can a hepatitis C test be wrong?
Yes, any laboratory diagnostics has an error rate. But such incidents are possible in relation to only ELISA or only PCR. Therefore, when diagnosing hepatitis C, it is necessary to conduct both types of research. By the way, PCR for HCV can give a false result if the cleanliness in the laboratory is not maintained or the laboratory technician is inexperienced.
How can hepatitis C be detected immediately after infection (for example, after a blood transfusion or needle stick)?
It will be possible to accurately answer the question of whether infection with viral hepatitis occurred or not earlier than after 3 months, then the blood will be examined for markers of HCV. A preliminary result is possible after 2 months, but there is a high probability of error.
Before donating blood for hepatitis C
Preparation for this type of study is not required; this analysis, unlike liver tests, does not require the patient to be on an empty stomach. As with other types of ELISA tests, it is not advisable to eat fried, fatty, spicy and salty foods the day before, or drink alcohol.
How long does it take to test for hepatitis C?
Often markers for hepatitis C are ready the next day after the test, no later than 7 days. It all depends on the laboratory, the need to deliver the material and results, and diagnostic methods.
Where can I get tested for hepatitis C and how much does it cost?
A test for hepatitis can be taken at any medical institution, both public and private, where only blood is drawn. The diagnosis itself is carried out in laboratories of infectious diseases institutions, immunological and private laboratories.
In clinics and hospitals, a doctor's referral is required. Laboratories can do analysis without a referral and even anonymously.
The average cost of the study ranges from 15 to 60 USD. e.*
*price is indicated in US dollars due to instability of exchange rates.
Rapid test for hepatitis C. Where to buy, what is the price?
Nowadays, there is a huge number of tests that can be carried out without leaving home, a kind of “laboratory in your pocket.” These are various rapid tests, which are mostly presented in the form of litmus soaked in special reagents. You can examine blood, urine, saliva. Such a rapid test also exists for the diagnosis of hepatitis C. It is based on the determination of total antibodies to HCV (Ig G anti HCV) in the blood.
Such a test can be bought in pharmacies, ordered on official websites on the Internet or in special medical equipment stores. The price averages 5-10 USD. e.
Technique for performing a rapid test for hepatitis C:
- wash and treat your hands with an alcohol wipe;
- Use a special needle (scarifier), which is included in the package, to pierce the fingertip treated with a napkin;
- use a pipette to collect 1 drop of blood;
- drop the blood into a special test window marked S, then add 2 drops of the reagent there;
- the result is assessed after 10-20 minutes, no later.
- negative result – the presence of one red stripe opposite mark C;
- a positive result is the presence of two red stripes opposite the C and T marks, while the second strip may be of less intensity;
- the test is invalid - if there are no stripes or if there is one strip opposite the T mark, such a test must be redone.
General blood analysis
With hepatitis C, a general blood test may be completely normal. But in most cases, the following changes can be detected in a blood test:A biochemical blood test allows you to assess the condition of the liver and its functions. After all, the liver is the “laboratory” of our body; if its functioning is disrupted, the metabolism of many chemicals suffers. Therefore, monitoring blood biochemistry parameters for hepatitis C is mandatory. For this study, venous blood is taken.
Liver tests for hepatitis C
| Index | Norm | Changes that may occur with hepatitis C |
| Alanine aminotransferase (ALT) | Up to 40 IU (from 0.1 to 0.68 µmol/l) | Aminotransferases
(ALT and AST) are enzymes released during the destruction of hepatocytes. In acute hepatitis C and reactivation of chronic hepatitis, liver destruction occurs, therefore ALT and AST are elevated
, and tens of times. This is the most consistent indicator for hepatitis C, even in the absence of any symptoms of the disease. If, against the background of reactivation of chronic HCV, aminotransferases decrease, this may indicate the development of liver cirrhosis, in which there is nothing left to be destroyed. |
| Aspartate aminotransferase (AST) | Up to 40 IU (from 0.1 to 0.45 µmol/l) |
|
| Bilirubin | Total bilirubin: up to 20 µmol/l:
| When hepatocytes are destroyed, a large amount of unbound bilirubin enters the blood, which is manifested by jaundice. Wherein total bilirubin increases due to the direct fraction . Bilirubin can be increased 10-100 times. With an indicator of 200 µmol/l the central nervous system is damaged, this is the so-called hepatic encephalopathy and coma. |
| Thymol test | Up to 5 | Reflects the state of protein metabolism. With increasing liver failure thymol test increases . |
| Gammaglutamate transferase (GGT) | For women: 6-42 U/l, For men: 10-71 U/l. | GGT is an enzyme involved in protein metabolism in the liver. This indicator increases significantly (up to 50 and above) with the development of liver cirrhosis. |
| De Ritis coefficient | 1,3 – 1,4 | This ratio of ALT to AST levels. In acute hepatitis C, this indicator decreases below 1, and in chronic hepatitis, on the contrary, it increases to 2 and above. |
The ALT indicator reflects the dynamics of the course of hepatitis C; it is used to determine the severity of the disease.
Determination of the degree of HCV hepatitis depends on the ALT level
Changes in other biochemical blood parameters in hepatitis C:
- decreased albumin levels (normal 20-36 mmol/l);
- increased levels of gamma globulins (normal 30-65 mmol/l);
- increased cholesterol levels (normal 3.4-6.5 mmol/l);
- increased iron concentration in the blood (normal 10-35 µmol/l).
- reduction or increase in size;
- surface roughness;
- deformation of the liver shape;
- the structure of the liver in the form of a mosaic;
- thickening of the walls of the portal vessels, disruption of blood flow through them;
- increase in the size of the spleen;
- the presence of fluid in the abdominal cavity.
- fibrogenesis factors;
- immunoregulatory proteins.
Liver biopsy
To collect biopsy material, a laparoscopic operation is performed, in which a puncture is made in the liver area and a “piece” of the organ is taken with special forceps. Next, the biopsy material is examined under a microscope and the degree of liver destruction and the formation of connective tissue (fibrosis) in it is assessed.Liver elastography
This is a new diagnostic method that is based on ultrasound scanning of liver tissue. A special range of ultrasound waves makes it possible to assess the distribution of connective tissue in the liver, that is, the degree of fibrosis. This method allows you to avoid the procedure of liver biopsy for hepatitis C.Immunogenetic studies
These are new research methods that determine the risk factors for the formation of fibrosis (cirrhosis) of the liver against the background of hepatitis C. These studies help assess the prognosis of the disease, which is necessary to determine treatment tactics.In this case, immunogenetic markers are identified:
Hepatitis C: prevalence of the disease, complications, mechanism of infection, symptoms, diagnosis, risk groups - video
What is the hepatitis C virus? The mechanism of hepatitis C disease, diagnosis, treatment (drugs, diet) - video
Hepatitis C: which organs does HCV affect? Complications of hepatitis C. Diagnosis (where to get tested for hepatitis C), treatment - video
Before use, you should consult a specialist.— What are viral hepatitis A, B, C, how do they differ and are they as scary as they say?
— Hepatitis is an inflammatory process in the liver that can be caused by a variety of reasons, including alcohol, toxic substances, and poor diet. The most common causes of hepatitis are viruses A, B and C.
Bella Lurie
Candidate of Biological Sciences, graduated from Moscow State University. M. V. Lomonosov. Specialist in liver diseases (author of more than 100 scientific papers, of which about 50 published works on the treatment of cirrhosis, as well as the correction of various metabolic disorders in functional liver disorders - together with leading clinicians - surgeons and hepatologists of the Russian State Medical University). Member of the European Association for the Study of the Liver since 2005, participant in International congresses and conferences of the Russian Association of Hepatologists. From 2000 to October 2009 - head of the hepatology research center at the Research Institute of Physical and Chemical Medicine of the Ministry of Health and Social Development. Currently - Head of the Hepatology Center "Hepatit.ru" (MC "Clinic on Sadovoy").
Viral hepatitis A most often has external manifestations - jaundice, fever, nausea. Treatment in a hospital is aimed at reducing intoxication and relieving symptoms of the disease. In the vast majority of cases, it ends in recovery with the formation of natural immunity.
Viral hepatitis B and C are much more dangerous diseases. They also have an acute form, but very rarely with characteristic symptoms of jaundice. Therefore, the disease passes unnoticed by a person, and the transition to a chronic form does not appear outwardly.
The danger of chronic viral hepatitis B and C is that long-term liver damage by these viruses in a large percentage of cases can result in cirrhosis or primary liver cancer - changes in the liver that are incompatible with life.
— How common is this disease in the world?
— Worldwide, more than 600 million people suffer from viral hepatitis B and C. The incidence rate is growing every year. The scale of the spread of viral hepatitis in the world allows us to assess the situation as a worldwide epidemic. In developed countries, the situation with hepatitis B has been improved thanks to vaccination. However, despite this, the number of newly infected people with viral hepatitis B reaches 50 million people every year.
Today there are 7 million sick people in Russia. An epidemic is a situation when the disease affects more than 1% of the population (1 million 400 thousand people).
The epidemiological threshold has been exceeded five times, and these are only official data. Another glaring fact is that an unacceptable number of patients become infected with hepatitis in medical institutions.
— How can you become infected with hepatitis?
— Hepatitis A is transmitted through the mouth with dirty hands, contaminated food, and water. Hepatitis B and C are transmitted through blood. The hepatitis B virus is especially contagious, which is transmitted in a large percentage of cases through sexual contact, in contrast to the hepatitis C virus, the sexual route of transmission of which is not relevant.
The hepatitis B virus is also transmitted from mother to child during pregnancy.
The risk group for contracting viral hepatitis includes everyone who has visited the dentist, had surgery, had tattoos, used intravenous drugs, used the services of a manicurist, etc. Thus, we can assume that the vast majority of the population can constitute one large risk group.
— Are there specific symptoms of this disease?
— Chronic viral hepatitis B and C are asymptomatic. Sometimes, with a fairly prolonged course, nonspecific symptoms may appear, that is, symptoms characteristic of many other diseases: weakness, loss of performance, insomnia, increased fatigue, joint pain.
— In such a dangerous epidemic situation, how can you find out about infection with hepatitis viruses? How often should these tests be done?
— It is recommended to be tested for antibodies to the hepatitis C virus and, if detected, to be tested for the presence of the virus in the blood using the PCR method. Only the presence of the virus in the blood allows a diagnosis of chronic viral hepatitis C to be made.
It is advisable to repeat this examination once a year.
To exclude viral hepatitis B, three tests must be taken: HBsAg, anti-HBcor and quantitative anti-HBs. These three tests allow you to either diagnose chronic viral hepatitis B, or identify recovered viral hepatitis B, or establish the absence of any contact with the hepatitis B virus. In this case, you should get vaccinated and be guaranteed protection from infection for 8-10 years.
— To characterize the hepatitis C virus, tests are prescribed for the genotype of the virus and viral load. What is the significance of these tests? What is the relationship between the amount of virus in International Units and copies of virus per milliliter of blood?
— The genotype of the virus is a type of hepatitis C virus. There are six such varieties. They respond differently to antiviral drugs. Therefore, this is extremely important for prescribing therapy: for some genotypes, the duration of therapy is 11 months, for others - 6 months.
Viral load is the amount of virus in the blood. It can be low, medium and high. Viral load measurement units can be converted from one to another using a factor of 5. Viral load is very important for assessing treatment prognosis, as well as for determining the effectiveness of antiviral therapy. It is assessed by counting the amount of virus before and after a certain stage of therapy and at the end of therapy. Therapy is considered effective if within a month the amount of virus has decreased by at least a hundred times, and after three months the result of treatment should be the complete absence of the virus in the blood.
— Why is the diagnosis of hepatitis scary? Does it lead to cirrhosis and death in all cases?
— The diagnosis of hepatitis is dangerous due to its consequences - the development of cirrhosis and liver cancer. From 20 to 60 percent of viral hepatitis develop into cirrhosis. The problem is that it is impossible to predict in advance how the disease will end in a particular patient, since we do not know what factors influence this process. It is because of this that when deciding who to treat, the European Association of Hepatologists recommends: the earlier treatment is started, the better the prognosis for recovery.
It is extremely important to understand the state of the liver in terms of the degree of fibrosis and the threat of rapid transition to an irreversible state (cirrhosis).
— How to determine how damaged a person’s liver is? Is a biopsy used for this?
— There are different ways to assess how much the liver is affected by the virus and the extent of fibrosis. Biopsy is one of them. However, this method is not safe and does not allow a sufficiently objective and accurate determination of the degree of fibrosis. More modern non-invasive methods for determining fibrosis are increasingly used in clinical practice: direct determination of the elasticity of liver tissue using the Fibroscan ultrasound machine or using biochemical blood markers - FibroMax, FibroTest. These methods make it possible not only to determine the degree of fibrosis at the time of initiation of therapy, but also to track positive changes as a result of antiviral therapy, since fibrosis is reversible up to a certain stage.
— Is there effective treatment for different types of hepatitis today? What therapy is prescribed for different hepatitis and different genotypes of the virus?
— For the treatment of viral hepatitis C, there has been standard antiviral therapy for many years for all genotypes of the C virus. This therapy gives good results and in a large percentage of cases allows for recovery, that is, complete removal of the virus from the body. However, this treatment should be considered imperfect: with a long-term illness and severe liver damage, and often for reasons unclear to us, recovery cannot be achieved.
In addition, serious side effects of drugs worsen the quality of life during treatment and require high qualifications and experience from the attending physician.
However, this is a real chance to protect your liver and your life. Even in the absence of a complete virological response, antiviral therapy has a positive effect on the condition of the liver, stops the formation of fibrosis, and often contributes to its reversal.
There is no standard treatment for hepatitis B virus. In each specific case, decisions are made that depend on how dangerous the virus is, how active it is, and how much the liver is already affected. A special examination of the virus and liver allows the doctor to determine the tactics: sometimes antiviral drugs are not prescribed at all, sometimes large doses are prescribed, but most often, if necessary, modern drugs in the form of tablets are used for treatment - nucleoside analogs that stop the active reproduction of the virus and help not only stop the destructive process, but also the reverse development of fibrosis. The disadvantage of this treatment is the length of the course, often requiring more than five years.
— Is therapy prescribed in all cases? Are there any contraindications for treatment?
— Therapy is prescribed only in cases where there are grounds for it and there are no contraindications. The basis for prescribing therapy against viral hepatitis C is the patient’s young age, changes in the liver according to ultrasound and biochemical data, as well as the degree of fibrosis 2-3. Contraindications for treatment are some chronic diseases, including those of the thyroid gland, changes in the blood, and autoimmune processes.
Fibrosis
Consolidation of connective tissue with the appearance of scar changes in various organs, usually resulting from chronic inflammation.
— How do you evaluate new drugs for hepatitis - protease and polymerase inhibitors of the hepatitis C virus?
“These drugs significantly increase the effectiveness of treatment and are especially important for patients who either did not receive an effect with standard therapy, or after successful therapy there was a relapse - the return of the virus. These drugs sometimes become a chance to save lives if the situation is close to decompensated cirrhosis, and standard drugs are not effective. However, their very high cost and serious side effects have so far limited their use.
— Is a special diet necessary for patients, giving up bad habits? Is it possible to play sports with this diagnosis? How often do you need to see a doctor?
— A special diet is recommended to preserve the liver, but it is not very strict. Reasonable limitation of fatty, fried and spicy foods is quite enough. An important limitation for viral hepatitis is the exclusion of alcohol.
Even small doses of alcohol activate the virus, and consequently its destructive effect on the liver. In addition, this makes antiviral therapy, which is aimed at suppressing the activity of the virus, meaningless.
— Can a woman with hepatitis give birth to a healthy child?
- Maybe. With viral hepatitis C, the virus can rarely pass through the placenta, so in the vast majority of cases, women with viral hepatitis C give birth to healthy children. With viral hepatitis B, the chance of a child becoming infected is about 40 percent. However, correct measures at birth - administration of immunoglobulin and vaccination against hepatitis B in the first hours after birth - protect the child from viral hepatitis B.
— How, if diagnosed with hepatitis, can you protect your friends and family from infection?
— Since viral hepatitis does not have a household route of transmission, friends and acquaintances of a patient with viral hepatitis B or C do not risk anything when communicating with him. For viral hepatitis B, sexual transmission is important, so partners should be tested and vaccinated. There is no vaccine against hepatitis C, and you should be very careful with the patient's blood - it is contagious.
The term hepatitis refers to inflammatory processes occurring in the liver, caused by various viruses. Therefore, there are several forms of hepatitis that have a destructive effect on the corresponding organ. Depending on the type of disease, you can answer the question of why hepatitis is scary in different ways.
In medicine, hepatitis is classified as follows: A, B, C, D, E, F and G. The disease can be caused by any of the following factors.
The first type A is the result of infection with the A virus, which is easily contracted through contaminated food and water. Popularly, this disease is called jaundice, due to the fact that the patient’s skin acquires a yellowish tint.
Modification B is caused by the corresponding type B virus, which can be infected through sexual, oral and household routes. Hepatitis of this form is present in almost all biological fluids of the human body, so many are interested in why hepatitis B is terrible.
The most dangerous form of hepatitis C remains, which cannot be diagnosed immediately and is transmitted through the oral method.
The RNA virus causes hepatitis type B, which is transmitted enterally. This virus is often detected in tests together with the B virus.
The causative agent of the next form of hepatitis is considered to be the E virus, which can be infected through the fecal-oral route. New diseases include modification F, which is caused by two viruses. Infection with one of them occurs through contact with donor blood, and the second is detected in the feces of patients after a blood transfusion.
You can become infected with the G virus anywhere, for example, during surgery, from mother to child, during blood transfusion, and also through sexual contact.
It is not for nothing that so many are concerned about the question of why hepatitis C is terrible, because doctors rightfully consider it the most dangerous not only to health, but also to human life. This is due to the fact that no effective drugs can be found against it. While hepatitis A or B can be prevented by vaccination, there is no vaccine against virus C.
What else is scary about this form of hepatitis? The strength of this viral infection lies in the fact that it can provoke severe complications, which include cancer or cirrhosis of the liver. The most important thing is that this modification in the human body is quite difficult to detect in the first stages of infection.
A person can calmly continue to live, without implying the presence of such a terrible disease in his body, because it is asymptomatic, dealing a crushing blow to health every day.
Therefore, we can safely answer the frequently asked question, “Is Hepatitis C scary?” - yes, scary! It first of all begins to affect one of the most important human organs - the liver, which is the main “filter” of the human body and a hematopoietic organ.
But a certain percentage of the population believes that hepatitis C is no longer scary. This may be due to the fact that the disease can progress over 10-40 years and yet the person lives a relatively normal life. And liver cancer, which is a consequence of hepatitis, develops only in 1-5% of people suffering from chronic infection. But with cirrhosis, things are a little different - 15-20%.
With acute forms of hepatitis B and A, under constant medical supervision and taking appropriate medications, the body can cope on its own. Modern methods of treating chronic viral hepatitis B and C consist of combination antiviral therapy, which includes interferon and nucleoside analogues. Thanks to this form of treatment, it is possible to stop the multiplying virus and protect the liver from destruction.
The most favorable form of hepatitis for treatment is that caused by virus A. It is also called Botkin's disease, and it is one of the most common. It does not cause serious consequences, but is provoked by E. coli, which enters the body through unwashed food, dirty hands and contaminated water. The infection is easiest to catch in the summer, because the virus is very “heat-loving.” The incubation period of the disease is about a month. At the first stages of diagnosis, it can be confused with a respiratory disease, because the temperature usually rises and general malaise appears, accompanied by headaches.
The disease can last from one week to two months, but the body successfully fights it on its own. Sometimes it can be done without medication. It is enough for the patient to eat properly and stay in bed.
Viral hepatitis B can occur in different ways. It happens that a person remains simply a carrier of the virus, but does not get sick himself. If the disease manifests itself, it is in a very severe form - the liver cells are severely affected, and the digestive tract may also be damaged. What is the insidiousness of this form of the disease? The hepatitis B virus adjusts the body's immune system so that it begins to perceive the liver as a foreign object, destroying its cells.
Hepatitis C is a viral liver disease that is transmitted primarily through blood. Its main danger lies in the long asymptomatic period, during which the patient is already a source of infection. The disease is considered curable, since the competent use of specific antiviral therapy can get rid of the pathogen within 1–2 years. However, it is worth understanding why hepatitis C is dangerous for the patient and for others, how to be treated correctly and how to avoid infecting loved ones.
Characteristics of the virus and development of the disease
The causative agent of hepatitis C is an RNA virus that persists in the blood and infects liver cells. Its reproduction in the body is accompanied by inflammation of hepatocytes and their gradual death. After the pathogen enters the bloodstream, a long incubation period follows - from 2 weeks to 2 months or more. After this, the first clinical signs begin to appear, which you should definitely pay attention to:
- chronic fatigue, decreased performance and concentration, disturbances in sleep and wakefulness;
- a feeling of heaviness in the right hypochondrium, sharp or dull pain that intensifies after physical activity or eating heavy food;
- nausea and vomiting, stool disorders;
- in severe cases - yellow coloring of the skin and mucous membranes, lightening of the stool and darkening of the urine.
REFERENCE. The unofficial name for hepatitis C is “the gentle killer.” He received it for a long asymptomatic course, during which liver tissue is destroyed slowly and imperceptibly. The first symptoms appear already at the stage when the processes have affected a significant part of the organ.
To understand why hepatitis C is dangerous for others and how to protect yourself when communicating with an infected person, you need to know what routes of transmission of the virus exist. The causative agent of this disease is in the blood, so the only way of infection is direct contact with contaminated liquid. This may occur in the following situations:
- during a blood transfusion or during a hemodialysis procedure;
- when sharing injection syringes without first sterilizing them, this is the most common method of infection among drug addicts;
- when visiting nail salons and tattoo parlors, there is virtually no risk if you choose the establishment responsibly;
- The virus is rarely transmitted through sexual contact, only in the presence of damage to the mucous membranes of the genital organs.
When diagnosing hepatitis C, several genotypes of the virus are distinguished. The most dangerous of them is type 1b. It is difficult to treat with specific antiviral drugs, progresses quickly and often leads to the development of complications.
How dangerous is hepatitis C for a patient?
It is worth understanding how dangerous hepatitis C is for an infected person. If treated promptly, it is not fatal. Modern antiviral drugs quickly destroy the infection, support the immune system and relieve all symptoms of liver damage. In addition, they do not cause side effects, unlike the first representatives of this group of drugs. However, if left untreated, hepatitis C can gradually progress. The virus constantly mutates, the liver parenchyma is destroyed, and the patient is diagnosed with dangerous pathologies. These include various liver dystrophies, cirrhosis, and in some cases, cancer.
IMPORTANT! According to statistics, in many patients hepatitis C goes away without treatment. In addition, a person can live his entire life as a carrier of the virus, but without experiencing clinical manifestations of the disease.
Fatty liver
The consequences of hepatitis C without timely treatment are various dystrophies. These include hepatosis and steatosis. At the cellular level, they are manifested by damage to inflamed hepatocytes and accumulation of adipose tissue in the parenchyma of the organ. This significantly reduces its functionality, as a result of which metabolism and digestive processes are disrupted. Fatty degeneration is a reversible phenomenon that can be eliminated with medication. However, in advanced cases, the disease progresses and develops into more dangerous pathologies.
The only way of transmission of the hepatitis C virus is when the infected blood of an infected person enters the blood vessels of a healthy person.
Cirrhosis
With chronic inflammation, liver cells gradually die, and in their place a dense scar of connective tissue forms. The danger of this condition is that hepatocytes cannot regenerate. Severe liver failure gradually progresses, leading to the development of complications:
- ascites – accumulation of excess fluid in the abdominal cavity, which causes peritonitis and sepsis;
- hepatic encephalopathy – brain intoxication, followed by coma and death;
- internal bleeding - in the absence of emergency medical care, they are life-threatening.
Liver cirrhosis is a fatal disease. The life expectancy of patients does not exceed several years, and treatment is ineffective. All therapeutic methods are aimed at maintaining life, prolonging it and improving its quality. At the initial stages, liver transplantation is possible, but only if the virus is completely eliminated and the patient’s condition is stabilized.
Liver cancer
Malignant tumors can be of different nature and are not necessarily associated with viral hepatitis. However, chronic inflammation and destruction of liver tissue gives rise to tumor growth. Oncological processes are life-threatening, and its duration is determined by the tendency of the tumor to become malignant, its localization and the presence of metastases.
Danger of the disease to others and precautions
In theory, hepatitis C can be transmitted even if a small amount of infected blood comes into contact with damaged skin or mucous membranes. Such situations can arise in the family or at home, so there is a risk of infection. However, in practice it is often found that the disease persists for many years in only one family member. Everyone who has been in contact with the patient’s blood or lived in the same area with him needs to be examined, but the results in most cases are negative.
Is the disease transmitted at home?
Hepatitis C is a disease that is not transmitted at home. An infected person is not dangerous for family members if simple safety rules are followed. You can safely share towels, bed linen and other items. It is important to bring your own shaving supplies and take precautions when using knives. In case of accidental cuts to the skin, objects should be disinfected. At home, simply boiling is enough.
Hepatitis C during pregnancy
When planning a pregnancy, it is advisable to take all blood tests and, if a virus is detected, undergo a course of treatment. The danger of hepatitis is that specific antiviral medications are contraindicated for women during this period. However, early diagnosis allows you to give birth to a healthy baby. There are several things that women with hepatitis C should be aware of:
- the virus is not transmitted through the placenta, so during pregnancy the likelihood of infection of the fetus is excluded;
- there is about a 6% chance of pathogen transmission during childbirth, so the process takes place with strict safety measures;
- during pregnancy, the load on the liver increases, which can cause rapid development of complications;
- Breastfeeding may be included in the list of contraindications - the virus can penetrate through simultaneous damage to the skin and mucous membranes of mother and child.
Hepatitis C is especially dangerous if infection occurs in the early stages of pregnancy. For this reason, it is necessary to donate blood for tests several times. This procedure will allow you to detect the disease in a timely manner and take all measures to prevent complications.
The disease is not transmitted in everyday life, but when one of the family members is diagnosed, the rest must also undergo examination
Restrictions for infected people
It is imperative to take some precautions. This will allow the infected person to remain safe for others even in emergency situations. Their main purpose is to prevent contact with blood and transmission of the virus. There is a set of rules that the patient should follow from the moment of diagnosis until complete recovery is confirmed:
- hepatitis C is a complete contraindication to donating donor blood and its fractions;
- all skin lesions should be covered with adhesive tape;
- if blood accidentally comes into contact with damaged skin or mucous membranes of a healthy person, it is necessary to urgently treat the cut site with disinfectant solutions;
- You should notify your employer of your diagnosis, even if the risk of transmitting the virus is minimal;
- You must have your own set of nail scissors and shaving accessories;
- You should avoid visiting nail salons and getting tattoos.
REFERENCE. People with hepatitis C may be denied employment if there is a risk of others coming into contact with their blood. Thus, infected people often experience difficulties when working in the armed forces, in health care, public catering and in child care institutions. However, in practice the likelihood of transmission of the virus is negligible.
Hepatitis C is a treatable disease. Modern medicine allows you to completely get rid of the virus without the risk of complications and side effects. A new generation of antiviral drugs acts both on the immune system, forcing it to produce protective cells, and directly on the causative agent of the disease. The duration of therapy can reach several years, and in the presence of aggravating factors (HIV infection, liver cirrhosis), its effectiveness is determined individually. In addition to taking antiviral medications, the treatment complex will include several more stages:
- hepatoprotectors – drugs that protect liver cells and stimulate regeneration processes;
- a gentle diet with a complete rejection of fatty, fried foods, sweets and processed foods;
- giving up bad habits, especially drinking alcohol.
Hepatitis C is an infectious disease that poses a greater danger to the patient himself than to others. The likelihood of infection at home is minimal, and precautions are easy to follow. According to statistics, many people find out about their diagnosis by chance during a routine examination. The disease is often asymptomatic or in the form of carriers, in rare cases it progresses and develops into complicated forms.
Despite the development of medicine and genetic engineering techniques, it has not yet been possible to develop a vaccine against the infection. This is due to the ability of the virus to mutate and change its structure. For this reason, the immune system cannot form a powerful defense against the pathogen.
The disease has six genotypes of pathogens and more than 30 subspecies. While the immune system produces specific antibodies against the infection, it manages to change its structure and evade the protective attack. Thus, the virus maintains a sluggish course of the pathology, and the immune system is powerless against it. A severe complication of the disease is cirrhosis, which is the basis for the formation of a malignant focus in the liver.
In this article we will take a detailed look at the course of the disease and also find out whether hepatitis C is dangerous.
Ways of spread of infection
The maximum content of pathogenic agents is recorded in the blood. Significantly lower concentrations in semen and vaginal secretions. As for saliva, sweat and feces, the amount of viruses in them is so small that it is not enough to infect others.
It is important to remember that the viral load increases significantly during the acute stage of the disease. So, the routes of transmission of pathogenic agents:
- during intimacy. This is especially true for supporters of unprotected sexual intercourse, frequent changes of partners, as well as lovers of aggressive sex, when the genital mucosa is injured. Compared to hepatitis B, the risk of infection through semen and vaginal discharge with “C” is significantly lower;
- during blood transfusion or hemodialysis;
- when using contaminated needles. This is relevant for injection drug addicts;
- hepatitis is dangerous for a newborn if its mucous membrane or skin is injured during labor (for example, when using forceps). As a result of this, contact with the mother’s blood occurs and pathogens are transmitted to the baby;
- when applying a tattoo, performing piercing or manicure with instruments contaminated with blood;
- if close people share hygiene items with a virus carrier. This applies to scissors, washcloths, towels, toothbrushes and razors;
- in medical institutions with insufficient sterilization of surgical, gynecological and dental instruments.
Infection of the fetus does not occur during pregnancy, since the pathogen cannot overcome the placental barrier. The risk of infection increases with increasing viral load.
What happens in the body after infection?
After HCV enters the body, the asymptomatic period can last up to six months, during which the carrier of the virus does not notice clinical symptoms and continues to live a normal life. This form of the disease is extremely dangerous, because the infected person has no idea about hepatitis and can infect healthy people. Every person around him is at risk if he comes into close contact with a sick person or uses his hygiene products.
The pathogenic agent, having penetrated the body, is transferred through the bloodstream to hepatocytes (liver cells). It has a direct cytotoxic effect, which is accompanied by their destruction and the release of enzymes to the outside. This is demonstrated in the laboratory (ALT, AST).
Intensive reproduction of pathogens leads to the progression of the disease and an increase in the number of dead organ cells. Thus, a sluggish infectious process predisposes to an increase in liver failure.
The consequences of hepatitis C depend on the effectiveness of drug therapy, the presence of concomitant diseases, and the stage at which the disease was diagnosed. The earlier treatment is started, the greater the chance of overcoming infection and hepatitis.
Main manifestations of the disease
The incubation period lasts from a month to six months. At this time, there are no symptoms, and the person’s general condition remains virtually unchanged. Only in 20% of cases are malaise, dyspeptic disorders and sleep disturbances observed.
The acute stage is manifested by jaundice, low-grade fever, aching joints and muscles, as well as increasing weakness. In addition, the patient's psycho-emotional state changes. He becomes depressed, irritable and reluctant to communicate with others.
In the case of chronic infection of the infectious-inflammatory focus in the liver, a wave-like course of the pathology is observed. During periods of remission, there are no clinical symptoms. Exacerbations are characterized by a picture of an acute form of the disease.
Complications of hepatitis C occur due to the progression of liver failure and increased viral activity.
How dangerous is hepatitis C to others?
To understand whether hepatitis C is dangerous for others, you need to remember how the infection spreads. So, a healthy person can become infected in the following cases:
- during intimacy, especially in the presence of erosions on the genitals;
- when kissing, if the integrity of the oral mucosa is damaged;
- a woman can infect her partner during sex during menstruation;
- in everyday life when using personal items of a virus carrier.
In addition, in medical institutions where the rules for processing medical instruments are not followed, there is a risk of infection of healthy people after servicing a virus carrier.
Thanks to a thorough examination of those wishing to become a donor, today the risk of infection through blood transfusion is not so high. The patient will not be able to donate blood, since markers of hepatitis will be detected during the diagnosis.
Complications
The consequences of hepatitis C can be divided into liver complications, as well as complications associated with dysfunction of other internal organs. The first group includes:
- cirrhotic degeneration of the liver. Each hepatocyte after destruction is replaced by connective tissue, thereby aggravating organ failure. As the disease progresses, the number of non-functioning cells increases, which stimulates the development of cirrhosis;
- tissue malignancy. The fact is that cirrhosis is a disease that predisposes cells to malignant transformation. The pathology is expressed in the form of hepatocellular carcinoma, which gives an unfavorable prognosis for life;
- Another consequence of sluggish hepatitis is portal hypertension. Its manifestations include ascites, pleurisy (accumulation of fluid in the abdominal and pleural cavities), varicose veins of the esophageal veins, as well as spider veins;
- increased bleeding. Against the background of protein deficiency, the functioning of the coagulation system is disrupted, which is manifested by frequent bleeding from the gums and ulcerative defects of the gastrointestinal tract. The consequences of hepatitis C in women are represented by prolonged menstruation, due to which hemoglobin decreases and signs of anemia are observed.
Extrahepatic complications include:
- damage to the peripheral part of the nervous system;
- Sjögren's syndrome;
- renal dysfunction due to glomerulonephritis;
- endocrine pathology, which is expressed by diabetes mellitus and thyroid dysfunction. Fluctuations in the level of sex hormones are accompanied by a decrease in libido and menstrual irregularities.
Diagnostic methods
Based on the clinical picture, it is impossible to accurately diagnose hepatitis C, because it is often asymptomatic. To detect a pathogen in the blood, a laboratory test is required, during which specific markers are searched.
Antibodies that are produced against infection can be detected no earlier than the sixth week after a person is infected. They are not a reliable indicator of the disease, as they may be present after recovery, indicating previous contact with the virus.
For a more thorough diagnosis, an analysis is required to determine the genetic material of the pathogen in the blood. For this purpose, the doctor prescribes a polymerase chain reaction, during which HCV RNA is detected.
In addition to laboratory diagnostics, ultrasound examination is required. It makes it possible to assess the size, structure, outline of the liver, as well as visualize additional foci in it (if any). In addition, it is necessary to analyze the blood flow and the condition of the blood vessels.
To establish the stage of cirrhotic changes, elastography or liver biopsy is needed. The latter technique is invasive and therefore requires local anesthesia. During the diagnostic process, material is collected and subjected to histological analysis.
Fibroscanning today is considered an alternative to biopsy, since it is absolutely as informative and at the same time does not require anesthesia.
Treatment of the disease
The widespread prevalence of hepatitis C forces specialists to closely study HCV. There are various antiviral medications that help block the proliferation of pathogens and reduce the rate of disease progression. The standard treatment regimen is Ribavirin and Interferon-alpha.
The consequences of treating hepatitis C with these medications can be expressed by varying degrees of severity of organ dysfunction. They concern damage to the cardiovascular, nervous, urinary and digestive systems. The duration of antiviral therapy is 24-48 weeks, which depends on the genotype of the pathogen.
It is worth mentioning a new drug that is used for hepatitis C, namely Sovaldi. It is an original medicine and is produced in the United States. Its mechanism of action is to block the enzyme responsible for the synthesis of viral RNA. The effectiveness of combination therapy with Daclatasvir is 100%. The only limitation to the widespread use of the drug is its high cost. The price of one tablet is about $1,000, and the full course of treatment can reach hundreds of thousands of dollars.
Taking this into account, many countries, for example, India, began to produce generics, that is, medicines that are analogues of the original. These manufacturers have a license to manufacture antiviral agents issued by an American company. The price of these medications is more affordable, which allows many virus carriers to complete the full therapeutic course without large financial costs.
Not all countries have received permission to produce generics, but they are still producing them. In this regard, they are not responsible for the quality of the drugs, and the technological process does not always meet WHO requirements.
Prevention of complications
To slow down the progression of the disease and delay the onset of complications, you must adhere to the following rules:
- strictly adhere to the dose of antiviral medications and do not interrupt the treatment course on your own;
- adhere to dietary nutrition. It involves avoiding fatty varieties of meat and fish products, as well as pickles, sweets, fresh baked goods, semi-finished products and spicy seasonings;
- completely give up alcohol;
- stop taking hepatotoxic drugs. If this leads to an exacerbation of concomitant diseases, the doctor should adjust the dose or replace the drug with a less aggressive one for the liver;
- give up narcotic drugs;
- avoid stress, as a violation of the psycho-emotional state is fraught with progression of the pathology;
- control the severity of physical activity;
- undergo regular examination, which is necessary to assess the viral load and determine the risk of complications.
It is important to remember that any overexertion can cause an exacerbation of hepatitis. In this regard, the virus carrier should radically change their lifestyle and adhere to preventive recommendations for life.
