Hepatitis C

Summary on Hepatitis C

Hepatitis C is an infectious disease caused by a virus (HCV or HCV) that attacks the liver and causes inflammation. Hepatitis C can lead to cirrhosis of the liver (20% of cases in carriers of the virus) or hepatocellular carcinoma (5% of cases in carriers of the virus). We should know that hepatitis C causes not only inflammation of the liver, but also many other pathologies (extrahepatic manifestations).
Hepatitis C is often asymptomatic (without clear symptoms) which makes diagnosis difficult.
An estimated 75% of Americans with HCV are unaware that they have hepatitis C. Fatigue can be a sign of hepatitis C.
HCV is transmitted primarily through blood transfusions and/or among injecting drug users.

Current standard treatment for hepatitis C is based on a combination of two drugs: interferon alfa and ribavirin, but promising new drugs such as telaprevir, boceprevir and sofosbuvir are now available in many countries. These drugs significantly improve the chances of curing hepatitis C. For more information see: treatment

Prevention is done by monitoring blood banks and not making shared use of syringes or materials that have come into contact with blood.

We should also know that most addicts infected with the AIDS virus (HIV) are also infected with Hepatitis C.

Definition

Hepatitis C is an often chronic infectious disease (between 75% to 85% of cases) that affects the liver and causes inflammation, this viral hepatitis is caused by the hepatitis C virus (HCV). The drug addict population is particularly affected.

We distinguish acute hepatitis C (minority) if it lasts less than 3 months and chronic hepatitis C (70% of cases, some sources say 85% of cases) if it lasts more than 6 months. For more information, see Hepatitis C symptoms.

Epidemiology

About 180 million people worldwide suffer from hepatitis C1 . Hepatitis C is the leading cause of cirrhosis and liver transplantation worldwide.

Causes

Hepatitis C transmission
Several contamination routes can be distinguished around the world.
– Transfusion with contaminated blood. It was a frequent source of hepatitis C before the 1990s, the main one. Nowadays, especially in emerging or high-income countries, blood transmission through contaminated blood is very rare due to the safety measures in place.
– Sharing syringes among drug users. It is the most common source of hepatitis C transmission today. Importantly, the virus is easily transmitted this way.
– Sexual contamination.
– Transmission from mother to child during childbirth, this route of transmission is rare.

Multiplication in the body:
When the hepatitis C virus enters the bloodstream, it tends to travel to liver cells (hepatocytes). Once in hepatocytes, the virus multiplies using the machinery of human cells. As the liver feels attacked, an inflammatory process begins to defend itself against this viral attack.

Hepatitis C transmission

The main route of transmission of the hepatitis C virus is contact with contaminated blood. Transmission also occurs during sexual intercourse , although it is rare, or through contact with materials contaminated by blood, such as syringes, needles, nail clippers, instruments used in tattoos, among others.

Transmission can also happen during childbirth, vertically. Despite reports on the presence of the virus in other secretions, such as saliva, milk, urine and sperm, there are no conclusive data on transmission through contact with these plasma derivatives.

Groups of risk

Groups at risk of catching hepatitis C include:

– Recipients of blood by transfusion;

– injecting drug users;

– Patients on hemodialysis;

– Health professionals who have direct contact with blood or body fluids;

– (Individuals with promiscuous and unprotected sexual behavior).

– Alcoholics are particularly at increased risk of developing cirrhosis.

Children infected with hepatitis C appear to have a more benign course than those with hepatitis B. In a study of children infected with hepatitis C genotype 1, 45% recovered spontaneously. Disease progression also appears to be slower than in adults who have acquired the disease.

HCV-HIV co-infection is common. In a European study of 3000 HIV carriers, 33% were anti-HCV positive (75% of IV drug users). Progression to cirrhosis is much more rapid in these patients, as high as 25% at 15 years in one study.

HBV-HCV co-infection speeds up the development of cirrhosis and hepatocellular carcinoma.

Symptoms

Unlike hepatitis A and B , most patients develop a slow and chronic disease, and around 85-90% are asymptomatic or have non-specific symptoms, such as lethargy, joint pain, nausea, tiredness , among others.

About 15% of patients have acute symptoms that include jaundice, fever , abdominal pain, malaise, diarrhea and fatigue . After a few months, these patients heal naturally.

Of patients with chronic disease, 40% rapidly progress to cirrhosis and death, 25% slowly progress to cirrhosis and die at the end of 10 years, and another 35% die after 20 years. Liver cancer appears after about 30 years in 5% of cases.

Diagnosis

As with hepatitis B, the main method for diagnosing hepatitis C is serology for anti-HCV using the ELISA and/or Immunoblot method. There are other methods for detecting viral RNA, which is found in the blood from 7 to 21 days after infection. There are several techniques, and qualitative and quantitative PCR are some of these methods. In addition, an effective way to determine the severity of the disease is through a biopsy of the injured tissue, although there are some less invasive techniques for such determination.

Complications

In addition to the hepatic symptoms, the virus can lead to some extra-hepatic manifestations through stimulation, such as the appearance of B-cell lymphoma, idiopathic pulmonary fibrosis, corneal ulcer, autoimmune thyroiditis, membranoproliferative glomerulonephritis, Reynaud’s phenomenon, among others. In addition, hepatitis C can progress to hepatocellular carcinoma and liver cirrhosis. Complications of liver cirrhosis include ascites, gastrointestinal bleeding, spontaneous bacterial peritonitis, and hepatic encephalopathy.

Treatments

The main drugs used for chronic hepatitis C infection are alpha interferon and ribavirin in combination. The effectiveness of this scheme is around 60%, however, not all patients respond equally to therapy and varies between 45 and 55% in genotype 1 and around eighty percent in genotypes 2 and 3.

PEG-interferon alpha is an alternative to interferon alpha, as this molecule has slower absorption and elimination. It is important that before any conduct, a doctor is consulted.

New treatments for hepatitis C

The new treatments, telaprevir and boceprevir active against HCV virus type 1 (majority virus in Brazil) are very promising in combination with the first two described above, these treatments are already available in Brazil.

Both drugs significantly improve the chances of treatment success (eg, 70 to 90% of patients are cured with telaprevir in six months instead of a year as before).

These two new drugs that are actually protease inhibitors can continuously increase the virological response (with a correlation with clinical cure) compared to conventional therapy (interferon and ribivirin). [Source: Pharmavista.net, Switzerland, June 2011].

In December 2013, the US Food and Drug Administration (FDA) authorized the marketing of Sovaldi (sofosbuvir), a new drug to treat chronic hepatitis C.

Transplantation
In severe cases of hepatitis C, a liver transplant may be the patient’s last hope, especially if the drugs don’t work.

Herbal medicine

Phytotherapy can help in the treatment of hepatitis C and some plants include silymarin and herbs that help liver and digestive functions, such as * milk thistle , artichoke , stonebreaker and Chilean boldo . It is important that, before using any medicine or medicinal plant, a doctor is consulted.
*An American study carried out in 2012, however, showed that this plant did not really have scientifically proven effectiveness against hepatitis.

Tips

For the patient with hepatitis C, it is recommended:

– Avoid the consumption of alcohol and drugs that damage the liver, such as paracetamol ;

– Constant follow-up with the doctor, to monitor the evolution of the disease;

– Healthy diet to maintain weight, mood, immune system and to help the onset of other diseases;

– Avoid obesity and dyslipidemia (increased blood cholesterol).

Prevention

– Prevention can be done by adequate screening of blood donors in blood banks.

– In addition, the best way to prevent the disease is to combat the shared use of syringes in injecting drugs.

– In addition, it is recommended to use condoms during sexual intercourse.

Also Read: Liver Cancer

Jeanne Kenney
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I’m a stylist trainer, a content creator, and an entrepreneur passion. Virgo sign and Pisces ascendant, I move easily between my dreams, the crazy world I want, and my feet on the ground to carry out my projects.

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