Viral hepatitis C is dangerous due to its asymptomatic course. The pathology is difficult to diagnose at an early stage, which leads to severe complications. Under the influence of infection, liver cells disintegrate, the process becomes chronic. Therapy does not always help to cope with the disease, especially if hepatitis is detected in an advanced state. If the diagnosis is made in a timely manner, the chances of a positive treatment prognosis are high.

150 million – This figure indicates the number of people in the world who, according to 2016 data, were diagnosed with hepatitis C virus (HCV). Every year, 600 thousand people die from complications of the disease. High rates indicate the seriousness and widespread nature of this pathology. And if we take into account those carriers of the virus who are unaware of it, the numbers will be even higher.

Hepatitis C is a dangerous liver disease caused by a viral infection. The causative agent of the disease is the HCV virus, which contains ribonucleic acid (RNA). There are 6 different types of the virus (genotypes), which have their own subspecies (about 30).

HCV infection is characterized by constant mutation, which prevents the body from producing effective protective antibodies. Pathological cells multiply rapidly, capture hepatocytes and destroy them. Hepatitis becomes chronic.

It is difficult to select a therapy to successfully treat the disease. Another thing that makes hepatitis C dangerous is that there is no universal vaccine to destroy the virus. In addition, someone who has overcome the disease can become infected with the virus again. The body does not acquire immunity from HCV.

If hepatitis is not treated, serious complications develop. The advanced form of the disease causes the death of the patient due to cirrhosis or liver cancer.

When the HCV virus enters the human body, it targets hepatocytes (liver cells). It destroys their structure, changes it, which causes mutation. The body begins to produce antibodies against the mutated cells. This phase of hepatitis is called acute. A large number of transaminases are released, which are specific.

Antibodies are not able to fight inflammation on their own; the immune system is not sufficiently prepared for such an attack. In addition, treatment at this stage is rarely carried out due to the lack of characteristic complaints and timely diagnosis. Therefore, hepatitis becomes chronic.

The pathology progresses, but the infected person does not experience visible changes or particularly unpleasant symptoms. The liver tissue gradually dies, the infection spreads to other areas, succumbing to necrosis. The asymptomatic incubation period lasts from 1 month to six months after the virus appears in the blood. At the same time, the carrier of the virus, unaware of his illness, can infect other people.

At a later stage of the pathology, when the process becomes chronic, the following symptoms of hepatitis C may appear in women and men (15–20% of the total):

• general weakening of the body, malaise;
• inability to work actively;
• decreased blood clotting (wounds take longer to heal, increased discharge during menstruation in women);
• digestive disorders (diarrhea, constipation, vomiting);
• painful sensations under the right rib;
• loss of appetite;
• sudden weight loss;
• lightening of stools, darkening of urine;
• feverish state, constantly elevated body temperature;
• joint pain.

Some patients infected with the virus consult a doctor with suspicion of ARVI or influenza. After special tests, it is possible to make the correct diagnosis.

Symptoms of hepatitis often appear already at the stage of the disease when it becomes chronic. Diagnostics shows serious changes in the liver due to the infectious agent. Treatment does not always bring the desired effect. If complex therapy is not carried out, then the chances of developing unpleasant consequences increase.

Complications of hepatitis C:

• hepatosis;
• cirrhosis;
• liver failure;
• carcinoma.

Without C, the chances of developing cirrhosis are 20% over 15 years. About 5% of infected patients without proper therapy develop a complication in the form of liver cancer.

The dynamics of the disease depend on the genotype of the HCV virus. Forms 1b and 3a are developing especially rapidly.

At the first stage of pathological complications, necrotization (death) of the liver tissue occurs due to inflammatory processes. The structure of the organ changes and its functionality decreases. Different types of hepatosis develop. With steatosis (fatty hepatosis), functional tissue is replaced by adipose tissue. Fibrosis is characterized by the proliferation of epithelial tissue in place of dead liver cells.

The progression of HCV infection in a chronic course without therapy leads to more severe complications. Fibrosis progresses to liver cirrhosis. This pathology can no longer be treated. After all, irreversible changes have occurred in the entire structure of the gland.

Manifestations of cirrhosis:

1. Proliferation of connective and adipose tissue in place of the parenchyma (main functional fibers) of the liver.
2. Deformation of the hepatic arteries and gastric veins. Under the influence of an enlarged gland, they change their structure and size.
3. Impaired blood supply due to narrowing of the lumen of the arteries, thrombosis.
4. Ascites. Due to disruptions in metabolic processes and problems with blood flow, fluid accumulates in the abdominal cavity.

Cirrhosis causes internal bleeding, intoxication of the body, and liver encephalopathy. These changes are dangerous to human life.

Particularly severe complications are malignant tumors caused by chronic hepatitis C without treatment. At this stage, hepatocellular carcinoma (in 5% of patients) and cellular lymphoma (1% of patients) develop.

Liver cancer grows very quickly and metastasizes to other organs located near the liver (lungs, stomach). Cancer pathology can be cured with timely therapeutic methods. Doctors use surgery to remove the tumor and radiation therapy. In advanced cases, an organ transplant is required.

Complications of the development of the HCV virus may include disturbances in the functioning of other body systems:

• decreased kidney function (glomeruloneuritis);
• inflammation of blood vessels (vasculitis);
• pathologies of the digestive system;
• endocrine diseases.

The consequences of hepatitis C in men and women in the form of severe stages of pathology with a fatal outcome do not develop if treatment is started on time. It is important to adhere to the course of therapy and lifestyle recommendations from your doctor to ensure a positive prognosis.

Many people are interested in the question: is it possible to be near an infected person and not get sick? It is important to know in what cases there is a danger for a healthy person to become infected.

Methods of transmission of viral hepatitis C:

1. Using non-sterile instruments. In this way, you can become infected in beauty salons, dental offices, and clinics if the rules for using and processing instruments are violated.
2. Sexual contact with an infected partner. There is a greater chance of transmitting the virus if protection is not used.
3. During a blood transfusion. There are situations when a donor’s blood is needed urgently, and there is no way to test it for viral infections.
4. Injection syringes. If several people use the same syringe, the risk of infection increases.
5. During childbirth. If the mother is infected with the hepatitis virus, there is a 5–10% chance that the baby will become infected during birth.
6. Using personal items of an infected person. There are traces of blood on a razor, manicure scissors, and toothbrush. Thus, the infection enters the body of a healthy person.

Whether hepatitis is dangerous for family members of a virus carrier depends on compliance with hygiene rules. Infection is possible if you use the patient's personal belongings. This virus is not transmitted through the air or through physical contact.

Treatment of the disease is based on the results of diagnostic tests. To prevent the consequences of hepatitis C from leading to death, diagnosis should be carried out as early as possible. Doctors face difficulties in this matter. The symptoms are not special; they are similar to those of many other pathologies. To do this, it is necessary to carry out differential diagnosis.

The first stage is checking the level of special markers in the blood that indicate the presence of the HCV virus. These are antibodies produced by the body to resist hepatitis C antigens. They have a special protein composition that is different from other antibodies. Markers appear in the blood a month to a month and a half after the infection enters the body.

The analysis does not always give a 100% result; besides, antibodies only indicate the presence of a virus. What type of hepatitis is acute or chronic, as well as its stage, cannot be determined by such an analysis.

A more sensitive test is the polymerase chain reaction method, which can detect RNA virus in the body. It also determines the number of pathological organisms, which is important to know for effective treatment. Establishing the genotype of the virus allows you to choose the right therapy.

In addition to laboratory tests, doctors use instrumental diagnostics. In particular, sonography (ultrasound examination) of the abdominal area is widely used. The procedure shows the condition of the liver, its size, structure, deviations in one direction or another. Ultrasound shows changes occurring in the organ, blood arteries, and symptoms of cirrhosis can also be observed.

To clarify the diagnosis and determine how dangerous hepatitis is for the patient and what stage it is at, a liver biopsy is performed. To do this, a microscopic part of the gland is taken using a puncture and research is carried out in a special laboratory. The results of the procedure enable the doctor to prescribe treatment that is appropriate to the degree of development of the pathology, safe and effective.

The earlier therapy is started, the more optimistic the prognosis will be. To successfully fight hepatitis, you must be under the supervision of a doctor.

The choice of drugs is made individually for each patient. The doctor takes into account the characteristics of the course of the disease and the HCV genotype. It is also important to choose the dosage based on the patient’s weight.

Components of complex therapy:

• antiviral agents (Ribavirin, Daclatasvir, Arviron);
• interferons (Pegasys);
• drugs to normalize the condition of the liver;
• immunostimulating medications;
• vitamin complexes;
• special dietary food;
• minimal physical activity;
• calm atmosphere, long period of rest.

If treatment methods do not improve the patient’s condition, the situation worsens, and a decision is made to undergo a liver transplant. Transplantation is an expensive operation, and not everyone can afford it. But even after a successful transplant, treatment must continue.

Long-term use of interferon during a course of therapy can cause side effects in patients:

• allergies (itching, rash);
• drowsiness, depressive disorders;
• inability to concentrate for long periods of time;
• fever, headache;
• brittle nails, hair loss.

If left untreated, the disease progresses; hepatitis C causes severe complications that reduce the quality of life and lead to death.

Prognosis and prevention

The danger of the disease is that it is impossible to make any prediction regarding the improvement of the condition. The result of treatment depends on many factors. The effectiveness of therapy is influenced by the speed of development, complications of hepatitis, individual characteristics of the body and the lifestyle that the patient leads.

According to statistics, 45–75% of patients who have completed a comprehensive course of therapy feel well and continue to live without complications. To do this, you must strictly follow the doctor's recommendations.

To ensure a favorable prognosis, in addition to supportive treatment, it is necessary to follow the principles of a correct lifestyle:

1. Normalization of the diet. It is necessary to exclude fatty, fried and spicy foods.
2. Quitting bad habits. Toxins found in alcohol, nicotine, and drugs increase the load on the liver and destroy it.
3. Improved emotional state. It is necessary to learn to resist stress and minimize nervous experiences. They negatively affect the functioning of the body as a whole, reduce immunity, and slow down metabolic processes.
4. Regular examinations by specialized specialists. Taking liver tests, instrumental studies, and examining a doctor will help to detect an exacerbation of the chronic form in time, begin treatment and avoid complications of hepatitis.

The cost of therapy does not contribute to complete recovery; it is quite high. Therefore, not all patients can afford to undergo a full course of treatment with effective drugs.

If you refuse medical care or ignore your doctor's recommendations regarding lifestyle, your chances of a favorable prognosis are reduced. Without treatment, hepatitis has severe consequences and shortens the patient’s life expectancy.

To protect yourself from infection with a pathological virus, you should follow the rules for the prevention of hepatitis C:

• use sterile instruments when performing procedures in medical institutions and beauty salons;
• adhere to sanitation rules, do not use other people’s personal hygiene items;
• protect yourself during sexual intercourse.

Every person is at risk. Statistics show that half of people infected with hepatitis C had no idea about the virus in their bodies until the disease began to progress.

This form of pathology is dangerous due to the absence of symptoms during the incubation period. But with timely detection, diagnosis and proper therapy, it is possible to cure hepatitis in the early stages. In severe cases of the disease, a liver transplant may be required.

It's no secret that in 2014 Hepatitis C received the status completely curable infectious disease. This sensational verdict was made by infectious disease hepatologists from around the world who gathered at the annual European Congress of Liver Diseases (EASL).

New treatment protocols demonstrate 99% success, which is equivalent to complete victory over the virus, and is also a consequence of medical progress. The editors of our website have prepared an article about modern methods of treatment, which will talk about the benefits of taking new drugs and how to purchase them.

Reasons

The etiology of hepatitis C is based on the presence of the virus and a susceptible organism, subject to the conditions of the infection mechanism. It must be said that this is one of the most persistent infections; it persists for up to 4 days on instruments and surfaces with which infected blood has come into contact.

At what temperature does the hepatitis C virus die? Boiling destroys it within 2 minutes, and at 60 degrees Celsius it takes about half an hour.

Despite the fact that the virus was discovered more than thirty years ago, controversy surrounding it still does not subside. There are adherents of the theory that hepatitis C does not exist. However, the evidentiary basis is the isolation of virus RNA and antibodies to it during specific studies.

According to the International Classification of Diseases (ICD-10), hepatitis C code is B18.2.

The classification of hepatitis C divides the disease into two forms: acute and chronic. In the acute form, there may be no symptoms or they may be similar to any other infectious hepatitis. The chronic course has such phases as latent (hidden) and clear clinical manifestations.

What is hepatitis C? In essence, this is an infection that deliberately selects the liver as a kind of “target”. The pathogen, which has six genotypes, feels great inside hepatocytes (liver cells), and the immune system is powerless to destroy it without at the same time destroying the liver parenchyma (tissue).

Type 1 hepatitis C is distributed throughout the globe. This is because subsequent variants are most likely the result of mutation - a means of adapting the virus to ways of fighting against it. Among drug addicts, type 3 hepatitis C predominates.

How dangerous is hepatitis C? First of all, the development of liver cirrhosis - a chronic irreversible process of replacement of functioning parenchyma with dense fibrous nodes.

The hepatitis C virus has several ways of entering the body. Among them:

1. Parenteral. Indicates infection through contact with blood. The amount of it in this case does not matter: just a tiny drop, not visible to the eye, can cause illness.
   Hepatitis C is transmitted during blood transfusions - this is a blood transfusion procedure, and hemodialysis - cleansing the body of metabolic products due to kidney diseases. Blood residues can be found on instruments for medical and non-medical procedures - surgical and endoscopic examinations, manicures, tattooing, ear piercing and other types of piercing.
   There is a risk even when using someone else's toothbrush or shaving accessories, kissing, if the infected person and his partner have wounds in the oral cavity. Of course, organ transplantation implies the same opportunities for the transmission of hepatitis C, while transplantation implies immunodeficiency, due to which the infectious process is more severe and faster.
   One of the most common mechanisms is the entry of the hepatitis C pathogen into the body with the same syringe needle in people who use injection drugs.
2. Sexual. Danger comes from discharge (secretion) of the glands of the genital organs, abrasions and microtrauma due to damage to the mucous membrane during unprotected sexual intercourse. The hepatitis C virus, as a rule, is secreted in significant quantities only during an active process in the body; During the latent period, hepatitis C is rarely transmitted sexually.
3. Vertical. This is an infection of the child in the womb transplacentally (through the vessels of the uteroplacental blood flow) or during the birth process, when the baby is forced to come into contact with the maternal mucosa and may receive minor damage that opens the “entrance gate” of the infection.
   Perhaps this mechanism provides a comprehensive answer to the question: is it possible to have children with hepatitis C? The disease does not affect reproductive function, i.e. the possibility of conception. The degree of viral load is important as a fundamental factor in the likelihood of pathogen transmission.

The source of infection can be not only the patient, but also a carrier of hepatitis C.

What is it? By carriage we mean a state when the virus is in the blood, but does not cause harm; there are no symptoms
liver damage. At the same time, it can be transmitted to another person, in whose body the disease is activated in full force.

Can hepatitis C be dangerous for family members who use the same household items as the patient? Contact and household transmission of this infection is not typical, however, in case of injuries to the oral mucosa, blood can remain on dishes, towels, and a toothbrush, therefore it is undesirable to transmit them to anyone.

What to do if you are diagnosed with hepatitis C? You must follow the instructions of your attending physician, who, if necessary, will prescribe additional diagnostic tests and select the optimal antiviral therapy regimen.

Symptoms

The incubation period for hepatitis C lasts from two weeks to six months; The virus RNA binds to cell surface receptors and penetrates the hepatocyte. Once under the reliable protection of a membrane impenetrable to immunity, the pathogen starts the process of replication (copying) and multiplies.

At this time, the course may be asymptomatic; inactive hepatitis C, or the latent period, can last months or years.

In the presence of immunodeficiency or concomitant liver diseases, it is reduced.

The hepatitis C clinic is characterized by the following symptoms:

• constant weakness, fatigue, apathy, depressed mood;
• decreased or lack of appetite, nausea, vomiting;
• abdominal pain mainly in the right hypochondrium;
• enlargement of the liver (hepatomegaly), less often – enlargement of the spleen (splenomegaly);
• darkening of urine, gray stool;
• yellowing of the skin, mucous membranes and sclera of the eyes;
• joint pain.

These signs are observed in the acute period. Depressive disorders are quite common with hepatitis C, but they are not a specific obligatory symptom.

Does your liver constantly hurt? The chronic form is accompanied by the formation of cirrhosis and portal hypertension, a syndrome that develops as a result of increased pressure in the portal vein.

Then, when examining the patient, you can notice dilated saphenous veins on the anterior abdominal wall, the liver is often enlarged and the person experiences discomfort, pain in the right hypochondrium during physical activity or dietary errors. Serous fluid accumulates in the abdomen - this phenomenon is called ascites.

During fibrogastroduodenoscopy (examination of the gastrointestinal tract with an optical tube), dilated venous vessels of the esophagus and stomach are detected. In later stages, disturbances in the coagulation system are characteristic, since one of the functions of the liver is the synthesis of vitamin K and blood clotting factors.

They manifest themselves as nasal and gastrointestinal bleeding of varying severity.

Such complications of hepatitis C indicate irreversible damage to the liver parenchyma.

Does hepatitis C cause disability and in what group? In fact, viral hepatitis with liver dysfunction is the basis for this. Clinical and laboratory indicators and the ability to self-care and work are taken into account.

Is it possible to work with hepatitis C? Since the virus is not transmitted through household contacts, there is no need to limit the patient’s activity in society, which also includes professional aspects.

Diagnostics

Today, medicine has ample opportunities to confirm hepatitis C.

The carrier is detected only by laboratory data.

Diagnostic methods are divided into nonspecific (reflect the general picture of damage to the liver and the body as a whole) and specific (aimed at detecting the virus or the immune response to its presence):

Sometimes the following situation arises: there are antibodies to hepatitis C, but there is no virus. This is possible if self-healing has occurred - the immune system has managed to overcome the infection. Antibodies indicate that the immune system has responded to the pathogen.

A false positive result when diagnosing hepatitis C is a very rare but possible occurrence. The reasons may be a violation of the rules for preparing and studying the material, a banal mix-up with test tubes, or the patient intentionally donating blood that is not his own, which is possible with remote sampling (taking blood outside the walls of the laboratory).

Microbiology, or microbiological diagnostics, is not carried out, since hepatitis C has a viral etiology, and simply will not grow on the nutrient medium used for bacteria.

Treatment

There is an opinion that hepatitis C is incurable. Is this so and how effective are the pharmaceutical drugs offered then? Unfortunately, once infected, the virus cannot be completely destroyed, but modern methods of therapy can suppress its replication so much that it will not be detected in the blood.

Positive hepatitis C must be treated, not with the goal of completely eliminating (removing) the virus from the body, but to prevent complications.
Cirrhosis in the absence of proper medical care is a threat of liver failure, the consequences of which in hepatitis C are very serious.

How is hepatitis C treated? There are several main groups of medications used to fight the virus:

1. Interferons (viferon, alfaferon).
2. RNA polymerase inhibitors (ribavirin, sofosbuvir).
3. Protease inhibitors (simeprevir, boceprevir, telaprevir).

The duration of medication use ranges from 16 to 72 weeks, and these drugs are combined for a more effective effect on the virus.

To support the liver, hepatoprotectors are also prescribed - substances that stimulate regenerative abilities and help the organ resist the destructive effects of hepatitis C.

Alcohol and its substitutes are incompatible with treatment; the diet involves avoiding fatty and fried foods, spicy seasonings, and synthetic flavorings.

Patients complain of constant fatigue, so it is necessary to rationalize the work and rest regime, engage in strengthening physical exercises, but avoid excessive fatigue.

It is better to consult a doctor and replace or discontinue completely hepatotoxic medications - a weakened liver has a hard time coping with the increased load, and the risk of side effects increases tenfold.

There is also a risk for women after menopause.

The type of infection is important - genotype 1 recurs much more often, unlike other variants of the disease, behind this is its high resistance to treatment, which can lead to
insufficient effect on hepatitis C. This should be taken into account when planning the duration of the drug regimen.

Alcohol abuse seriously aggravates and accelerates the onset of the consequences of hepatitis C, since even in uninfected people it leads to the development of cirrhosis.

It is impossible to deny that hepatitis C is a serious disease, but nevertheless this is not a death sentence. The main obstacles to quality treatment are its high cost and late diagnosis, when the pathogen is detected already at the stage of liver cirrhosis. If detected early, the course of hepatitis C can be slowed down and even stopped.

Prevention

What to do to avoid becoming infected with hepatitis C? Strictly individual use of medical and cosmetology instruments or careful sterilization with proper quality control are required.

When performing procedures that involve the risk of the patient’s blood or other biological fluid coming into contact with the skin and mucous membranes, medical workers wear gloves, masks and goggles.

Protective equipment must be disposable and destroyed after use according to existing regulations.

It is recommended to use a condom during sexual intercourse. This also applies to a regular partner if he is a carrier or has a confirmed hepatitis C infection. Pregnant women and women planning to conceive undergo screening diagnostics for hepatitis C.

You can find out everything about the risk to the child by consulting an obstetrician-gynecologist.

Hepatitis is damage to the liver, one of the largest internal human organs. There are many infections that affect its functioning. Lifestyle, diet and excessive alcohol consumption also play an important role in the destruction of a normal, healthy liver. Hepatitis A, B and C, the most common hepatitis viruses, and their causative agents are dangerous because they are viruses of a special group.

Vaccinations against hepatitis A and B have already been invented and are often recommended for infants. Newborns are not vaccinated against hepatitis C. The fact is that the virus itself was discovered relatively recently, a little over twenty years ago, and it is so variable that it is still not possible to find an effective vaccine. At this stage, the main six genotypes of hepatitis C virus (HCV) and more than fifty subtypes (1, 1b, etc.) are known. Scientific research into this issue continues.

What is it?

Hepatitis C, abbreviated as hepatitis C, is a viral, infectious disease that develops in the liver as a result of infection with the hepatitis virus (HCV). The virus spreads through contact with an infected person, namely through blood. Infectious hepatitis C has acute and chronic forms.

HCV is a small chain of ribonucleic acid (RNA) viral envelopes that uses material from liver cells for reproduction. The mechanism of RNA activity triggers inflammatory processes in the liver, gradually destroys liver cells (the process of cytolysis), triggers the immune mechanism for the synthesis of specific antibodies, autoimmune aggression of the body's protective functions in relation to inflammatory processes of hepatocytes (attack on healthy cells of the immune system).

How is hepatitis C transmitted?

Globally, approximately 150 million people are chronically infected with hepatitis C virus and are at risk of developing cirrhosis and/or liver cancer. Every year, more than 350 thousand people die from hepatitis C-related liver disease. Every year, 3-4 million people are infected with the hepatitis C virus. Today, 7 genotypes of the virus are known.

How is hepatitis C transmitted? The source of infection is patients with active hepatitis C and latent patients who are carriers of the virus. HCV infection is an infection with a parenteral mechanism of infection - through infected blood and its components, as well as through semen and vaginal secretions (approximately 3%). Infection is possible during parenteral manipulations, including in medical institutions, including the provision of dental services, through injection equipment, during acupuncture, piercing, tattooing, and during the provision of a number of services in hairdressing salons, however, during sexual contact the likelihood of contracting hepatitis C is much less than hepatitis B, and is reduced to minimum indicators. In 20% of cases, it is not possible to establish the mode of transmission of the virus.

You cannot become infected with hepatitis C:

• when using some household appliances (with the exception of razors, manicures and other accessories that may contain traces of blood);
• when shaking hands, hugging;
• when kissing;
• when eating together.

The most dangerous, from the point of view of the source, are patients with chronic hepatitis C.

Genotypes

Genotypes have a specific territorial distribution. For identical genotypes in different territories, the same principles of treatment apply. They are designated by Arabic numerals (from one to six), and quasitypes or subtypes are designated by letters of the Latin alphabet (a, b, c, d, e) and so on:

1. First genotype. Distributed everywhere, three quasitypes are distinguished (1a, 1b, 1c). If this genotype is confirmed, long-term treatment should be expected, for one year or more.
2. Second genotype. Characterized by the widespread distribution of the genotype and four quasitypes (2 a, b, c, d). The duration of treatment is usually no more than six months.
3. Third genotype. Distributed everywhere. The presence of six quasitypes (3 a, b, c, d, e, f) has been proven. This genotype is characterized by fatty degeneration (infiltration) of the liver parenchyma - steatosis. Treatment time depends on the quality of diagnosis. The average treatment time is limited to six months.
4. Fourth genotype. Distributed in the countries of the Middle East and Central Africa. In Russian conditions it is little studied. Ten quasitypes have been identified (4a, b, c, d, e, f, g, h, i, j).
5. Fifth genotype. First registered in South Africa. Has one quasitype. In the conditions of our country it remains a little-studied pathology.
6. Sixth genotype. Registered in Asian countries, has one quasitype. In Russian conditions it is little studied.

The term “genotype” means the differences of the virus at the molecular (genetic) level.

Symptoms of hepatitis C in women and men

The incubation period of the disease before the first signs appear lasts from 1.5 to 6 months (on average 2–3). Acute hepatitis C (see photo) is characterized by a benign course, the condition quickly normalizes, the symptoms of the disease are mild or moderate:

• unexpressed dyspeptic symptoms (1-2 times vomiting, heaviness or dull arching pain in the right hypochondrium, unstable stool, nausea, loss of appetite, feeling of bitterness in the mouth);
• a rise in body temperature to subfebrile levels (noted by about a third of patients), high fever is uncharacteristic;
• liver enlargement;
• icteric staining of the skin and visible mucous membranes, icterus of the sclera;
• dark coloration of urine, discoloration of feces.

It is characteristic that the severity of the disease in acute hepatitis C is less pronounced than in other forms of viral hepatitis. Recovery from an acute process occurs in 15–35% of infected individuals; in other cases, the disease becomes chronic and continues for many years and even decades.

Symptoms of chronic hepatitis C

Unfortunately, in 70-80% of cases, hepatitis C has a primary chronic course. For many years the disease flows hidden, practically without showing itself. The person is unaware of his illness, leads a normal lifestyle, drinks alcohol, aggravating his condition, has unprotected sex and infects others. Liver function in hepatitis C remains compensated for a long time, but often such imaginary well-being ends in acute liver failure.

What indirect signs can lead a person to think about liver dysfunction?

1. Dull pain under the right rib, periodic nausea, loss of taste. It is important to understand that with the gradual death of liver cells, the remaining tissue mass increases compensatoryly. The liver increases in size and stretches the liver capsule, causing pain. Since this happens gradually, cirrhosis of the liver due to hepatitis is not characterized by sharp or acute pain.
2. Weakness, lethargy and drowsiness. Extremely nonspecific symptoms characteristic of many diseases, but patients with hepatitis often characterize their weakness as “terrifying.” “I can’t open my eyes”, “I’m ready to sleep 20 hours a day”, “my legs are giving way” - these are characteristics often heard by infectious disease doctors.
3. Periodic yellowing of the skin and mucous membranes. In the chronic course of hepatitis C, jaundice appears and disappears. Often patients note a slight yellowing of the sclera or skin the morning after a festive dinner with an abundance of fatty foods, meat and alcohol. Thus, on normal days the liver copes with the exchange of bilirubin, but after a “double” hit of fatty foods and alcohol, it temporarily fails.
4. Joint pain is also a nonspecific symptom of hepatitis, but occurs quite often.
5. The appearance of bruises, hematomas, spider veins, excessive bleeding of the gums, and heavy menstruation in women indicate a deficiency of blood clotting factors, for which the liver is responsible.
6. Dry and pale skin, hair loss, brittleness and layering of nails are the consequences of a lack of vitamins and iron metabolism disorders, for which the liver is responsible. Often, patients with hepatitis have a severe lack of B vitamins and iron, leading to anemia (anemia).
7. Impotence and infertility are often observed in patients with hepatitis C. The inability to conceive a child, recurrent miscarriage are often observed in women carriers of hepatitis C. The main “sexual” symptoms of hepatitis C in men: impotence and spermatogenesis disorders. This occurs due to a violation of the metabolism of sex hormones, which necessarily undergo their transformations in the liver.
8. Edema syndrome and its extreme manifestation is ascites. Edema occurs due to insufficient amounts of protein and nutrients in the blood. Ascites is an accumulation of fluid in the abdominal cavity with a proportional increase in the abdomen, which the patient notices. This occurs due to impaired blood flow in the vessels of the abdominal cavity. This symptom is characteristic of liver cirrhosis due to hepatitis. Sometimes up to 20 liters of fluid accumulate in the abdominal cavity.

Most often (in approximately 70% of cases), there are no symptoms of either acute or (subsequently) chronic hepatitis for many years; the infected person is bothered by increased fatigue, periodic heaviness in the right hypochondrium, and intolerance to intense physical activity. In this case, carriage of the virus is determined by chance during preventive examinations, during hospitalization or an attempt to donate blood as a donor.

How to treat?

In the treatment of chronic hepatitis C there is no single standard of treatment; each case is purely individual. Complex treatment is prescribed after a thorough analysis of the following factors:

1. Degree of liver damage;
2. Probability of success;
3. The patient's readiness to begin therapy;
4. The presence of concomitant diseases;
5. Potential risks of adverse events.

The most effective treatment for viral hepatitis C today includes complex antiviral therapy with ribavirin and interferon. These drugs are general genotypic, that is, they are effective against all genotypes of the virus.

The difficulty with treatment is that some patients do not tolerate interferon well, and the drug is not widely available. The cost of treatment for hepatitis C is not affordable for everyone, so many patients simply do not complete treatment and the virus develops resistance to the drugs they are taking. If the patient subsequently starts a new course of therapy with resistance to antiviral drugs, there will be no effect from the treatment.

People are more likely to show positive signs of response to hepatitis C combination therapy:

1. European race;
2. Female gender;
3. Weight less than 75 kg;
4. Age under 40 years;
5. Low insulin resistance;
6. No signs of severe liver cirrhosis.

Most doctors use a combined treatment regimen for hepatitis, the so-called dual therapy - a combination of interferon, which actively fights the virus, and ribavirin, which enhances the effect of interferon.

The patient is administered short-acting interferon daily or once every three days, and long-acting interferon (pegylated interferon) in combination with ribavirin (used daily in tablet form) once a week. Depending on the type of virus, the course is 24 or 48 weeks. Genotypes 2 and 3 respond best to therapy - treatment success is 80-90%.

For genotype 1, combination therapy is successful in 50% of cases. If the patient has contraindications to combination therapy, interferon-alpha monotherapy is prescribed. In this case, the course of therapy lasts 12-18 months. Long-term monotherapy with interferon-alpha reduces the viral load in 30-50% of cases.

New drugs for treatment

As of November 2016, next-generation therapeutic regimens consisting of two or three replication inhibitors sofosbuvir/velpatasvir/voxilaprevir from Gilead and glezaprevir/pibrentasvir ± sofosbuvir, tested by AbbVie, are undergoing the final phase III of clinical trials. Both regimens demonstrate high pangenotypic activity and efficacy in multidrug-resistant individuals.

The first pangenotypic representatives of the class of non-nucleoside NS5B polymerase inhibitors CC-31244 and the long-acting injectable form GSK2878175 are undergoing phase I-II clinical trials. Both inhibitors can potentially be used in combination therapy with both other classes of DAAs and indirect-acting antiviral drugs.

Can hepatitis C go away on its own without treatment?

The probability of getting acute hepatitis C and recovering is, according to various sources, up to 10-30%. Acute hepatitis C is practically not diagnosed and in most cases becomes chronic.

Chronic hepatitis C does not go away on its own and requires treatment.

How much does treatment cost?

Costs for modern medications needed for treatment can range from $550 to $2,500 per month. The duration of treatment is 12 months (respectively, $6600-30000 per year).

Newer, effective, studied, easy-to-use drugs produced by well-known companies are more expensive - 40-100 thousand dollars for a course of therapy.

The main costs are for interferon drugs. Foreign-made pegylated interferons are more expensive than conventional interferons from any manufacturer.

How long can therapy last?

The choice of regimen and duration of treatment depends on the course and stage of hepatitis C, which is determined by the doctor. Treatment with a combination of interferon and ribavirin can last 12 months.

Moreover, unlike many other infectious diseases, for chronic hepatitis C there is no single standard of treatment; individual planning is recommended in special cases. Complex treatment protocols are provided, taking into account the genotype of the virus, the condition of the liver (indicators of its function and changes in its tissue during biopsy), and viral load.

Doses of drugs and the schedule for their administration may vary, and also depend on the types of drugs (for example, different forms of interferon).

Is there a vaccine for hepatitis C?

There is no current vaccine yet. However, the search for her is ongoing.

For a long time, scientists have been unable to discover a stable viral protein specific to all genotypes and subtypes of the hepatitis C virus, for which neutralizing antibodies would be produced. The possibilities of genetic engineering technologies to create such a vaccine are being studied.

Currently, several teams of researchers are searching for technologies for creating vaccines against the hepatitis C virus. According to WHO, a vaccine for the treatment of hepatitis C is undergoing clinical trials in Europe. There are several international projects to develop a preventive vaccine against hepatitis C.

How to protect your liver if hepatitis C has already been detected

If tests show the presence of infection (anti-HCV), then you should:

1. Immediately stop drinking alcohol;
2. Find your doctor and see him periodically;
3. Do not take any treatment methods (including over-the-counter, “non-traditional”, “approved as harmless”) without consulting your doctor;
4. Get vaccinated against hepatitis B (in any case) and against hepatitis A (if there are any changes in liver function).

Nutrition and diet

Diet for hepatitis C should differ from the standard diet. Compliance with a specific diet is urgently necessary, so changes should be taken with full responsibility. The complete exclusion of alcoholic beverages is the first and mandatory point. In addition, there is a completely acceptable list of food products allowed for consumption:

• beef, rabbit, veal, steamed or boiled. Meatballs, cutlets and other variations of meat dishes should be cooked in a double boiler;
• yogurt, kefir and low-fat cottage cheese;
• pasta, all types of cereals;
• vegetable and light butter;
• clear, vegetarian soups (vegetables, cereals, noodles);
• lean chicken and boiled fish;
• fresh and boiled vegetables, except legumes, garlic and radishes;
• raisins, dried apricots, prunes and ripe, juicy, sweet fruits.

Sweets, spicy, salty, smoked, fried foods and raw eggs must be completely excluded. When choosing proper nutrition tactics, remember that in order to fully satisfy the body and build new cells, food must contain not only carbohydrates, proteins and fats, but also vitamins, minerals, and water. A strict but balanced diet is very important for the first six months of treatment, but it is better to stick to a similar diet for several years. The longer you eat according to the above list, the easier it is to finally give up prohibited foods.

Prevention

There is currently no specialized vaccine against hepatitis C. Therefore, to prevent the disease, it is recommended to follow a number of simple rules:

1. When injecting, you cannot use one needle on several people.
2. Piercing and tattooing instruments should be sterilized after each use, and the artist should use disposable gloves.
3. Manicure tools, razors, toothbrushes must be personal and not used by other people.
4. Safe sex. It must be remembered that although the likelihood of infection during unprotected sexual intercourse is relatively low, it increases sharply with casual relationships. In such cases, the use of a condom is mandatory.

To avoid infecting the unborn child, when planning a pregnancy, a woman should be tested for hepatitis C.

Life forecast, how long do they live?

In patients with active hepatitis, i.e. with constantly elevated transaminase activity, the risk of transformation into cirrhosis within 20 years reaches 20%. 5% of patients with cirrhosis may develop primary liver cancer.

The likelihood of developing liver cancer is higher if two infections occur simultaneously - hepatitis B and hepatitis C. Long-term alcohol consumption is also associated with a higher risk of developing liver cancer.

How long do people live with this diagnosis? General statistics on hepatitis C outcomes are as follows. For every 100 people infected with the hepatitis C virus,

• 55-85 people will have a chronic infection (chronic hepatitis or carriage without symptoms);
• 70 people will have chronic liver disease;
• 5-20 people will develop cirrhosis of the liver within 20-30 years;
• 1-5 people will die from the consequences of chronic hepatitis C (cirrhosis or liver cancer);

To prevent these consequences of chronic hepatitis C, you need to undergo treatment.

More than 500,000 people worldwide suffer from hepatitis C! And this data does not take into account those people who are not even aware of their illness.

In many cases, the pathology develops unnoticed, without significant clinical symptoms. In an instant, the situation can change dramatically when the disease begins to be accompanied by unforeseen complications.

Such cases usually end in failure. If you are interested in the question: “What is the danger of hepatitis C?”, then the answer can be very saddening, because the result of the disease is cirrhosis of the liver or an oncological diagnosis.

The Hidden Enemy: Hepatitis C

The form of hepatitis C is understood as an infectious disease provoked by a virus. It is transmitted through blood.

During the bloodstream, the virus enters the cells of the liver organ. There it multiplies quickly, progressing with renewed vigor.

It should be noted that after conducting a study, scientists were able to come to the conclusion that more than 85 percent of patients with hepatitis C do not even suspect that they have such a serious pathology.

The reason for this is the fact that the disease does not make itself felt with clear external signs, while the liver is destroyed without stopping.

It is possible that in the remaining 15 percent, sick people feel unwell. They complain about weakness, fatigue, and even suffer from asthenia.

But you must admit that the same symptoms are inherent in other diseases and, taking them into account, diagnosing hepatitis turns out to be very difficult.

The disease does not stand still. It destroys the liver, and therefore the answer to the question: “is hepatitis C dangerous?” - will always be positive.

This process is accelerated by alcohol and the consumption of narcotic substances, which contribute to changes in the organ. The situation gets worse with each use of illegal substances.

Routes of transmission of hepatitis C

You can become infected with the hepatitis C virus in different ways. It can enter the organ through the blood.

The parenteral method is appropriate if non-sterile medical syringes or instruments were used.

It can be transmitted through cutting household items that are used to care for nails, for example, scissors. The virus is common among drug addicts.

Sexual transmission of hepatitis C is also possible. It passes during sexual intercourse, like HIV or other sexually transmitted pathologies.

The fetus of a pregnant woman can also get sick. This happens when the mother was carrying a child with an acute form of hepatitis.

Fortunately, too many such cases have not been recorded. In 5-10 percent of cases, the baby acquired the disease from the mother while in her womb.

The risks of infection are minimal in medical institutions. Doctors mainly use disposable syringes, as well as other instruments, having previously carried out high-quality sterile treatment, which involves a multi-stage process: washing with soap and soda solution, wiping with disinfectants, sterilizers, etc.

Threatening: hepatitis C

An infectious agent that attacks the liver causes the organ to begin to die. Some cells remain alive, but since the immune system is weak, the body is not able to fully resist the pathology.

But is hepatitis C dangerous for organs other than the liver? Yes, it provokes serious tissue changes in the liver, which leads to serious consequences throughout the entire structure of the body.

There is not a single organ that would not be affected in the future by this virus. When answering the question of why hepatitis C is dangerous, you need to list all those organs that will subsequently suffer from the virus.

Heart

As the pathology progresses, it will provoke the development of portal hypertension or liver cirrhosis.

In turn, these ailments reduce the norms of systemic blood pressure. This causes the cardiovascular system to be under stress.

The pathology leads to the patient being diagnosed with heart failure. The pumping function of the organ will be disabled.

Lungs

In the case of a severe form of the pathology, a person may develop cirrhosis of the liver. This disease increases pressure in the pulmonary artery, which causes shortness of breath.

Portal hypertension progresses to more serious stages of pathology. Abdominal fluid becomes inflamed and enters the pleural cavity.

Breathing becomes even more problematic, because the peripulmonary sac harms the condition of the lungs.

Digestive systems

When hepatitis C develops into serious complications, a person begins to lose weight sharply, and is overcome by vomiting and bouts of nausea.

Cirrhosis provokes bleeding of the rectum or esophageal veins. The affected organ is no longer able to cope with the task of producing albumin protein in the amount that the human body needs.

The result of this process is exhaustion of the patient. But the worst thing is that against the background of these events, liver cancer may develop.

Kidneys

The blood supply to the kidneys will result in a decrease in blood pressure. This suggests that the blood filtration capacity will be significantly reduced.

This deviation from the norm leads to the development of renal failure. Doctors call this form of pathology hepato-renal syndrome.

Hematopoietic system

A disruption in the functioning of the coagulation system provokes a serious risk of bleeding.

Similar processes can occur not only from the veins of the esophagus, but also from the arteries of the brain. Common cases of hepatitis C include anemia and stroke.

Nervous system

In addition to the above complications, the human body will suffer greatly from liver failure. Toxins accumulate in the liver when the organ itself is unable to remove them from its body. After a while, the patient begins to suffer from disorientation. It is possible that he will lose his normal state of thinking, begin to talk delirium, and in some cases a coma may occur.

Genitourinary system

Disruptions in the genitourinary system after hepatitis C are fraught with infertility for the female half of patients, and impotence for the male half.

It should be noted that many of the above pathologies will not be the result of direct exposure to the C virus, but of the complications that hepatitis provokes in the presence of infection in the body.

There are cases when it does not make itself felt for a long time, being asymptomatic, or does not respond to treatment.

Treatment course for hepatitis C

In the treatment of hepatitis C, medicine is gaining momentum every year. Modern doctors claim that this form of the disease is treatable, and therefore it is worth getting vaccinated against the pathology on time, so as not to go through a difficult stage of recovery in the future.

If you plan competent treatment therapy in time, the percentage of recovery will be from 50 to 80. These indicators will vary depending on the type and stage of the disease.

The hepatologist must make the correct diagnosis. For these purposes, the patient will need to undergo a series of tests, thanks to which the specialist will be able to prescribe an effective therapeutic course.

It is possible that in addition to blood tests, you will need to undergo an ultrasound, and a liver biopsy may also be required.

This information will make it possible to create a complete picture of the condition of the liver, determine the extent of damage and indicate a diagnosis.

Only in this case can you count on safe and effective treatment therapy, which will soon put the patient back on his feet.

If a person has a chronic form of hepatitis C, then there are some other differences. The doctor will have to solve the problem individually, choosing which medications will be most effective.

Based on many years of practice, we can conclude that two drugs called Ribavirin and Interferon are popular among doctors.

The complex effect of these drugs can increase the effectiveness of the treatment course. These are not just words, because special studies have been conducted that have proven that the products can really be useful in the treatment of hepatitis C.

The danger of an advanced form of hepatitis C is that the disease is difficult to treat. The doctor sets himself the goal of stopping the process of virus replication.

Such inhibition of the process will reduce the level of recovery and stop the development of fibrosis.

Forecasts for a healthy life

It was already noted above that the virus can become chronic. To accurately assess the danger of hepatitis C, you need to understand what it threatens when it ends up in the human body.

The probability of degeneration of hepatitis C form into cirrhosis or cancer, if there is no proper maintenance therapy, is very high.

It is possible to say exactly how long a person with hepatitis C will live only by assessing the rate of development of the pathology.

This indicator is determined based on the patient’s lifestyle, as well as compliance with dietary therapy standards.

It is important that the patient removes all bad habits from his lifestyle. These include: drinking alcohol, drugs, smoking.

The thing is that, on the contrary, they act as impetus for the accelerated process of pathology.

It is important that the patient’s life is devoid of worries, anxiety and constant stress.

The psycho-emotional component of the lifestyle also carries great value for the purpose of recovery.

If a person experiences any nervous shocks, then these factors will become levers for triggering a mechanism that has an irreversible effect.

In addition, systematic visits to an infectious disease doctor, as well as routine examinations of patients with hepatitis C should be part of life.

These measures enable doctors to know exactly about the condition of the liver and how the body as a whole is feeling.

If signs of exacerbation of the pathology are identified, the patient will quickly oppose the progression of hepatitis C, following the precise instructions of the doctor.

It is impossible to say exactly when hepatitis C begins to move into more severe stages. Maybe this won't happen at all.

Everything here will depend on the patient’s responsibility for his health. You must always keep your finger on the pulse, doing everything that your doctor says. By complying with such requirements, the patient gets a chance to live a happy and long life without problems.

Danger to others

People with hepatitis C do not pose a danger to others. You can shake hands with them, kiss and hug.

The virus cannot be transmitted this way. But if there is an infection with hepatitis C, then the consequences are really terrible.

This is due to the fact that the pathology is hidden. Today it has still not been possible to understand what the main reason that provokes the virus is.

Carrying out diagnostics in accordance with a simple clinical blood test is complicated, but the task of drawing up a treatment regimen for hepatitis C form will be no less simple.

The contribution to the fight against this pathology is great. In our country, doctors have been fighting hepatitis C for more than 2 decades.

Despite the fact that it is still impossible to cure patients with a chronic form of the disease, we can definitely be proud that there is a chance to achieve long-term remission.

Thus, the virus enters an inactive phase, eliminating the risk of complications for the human body. Don’t just think that many managed to avoid this disaster.

Indeed, in accordance with numerous studies, it was possible to find out that the diagnoses were confirmed in half of the infected people, the same number did not know that they were a threat to others by spreading the virus in the country.

If in the early stages hepatitis C can be completely cured, then in later stages the only measure to save the patient is an organ transplant. This is not only a very risky operation, but also expensive.

Preventive measures

Hepatitis C has a tendency to mutations and the proliferation of other subtypes of pathology. It is for this reason that the development of vaccinations remains incomplete.

Nonspecific measures to prevent pathology include restrictive actions related to protection against infection entering the body. Of course, it’s worth making an effort to strengthen your immune system.

Transmission of hepatitis C occurs through contact with biological fluids that have absorbed the virus, subcutaneous tissues, or wounds.

Based on this information, the main prevention of the disease will be:

1. Compliance with sanitary and hygienic standards in cases of using the services of medical institutions, beauty salons, and dentists. If possible, it is worth monitoring that employees of these establishments use disposable syringes and exclusively sterile surgical instruments.
2. Limiting the number of sexual contacts with partners without using condoms.
3. Introduce constant testing for the presence of the hepatitis C virus into your daily routine if there are environmental conditions of increased risk of infection.

Experts note that more than 20 percent of cases of virus C entering the body have an unclear etiology.

Hepatitis has affected even those who lead a healthy lifestyle and have not undergone blood transfusions or organ transplants.

The same problem affects people who do not have more than one regular sexual partner and are not interested in drug addiction.

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