Contents
In line with its mission, the Editorial Board of MedTvoiLokony makes every effort to provide reliable medical content supported by the latest scientific knowledge. The additional flag “Checked Content” indicates that the article has been reviewed by or written directly by a physician. This two-step verification: a medical journalist and a doctor allows us to provide the highest quality content in line with current medical knowledge.
Our commitment in this area has been appreciated, among others, by by the Association of Journalists for Health, which awarded the Editorial Board of MedTvoiLokony with the honorary title of the Great Educator.
Many Poles fear HIV infection the most. Meanwhile, among us, there are probably about a million carriers of hepatitis viruses, who, as in the case of HIV infection, may not experience any significant ailments for years, but whose liver is being tricked out all the time. The bad news is that hepatitis viruses spread to a new host dozens of times more easily than the HIV virus. The effect of viruses entering the body is – most often after many years – cirrhosis of the liver and one of the most malignant cancers – hepatocellular carcinoma.
Viruses that cause hepatitis B and C
These viruses are the hepatitis B virus (HBV) and the hepatitis C virus (HCV), which account for approximately 90% of the viruses. all primary liver cancers. They travel through the blood and other body fluids. You can also get infected with hepatitis B and C viruses through sexual contact.
In Poland, the prevalence of HBV has been drastically reduced in recent years. This is because there is a vaccine – in fact, the first anti-cancer vaccine that was introduced into the mandatory immunization calendar in the mid-90s.
Nevertheless, the PZH estimates that there are about 380 in Poland. HBV carriers. Experts recommend: if someone has not been vaccinated so far, they should see a doctor as soon as possible. Three doses of the vaccine give life-long immunity. It is also absolutely necessary to get vaccinated before going to the hospital for any treatment – both HBV and HCV are viruses that can be easily infected in health care facilities.
Factors causing HBV and HCV
How to protect yourself against hepatitis B and C? The group at risk of hepatitis B and C is primarily those who have undergone surgeries during which the continuity of the tissues has been interrupted. The greatest responsibility rests with health care workers and … beauty salons or tattoo studios. Patients and clients should pay attention to whether the procedures are performed with disposable or well-sterilized equipment, and the person who performs them washes and disinfects hands and wears disposable gloves. Any waste should be put into a closed, separate container after the treatment. It should be demanded that the pliers, tweezers etc. be washed, disinfected and sterilized. Attention! HCV and HBV are very heat resistant and only destroyed by a combination of high temperature and pressure.
It is necessary to periodically perform blood counts and the so-called liver function tests, as well as the determination of anti-HCV antibodies in the blood. These tests will be ordered by a doctor, and the NHF will reimburse their cost.
When HCV attacks
Hepatitis C is usually, unfortunately, detected incidentally or late in the infection, when cirrhosis and / or primary liver cancer are found. The earlier an infection with hepatitis viruses (HCV and HBV) is detected, the greater the chance of recovery.
Treatment
In Poland, modern hepatitis treatment is available, which is a standard all over the world. It consists in administering to patients, depending on the severity of the disease, age and several other factors, pegylated interferon alfa-2a or alfa-2b in monotherapy or in combination with ribavirin. As part of the therapeutic program. The treatment is long-term: from several to several dozen weeks.
Polish Group of HCV Experts under the supervision of prof. Waldemar Halota recommends that people infected with HCV be regularly monitored for hepatocellular carcinoma. This means that such people should have AFP determined and liver ultrasound performed every 24 weeks.
Such a procedure enables early detection of a neoplastic lesion.
Hepatitis B and C and liver cancer (treatments)
The primary treatment for hepatocellular carcinoma is surgery and this method remains the most effective. Unfortunately, as a result of late diagnosis, the percentage of patients who qualify for surgery is around 30%. The procedure involves resection of the tumor with a healthy tissue margin. – The liver is an organ that has remarkable regenerative abilities – says Dr. Grzegorz Luboiński, an oncologist surgeon from the Warsaw Oncology Center. – You can cut up to 80 percent. liver parenchyma.
In some cases it is possible organ transplant. Nevertheless, it is a chance for a few patients, both due to the fact that a relatively small percentage of them may be qualified for such a procedure and the fact that Poland is a country where organ donation is not the best developed.
One of the essential success factors in the surgical treatment of liver cancer early detection. “Despite the undoubtedly very significant improvement in the results of surgical treatment, both in liver transplantation and resection, which, however, concern a small, selected group of patients, the overall mortality in the course of HCC does not decrease. The overwhelming majority of patients, i.e. over 80%, at the time of diagnosis, show a very significant advancement of the disease ”- you can read in the work of prof. Piotr Małkowski et al., Published in “Przegląd Epidemiologiczny”.
A small group of patients with inoperable liver cancer has had a chance of a different treatment for several months – radioembolization, so far used only in two hospitals in Warsaw: the Ministry of Interior and Administration and the Military Medical Institute. It consists in precise, internally performed irradiation of the tumor by introducing microparticles of the radioactive element – yttrium through a thin catheter. The procedure is performed by interventional radiologists. It is not a service included in the guaranteed benefits basket; the consent of the National Health Fund is required each time to finance such – expensive (about PLN 50) – therapy. The limitation in the use of this therapy is not only its high cost – a highly qualified team of doctors of narrow specialization is required to perform radioembolization of the tumor.
Perhaps this benefit will be included in the list of guaranteed benefits; so far, however, the Agency for Health Technology Assessment has not received an order from the Minister of Health to develop a recommendation for this method.
It is also used to treat liver cancer chemotherapyhowever, it is classified as palliative treatment. According to the medTvoiLokony National Health Fund, systemic chemotherapy for hepatocellular carcinoma involves the use of such cytostatics as: cisplatin, doxorubicin, 5-fluorouracil as monotherapy or in combination therapy. In Poland, the most common treatment is the doxorubicin (DCF – doxorubicin, cisplatin, fluorouracil) regimen.
It is also used as part of non-standard chemotherapy sorafenibwhich prolongs the life of the sick. Clinical studies have shown that the mean survival of placebo-treated patients with hepatocellular carcinoma was 7,9 months, while patients receiving sorafenib lived on average for 10 months.
– The AOTM Consultative Board in its position recognized the benefit of 2,8 months in terms of extended overall survival for patients with hepatocellular carcinoma thanks to sorafenib therapy. Thanks to this, the Minister of Health obtained the basis for the implementation of a new therapeutic program, but at the same time to negotiate from the manufacturer lower treatment costs than those currently incurred by the National Health Fund under non-standard chemotherapy – says Rafał Zyśk, expert in the field of pharmacoeconomics, head of Health Economics Consulting.
The therapeutic program guarantees access to a given therapy to a certain number of patients (calculated on the basis of forecasted needs) who meet certain medical criteria. The procedure for granting non-standard chemotherapy may turn out to be longer and for each patient it requires individual consent from the director of the relevant department of the National Health Fund.
HCV and HBV prophylaxis
The most effective method of treating hepatitis B and C is prophylaxis. It should be remembered that the chronic carrier of HCV and HBV increases the likelihood of developing hepatocellular carcinoma 100-fold and everything must be done to prevent this from happening. Prevention of this is through vaccination against hepatitis B and effective treatment of hepatitis B and C, when it occurs.
To check the health of your liver, buy the Liver Package – Diagnostic Testing. Also, do diagnostic tests – Sexually Transmitted Diseases available on Medonet Market, to make sure you have not been infected with any STD.
See also: Hope for more effective treatment of viral liver infections