Hepatitis C – symptoms and treatment of hepatitis C

Proven content

Hepatitis C virus (HCV) leads to approx. 20 percent. acute hepatitis, mainly blood-borne. Globally, it is the cause of 70% of chronic hepatitis cases. In infected people who have undergone acute hepatitis, recovery most often occurs, while on average 35%. patients eventually develop chronic hepatitis with the possible sequelae of cirrhosis and primary liver cancer.

What is hepatitis C?

Hepatitis C is caused by HCV virus, which occurs in six different genotypes, each divided into subtypes – the main difference between the subtypes and genotypes is their response to treatment. Unfortunately, in Poland the dominant (75% of infections) subtype b of genotype 1 is the most poorly responding to treatment. This virus is very dangerous because the infection often does not give any symptoms and very often acute inflammation turns into a chronic form, which in turn leads to cirrhosis of the liver and cancer. Unfortunately, there is no vaccine that can prevent the disease from developing.

Hepatitis C breeding period: 20–150 days.

The causes of hepatitis C infection

Hepatitis C infection is spread parenterally by transfusion of blood and blood products, as well as by medical procedures performed with the use of non-sterile equipment, combined with a violation of the continuity of the body integuments. Infection through sexual contact is also possible, but to a much lesser extent than with HBV. In the past, infection was mainly achieved through blood transfusions, but nowadays in developed countries this route is of minimal importance as blood donors are tested for the virus. Vertical transmission of infection from mother to child has been demonstrated. Although antibodies to HCV have been found in breast milk, the frequency of transmission by this route is low.

The following are people at high risk of hepatitis C infection:

1. healthcare professionals,
2. drug addicts who inject drugs (sharing needles promotes infection),
3. people with blood transfusions,
4. people who frequently change sexual partners (casual sex) – this applies to both homosexuals and heterosexuals,
5. haemophiliac patients who require the administration of blood-derived clotting factors
6. people who live under the same roof or have very close contact with someone infected with hepatitis C,

Hepatitis C can also be infected by transmission from mother to fetus during delivery.

Symptoms of hepatitis C

In most cases, hepatitis C occurs without any more obvious symptoms. This is a very big problem because the onset of the disease is often overlooked as a result. Only 35% of patients develop jaundice with preceding flu-like symptoms. However, it is worth remembering that the virus is very insidious and dangerous, because in half of the cases of acute infection, chronic hepatitis C occurs. This condition is characterized by general weakness, sensory disturbances, muscle pain and itching of the skin.

Chronic hepatitis C is often associated with autoimmune disorders, the most common of which are:

1. glomerulonephritis,
2. porphyria,
3. thrombocytopenia,
4. autoimmune thyroiditis,
5. krioglobulinemia.

Inflammatory changes in the salivary glands, neurological disorders such as peripheral polyneuropathies, and more often dementia or paralysis of the cranial nerves are also described in HCV-infected people.

Diagnosis of hepatitis C

Hepatitis C infection can be diagnosed by detecting antibodies to the virus in the blood (usually 4–10 weeks after infection), by ELISA test, the genetic material of the virus (RNA), by RT-PCR test (it can be detected 1–2 weeks after infection). Due to high costs, antibody detection is routinely used, and RT-PCR is used in justified cases (e.g. in immunodeficient patients who do not produce antibodies in sufficient quantity).

In patients diagnosed with hepatitis C, other diagnostic tests should also be performed, thanks to which it is possible to assess the stage of the disease and treatment prospects. Such studies include:

1. liver biopsy (puncture with a special needle and collection of a small amount of cells) with microscopic evaluation of the collected material; a test once needed to assess the degree of liver damage (and its fibrosis), today used in doubtful cases;
2. instead of biopsy, various non-invasive tests (fibroscans, elastography, tests of various blood parameters) are used to assess organ fibrosis initially and during treatment;
3. in addition, the virus genotype and subtype must be determined to determine the course of treatment;
4. Besides, depending on the clinical course of the disease, other tests are performed if necessary.

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Hepatitis C prevention

The main methods of preventing the spread of hepatitis C infection are similar to those of HBV infection. However, at the moment there are no vaccines or specific immunoglobulins against this virus. Only vaccines are available against:

1. viral hepatitis B (hepatitis B),
2. viral hepatitis A (hepatitis A).

Current treatments that target a given virus subtype can cure most chronic infections (if implemented at the right stage).

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Treatment of hepatitis C

Currently, there is no preparation that eliminates the virus from the body. In the treatment of hepatitis C, ribavirin and alpha interferon are used to stop the reproduction of HCV in the body. Thanks to this, the risk of liver cancer or cirrhosis is lower.

1. interferon: obtained synthetically and used most often in pegylated form (Peg IFN-α; interferon here is bound to polyethylene glycol), which has a longer half-life in the body.
2. ribavirin: interferon alone is used in acute HCV infections and combined with ribavirin in chronic HCV infections. Treatment of the disease is controlled by the detection of DNAHCV in the blood and the determination of viral load (the number of viruses in 1 ml of blood).

General recommendations for the treatment of hepatitis C include: complete withdrawal of alcohol, as it causes the development of liver damage and cirrhosis. As you know, there is no vaccine against hepatitis C, so in order to reduce the risk of infection, it is necessary to eliminate the factors contributing to the disease, such as: casual sexual intercourse or injecting drugs.

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In patients with severe liver cirrhosis, the only treatment may be the only treatment liver transplant (if HCV is not removed with antiviral therapy, secondary infection of the transplanted liver may occur).

If you have worrying symptoms that indicate liver problems, you can make an appointment for laboratory tests. Thanks to the results, you will quickly implement a treatment that will facilitate everyday functioning.

Undesirable effects treatment of hepatitis C

Occasionally, many patients need to stop treatment of hepatitis C. The reason for this situation is the side effects that may occur in the form of:

1. headaches
2. muscle aches
3. fatigue,
4. emotional disturbances that can even lead to depression.

Hepatitis C and complications

In chronically infected hepatitis C, cirrhosis of the liver may occur due to inflammation. Consequently, this condition can lead to the failure of this organ, which, if left alone, leads to death. Liver markers are most common in patients who abuse alcohol. In such people, cirrhosis very often turns into liver cancer, which, if left untreated, gives only a 3% chance of survival for five years, and if diagnosed and treated early enough – up to 50% of survival. In addition, complications include other diseases that do not affect the liver:

1. glomerulonephritis,
2. vasculitis,
3. neuropathy.