Viral hepatitis: symptoms, routes of infection, treatment methods. Reference. Signs, symptoms and genotypes of hepatitis C, causes of infection

Hepatitis C – inflammatory disease liver, it develops under the influence of the hepatitis C virus. An effective vaccine that could protect against this virus simply does not exist in nature yet, and it will not appear soon.

It comes in two types – acute and chronic. In 20% of cases, people with acute hepatitis have a good chance of recovery, and in 80%, the patient’s body is not able to overcome the virus itself and the disease becomes chronic.

Transmission of the virus occurs through infection through blood. Today, there are 150 million people in the world who are carriers of chronic hepatitis C, and every year hepatitis ends in death in 350 thousand patients.

Basically, the first symptoms of hepatitis C appear 30-90 days after infection. That's why if you bad feeling, apathy, fatigue and other phenomena unusual for your body, then you better consult a doctor. This is necessary for the doctor to make an accurate diagnosis and, based on it, choose the most effective treatment.

How is hepatitis C transmitted?

What it is? Infection occurs mainly through contact with the blood of an infected person. Hepatitis C is also transmitted through medical procedures: blood collection and transfusion, surgical operations, dental procedures.

The source of infection can be manicure instruments, tattoo devices, needles, scissors, razors, etc. If the skin or mucous membranes are broken, contact with the blood of an infected person can cause infection.

In rare cases, hepatitis C is transmitted through sexual contact. Infected pregnant women have a risk that their baby will also become infected with the virus at birth.

The most severe cases of the virus are:

• persons who abuse alcohol.
• persons suffering from others chronic diseases liver, including others.
• older people and children.

Hepatitis C disease is not transmitted through household contacts through hugs or handshakes; with this disease, you can share dishes and towels, but you cannot share personal hygiene items (razors, nail scissors, toothbrushes). The mechanism of transmission of the disease is only hematogenous.

Symptoms of hepatitis C

In most situations, viral hepatitis C progresses slowly, without severe symptoms, remaining undiagnosed for years and already manifesting itself with significant destruction of liver tissue. Often, patients are first diagnosed with hepatitis C when they already have hepatocellular liver cancer.

The incubation period of hepatitis lasts from 1 to 3 months. Even after this period ends, the virus may not manifest itself until liver damage becomes too obvious.

After infection, 10-15% of patients undergo self-healing, the remaining 85-90% develop primary chronic hepatitis C without any specific symptoms(such as pain, jaundice, etc.). And only in rare cases do patients develop acute form with jaundice and severe clinical manifestations, which, when adequate therapy leads to complete cure of the patient from hepatitis C.

The first signs of hepatitis C in women and men

For a long time, symptoms practically do not bother patients. In the acute period, the disease manifests itself only as weakness, fatigue, and sometimes occurs under the guise of a respiratory viral infection with pain in the muscles and joints. These may be the first signs of hepatitis C in women or men.

Jaundice and other clinical manifestations Hepatitis develops in a very small percentage of those infected (the so-called icteric form of the disease). And this is actually great - patients immediately turn to specialists, and the disease is cured.

However, the majority of infected people suffer from hepatitis C on their feet: in the anicteric form, they either do not notice anything at all, or attribute the malaise to a cold.

Chronic hepatitis

The peculiarity of chronic hepatitis C is a latent or asymptomatic course for many years, usually without jaundice. , detection of anti-HCV and HCV RNA in the blood serum for at least 6 months are the main signs of chronic hepatitis C. Most often, this category of patients is discovered by chance, during examination before surgery, during medical examination, etc.

The course of chronic hepatitis C can be accompanied by such immune-mediated extrahepatic manifestations as mixed cryoglobulinemia, mesangiocapillary glomerulonephritis, porphyria cutanea tarda, etc.

Photo

The photo shows liver damage due to long-term hepatitis.

Forms

According to the presence of jaundice in the acute phase of the disease:

1. Icteric.
2. Anicteric.

According to the duration of the flow.

1. Acute (up to 3 months).
2. Protracted (more than 3 months).
3. Chronic (more than 6 months).

By severity.

1. Easy.
2. Medium-heavy.
3. Heavy.
4. Fulminant.

Complications.

1. Hepatic coma.

1. Recovery.
2. Chronic hepatitis C.
3. Cirrhosis of the liver.
4. Hepatocellular carcinoma.

According to the nature of clinical manifestations acute phase diseases distinguish between typical and atypical hepatitis C. Typical include all cases of the disease accompanied by clinically visible jaundice, and atypical include anicteric and subclinical forms.

Stages

The disease is divided into several stages, depending on which treatment is prescribed.

1. Acute – it is characterized by an asymptomatic course. A person often does not even suspect that he is a carrier of the virus and a source of infection.
2. Chronic - in the vast majority of cases (about 85%), following the acute stage, it begins chronic course diseases.
3. Liver cirrhosis develops with further progression of the pathology. This is a serious disease that threatens the patient’s life both in itself and because its presence significantly increases the risk of developing other complications - in particular, liver cancer.

A distinctive feature of the virus is its ability to genetic mutations, as a result of which in human body Approximately 40 subtypes of HCV (within one genotype) can be detected simultaneously.

Virus genotypes

The severity and course of the disease depend on the genotype of hepatitis C infecting the body. On this moment Six genotypes with several subtypes are known. Most often, viruses of genotypes 1, 2 and 3 are found in the blood of patients. They are the ones that cause the most pronounced manifestations diseases.

In Russia, the most common genotype is 1b. Less often – 3, 2 and 1a. Hepatitis C, caused by genotype 1b virus, is characterized by a more severe course.

Diagnosis of hepatitis

The main method for diagnosing hepatitis is to determine the presence of antibodies to the hepatitis C virus (anti-HCV) and HCV RNA. Positive results Both tests confirm the presence of infection. Presence of antibodies IgM class(anti-HCV IgM) allows you to distinguish active hepatitis from carriage (when there are no IgM antibodies and ALT is normal).

A PCR test for hepatitis C (polymerase chain reaction) allows you to determine the presence of hepatitis C RNA in the patient’s blood. PCR testing is mandatory for all patients with suspected viral hepatitis. This method is effective from the first days of infection and plays an important role in early diagnosis.

When is hepatitis C more difficult to treat?

According to statistics, hepatitis C is more difficult to treat in men, people over 40 years of age, in patients with normal transaminase activity, with a high viral load, and in those with genotype 1 b of the virus. Of course, the presence of liver cirrhosis at the time of treatment worsens the prognosis.

Efficiency antiviral treatment depends on many factors. With a long course of hepatitis C, it is not easy to achieve complete eradication of the virus. The main task is to slow down the process of active reproduction of viruses.

This is possible in most cases when using modern circuits antiviral therapy. In the absence of active reproduction of viruses in the liver, the severity of inflammation significantly decreases and fibrosis does not progress.

Treatment of hepatitis C

In the case of hepatitis C, combination therapy with interferon-alpha and ribavirin is considered the standard of treatment. The first drug is available as a solution for subcutaneous injection under trademarks Pegasys®, PegIntron®. Peginterferons are taken once a week. Ribavirin is available under different brand names and is taken as tablets twice daily.

1. Interferon-alpha is a protein that the body synthesizes independently in response to a viral infection, i.e. it is actually a component of natural antiviral defense. In addition, interferon-alpha has antitumor activity.
2. Ribavirin as self-treatment has low efficiency, but when combined with interferon it significantly increases its effectiveness.

The duration of therapy can range from 16 to 72 weeks, depending on the genotype of the hepatitis C virus, the response to treatment, which is largely associated with individual characteristics patient, which are determined by his genome.

A course of antiviral therapy using the “gold standard” can cost a patient from $5,000 to $30,000, depending on the choice of drugs and treatment regimen. The main costs are for interferon drugs. Foreign-made pegylated interferons are more expensive than conventional interferons from any manufacturer.

In most regions of Russia, treatment is not covered by compulsory medical insurance and is provided through regional programs. For example, in Moscow alone, up to 2,000,000,000 rubles are spent annually on treating people with hepatitis C, treating up to 1,500 patients per year. At the same time, 70,000 patients are officially registered in Moscow alone. It turns out that it will take 50 years to cure them all.

In addition to standard therapy, in 2018, for patients with chronic hepatitis C who are not at high risk of death from other causes, interferon-free therapy with direct-acting antivirals (DAAs) is recommended for a period of 8 to 24 weeks. Patients at high risk of complications (assessed by the degree of liver damage) should be considered first. Currently, interferon-free AVT regimens use inhibitors of the replication of three non-structural HCV proteins: NS3/4A protease, NS5A interferon-resistant protein, and NS5B polymerase.

The effectiveness of hepatitis C treatment is assessed by biochemical blood parameters (decreased transaminase activity) and the presence of HCV-RNA, and a decrease in the level of viral load.

New in hepatitis treatment

Despite the fact that AbbVie Inc., consisting of second-generation inhibitors of the viral proteins NS3 and NS5A glezaprevir/pibrentasvir, passed FDA registration on August 3, 2017, the final, third phase clinical trials individual regimens based on Maviret are still ongoing and will last until 2019. In particular, the optimal duration of therapy with glezaprevir/pibrentasvir for acute hepatitis C is being established, and as a “last hope” therapy for people with multiple drug resistance, the combination of glezaprevir/pibrentasvir and sofosbuvir is being studied.

The first pangenotypic representatives of the class of non-nucleoside NS5B polymerase inhibitors GSK2878175 and CC-31244 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.

Maviret was officially registered with the Ministry of Health of the Russian Federation on April 13, 2018, after which it appeared in pharmacies. average cost Mavyret packages exceed 350 thousand rubles, and the price of a standard 8-week course of treatment reaches 600-700 thousand rubles or more.

It is worth noting that treatment standards for people with hepatitis C are changing rapidly. Sofosbuvir, daclatasvir and combination drug sofosbuvir/ledipasvir are part of the preferred treatment regimens in WHO guidelines and can achieve cure rates of 95%.

Side effects of antiviral therapy

If treatment with interferons is indicated, then side effects cannot be avoided, but they are predictable.

After the first interferon injections, most people experience the syndrome. After 2-3 hours, the temperature increases to 38-39 0 C, there may be chills, pain in muscles and joints, and noticeable weakness. The duration of this condition can be from several hours to 2-3 days. Within 30 days, the body is able to get used to the administration of interferon, so by this time the flu-like syndrome disappears. Weakness and fatigue persist, but we have to put up with it.

As for Ribavirin, it is usually well tolerated. But quite often in a general blood test, symptoms of mild hemolytic anemia. Mild dyspepsia, rarely headache, increased blood levels may occur. uric acid in the blood, drug intolerance is very rarely observed.

How long can people live with hepatitis C if left untreated?

It is very difficult to say unambiguously how many people live with hepatitis C, just like with HIV infection. In the average number of patients, cirrhosis can develop in approximately 20 to 30 years.

In percentage, depending on the age of the person, cirrhosis develops:

• in 2% of patients infected before 20 years of age;
• 6% of those who received the virus aged 21–30 years;
• in 10% of those infected at 31–40 years of age;
• in 37% of cases aged 41–50 years;
• 63% of those infected are over 50 years of age.

Also, most studies have proven that the development of fibrosis also depends on gender. In men this pathology develops much faster and in a more severe form, even if treated.

This is the most common infectious and inflammatory liver disease caused by the hepatitis C virus.

About half a million people worldwide suffer from hepatitis C. Young people aged 18 to 40 years are affected by the hepatitis C virus. The disease is called gentle killer, because it is asymptomatic and serious complications such as liver cirrhosis and hepatocellular carcinoma often occur.

The risk of contracting hepatitis C is very high, so every person should know how hepatitis C is transmitted in order to protect themselves from this insidious disease.

is an RNA virus. The sources of the disease can be both patients with acute or chronic forms of hepatitis C, and carriers of the virus.

Occurs by hematogenous (parenteral) route - when the pathogen enters the body with blood or its components. The blood of a sick or infected person contains a large number of viral bodies.

In addition to blood, some hepatitis C virus is found in saliva, menstrual blood, sperm, vaginal lubrication, lymph. The virus is so stable that even in dried and frozen blood it retains its pathogenicity and virulence for three days.

Important! The highest risk of contracting hepatitis C is when injecting with a shared needle, which may contain the virus.

No less often, infection occurs during such manipulations as acupuncture, piercing, tattooing, and manicure. Therefore, it is very important to carry out these procedures in specialized institutions where all sanitary and hygienic standards are followed.

Until recently, hepatitis C infection was common through blood transfusions (transfusion of blood and its components), because blood and its components were not tested for the presence of antigens to hepatitis viruses.

The increasing incidence of hepatitis C and other diseases that are transmitted through blood prompted the development of an algorithm for testing blood for hepatitis C. After 1992, all blood and transplant materials are carefully tested for viral hepatitis and HIV.

In medical institutions of developed countries, much attention is paid to training staff on issues that relate to diseases with parenteral transmission; a sanitary and epidemiological regime is also ensured, instruments are thoroughly sterilized, etc.

Interesting! Therefore, hepatitis C is rarely transmitted through surgical instruments, injections and dental procedures.

Where can you get infected with hepatitis C?

• Shared drug injection sites. Hepatitis C is also called a drug addict's disease, because young people are most often infected by injecting drugs into a vein with a non-sterile shared syringe.
• Tattoo and beauty salons offering piercings, acupuncture, permanent makeup, manicures, pedicures and injection methods cosmetology. Infection can occur due to poor sterilization instruments and non-compliance with sanitary and hygienic standards. Also, the master must carry out all procedures wearing disposable sterile gloves.
• Places of detention.
• In the workplace, this means the medical staff of a hospital, clinic, or dental office.
• Medical institutions. When performing a blood transfusion (very rarely, about 4% of cases), surgical interventions, invasive diagnostic methods, childbirth, injections, dental procedures.
• IN home life if you live with someone who has hepatitis C.

Infection with the hepatitis C virus during traditional sexual intercourse occurs rarely, due to the small number of viral bodies in semen, vaginal secretions and saliva. Approximately 5% of people with hepatitis C are infected through sexual contact.

The risk of acquiring hepatitis C increases in people who behave dishonestly sex life, have a large number of partners, do not use condoms.

The risk also increases significantly if there is inflammatory diseases genital organs that violate the integrity of the mucous membrane, with a large amount of virus in biological fluids, sexually transmitted diseases.

Important! Using a condom during sexual intercourse will reduce the risk of contracting hepatitis C to zero.

The following groups at high risk of contracting hepatitis C through sexual contact can be identified:

• men and women who frequently change sexual partners;
• sex workers;
• gay men.

The low-risk group for contracting hepatitis C through sexual contact includes the following:

• with a regular sexual partner for many years;
• using condoms during sexual intercourse.

The majority of patients with hepatitis C who were infected through sexual contact are in Asian countries, and the least in Europe.

Based on the above, we can conclude that although the risk of contracting hepatitis C during sexual intercourse is low, it still exists.

Interesting! Vertical transmission is the transmission of the disease from mother to child during childbirth, breastfeeding and child care.

The hepatitis C virus does not cross the placenta, so the baby can only become infected during passage through the birth canal. Only 5% of children born to mothers with hepatitis C were infected.

During pregnancy, all women are tested for the presence of antigens to viral hepatitis, including hepatitis C.

Before giving birth, patients must have their viral load determined.

Depending on the number of viral bodies in a woman’s blood, the optimal delivery option is selected – cesarean section or natural birth.

Italian scientists conducted a study and determined that the risk of infection during a caesarean section is five times lower than during natural childbirth.

Due to the long incubation period of the disease and the immaturity of the newborn’s immune system, hepatitis C can only be diagnosed at 12-18 months. Until then, tests for the presence of HCV antigens will be uninformative.

Unfortunately, there is no reliable information about the safety of breast milk from mothers with hepatitis C. Some scientists are trying to prove that the virus is not contained in breast milk, while others are trying to prove the opposite.

Therefore, in our country, doctors advise mothers who are sick with hepatitis C and have cracked nipples not to breastfeed the baby.

But still, a woman should receive full information about all the risks of infecting the child and make a choice in favor of breastfeeding or artificial feeding.

Important! Also, a woman should know how to care for her child so as not to infect him with hepatitis C. She can ask an infectious disease specialist or pediatrician about this.

Is hepatitis C transmitted through household contact?

Airborne transmission is not typical for hepatitis C. Therefore, you will not become infected if you are in the same room with a sick person.

Infection with hepatitis C in the home can only occur if its blood enters your body through a wound on the skin, when using one syringe, toothbrush, manicure accessories, scissors, razor, etc.

Patients with hepatitis C do not need to be isolated from society and relatives, or create special conditions at work or study. In Russia, such patients are exempted from military service in the army. Whether this is a privilege or an infringement, I don’t know how to evaluate it correctly.

Interesting! Hepatitis C is not transmitted by hugging, shaking hands or kissing someone who has hepatitis C, or by using their utensils or sharing a bathroom.

What is the risk of getting sick if you do become infected with the hepatitis C virus?

In 20% of cases, infection occurs, mainly in people with good immunity, goes to acute hepatitis C, which ends in recovery without consequences. But in 80% of those infected with the hepatitis C virus, an initially or secondarily chronic form of the disease develops.

For early diagnosis of hepatitis C in infected people, systematic tests are required to determine the presence of the pathogen and to determine the viral load.

There are also carriers of the hepatitis C virus, in whose bodies the pathogen multiplies very slowly, so clinical and laboratory signs there are no diseases.

Due to long-term persistence and multiple mutations of the virus in the body, immunity against hepatitis C is not formed. Therefore, you can get sick again, even with timely and effective treatment.

Risk groups for hepatitis C disease

The following people are at highest risk of getting hepatitis C:

• recipients who underwent transfusions of blood and its components or organ transplantation before 1992;
• healthcare workers who have contact with blood;
• in injection drug addicts;
• in HIV-infected people.

The average risk of hepatitis C infection in these people is:

• with liver diseases of unknown etiology;
• for those who systematically undergo hemodialysis;
• in children born to mothers with hepatitis C.

The following groups of people are at low risk of acquiring hepatitis C:

• medical workers of the sanitary and epidemiological service;
• men and women who are sexually active and neglect condoms;
• spouses of patients with hepatitis C;

For early detection hepatitis C, persons at risk should be screened annually for hepatitis C.

How is hepatitis C diagnosed?

Interesting! The most accurate methods for diagnosing hepatitis C are polymerase chain reaction and enzyme immunoassay.

These tests are carried out in all private laboratories and clinics. Using polymerase chain reaction determine the presence of genetic material (RNA) of the virus in a person’s blood, and using an enzyme immunoassay - antibodies to the hepatitis C virus. Using the latter test, you can find out the patient’s viral load.

Biochemical analysis liver, although it will not help identify the pathogen, it will indicate functional state liver.

With hepatitis C, there is an increase in the activity of alanine aminotransferase and aspartate aminotransferase, the amount direct bilirubin, alkaline phosphatase, positive Thymol test, decrease and imbalance of proteins.

How to protect yourself from becoming infected with hepatitis C if you live with someone who is sick?

• Stains of the patient's blood on clothing, household items, and furniture should be treated with a product that contains chlorine. Domestos, Belizna or Chlorhexidine are great for this. The procedure must be carried out with gloves.
• Clothing, underwear and bed linen, and towels should be washed at temperatures above 60°C for half an hour or boiled for about 5 minutes.
• Any injuries or wounds of the patient are immediately bandaged or covered with a plaster. If this is not carried out by the patient, but by one of the family members, then you must wear gloves.
• The patient must have his own individual manicure set, razor, epilator, toothbrushes.

No one is immune from hepatitis C infection, so you always need to be vigilant. Avoiding infection with the hepatitis C virus is much easier than curing it. Now that you know how hepatitis C is transmitted, you can protect yourself from this dangerous disease.

The pathogen virus is more often detected in people aged 20-29 years, but in last years There is a tendency towards a gradual “maturation” of the disease.

There are 170 million patients worldwide suffering from this form of hepatitis. About 4 million new cases of the disease are recorded annually, while the number deaths from its complications there are more than 350 thousand.

The causative agent of hepatitis C is the RNA-containing HCV virus, which is variable and prone to mutation, due to which several of its subspecies can be simultaneously detected in the patient’s body.

The HCV virus enters the liver parenchyma, where it begins the induction process. In this case, liver cells are destroyed, which causes inflammation of the entire organ. Gradually, hepatocytes are replaced by connective tissue, cirrhosis develops, and the liver loses its ability to perform its functions.

Many people are interested in the question of whether hepatitis C is transmitted in everyday life through touching or using common things. Based on the information obtained after the research, it is safe to say that this is unlikely.

HOW CAN YOU GET INFECTED?

There are two main methods of transmission of the hepatitis C pathogen: transfusion (through blood and its components) and sexual. The first one is considered the most common.

The only source of infection is a sick person in the active phase of the disease or a carrier of the virus in whom the disease is asymptomatic.

Hepatitis C, like hepatitis B, is transmitted sexually, however, the risk of contracting hepatitis C through sexual contact is much lower. This is explained by the reduced concentration of the pathogen in the carrier’s blood.

Mechanisms of transmission of infection:

• vertical - from mother to child;
• contact – during sexual intercourse;
• artificial - infection during manipulations associated with violating the integrity of the integument.

AT-RISK GROUPS

There are certain groups of people who are at high risk of contracting hepatitis C during treatment or due to professional activity and way of life.

Infection can occur during:

• persons who use drugs by injection;
• patients whose disease requires constant hemodialysis;
• persons who have been repeatedly transfused with blood and its components (especially before 1989);
• persons after organ transplantation;
• children born from infected mothers;
• patients of oncology clinics with malignant diseases hematopoietic organs;
• medical personnel in direct contact with the blood of patients;
• persons who do not use barrier contraception and prefer to have several sexual partners;
• sexual partners of persons with hepatitis C;
• carriers of the immunodeficiency virus;
• homosexuals;
• people who regularly visit manicure, piercing, tattoo salons, and beauty salons for invasive procedures;
• people who share razors, toothbrushes and other personal hygiene products in everyday life with a hepatitis carrier;
• people with unknown causes of liver disease.

It is rarely possible to determine how hepatitis C was transmitted. In 40–50% of patients, it is not possible to identify the route of transmission of the pathogen. Such cases are considered sporadic.

WHERE CAN YOU GET INFECTED?

Dangerous places from the point of view of infection with hepatitis C:

• tattoo parlors (for piercing and tattooing);
• shared drug injection sites;
• dental office;
• correctional institutions, places of detention;
• medical institutions (very rare in developed countries).

Visiting salons and medical institutions, you need to be confident in the qualifications of the staff, ensure that only disposable materials are used, and seek help from specialists licensed for this type of activity.

FEATURES OF HEPATITIS C INFECTION THROUGH BLOOD

Hepatitis C is primarily transmitted through blood. The serum and blood plasma of carriers of the infection pose a danger even a week before the onset of symptoms of the disease and remain capable of infection for a long time.

In order for transmission of infection to occur, a sufficient amount of infected blood must enter the bloodstream, so the most frequent way transmission of the pathogen is its introduction through a needle during injection. The highest concentration of the pathogen is found in the blood, while in other liquid media it is much lower.

Statistics data:

• blood transfusion – more than 50% of cases;
• injection drug use – more than 20% of cases;
• hemodialysis (artificial kidney) – more than 10% of cases.

Statistics among drug addicts who inject drugs indicate that 75% of them are infected with hepatitis C.

The source of infection can be unsterile medical instruments, needles for tattooing and piercing, contaminated with the blood of a patient, razors, manicure scissors when used sharing with an infected person.

The likelihood of contracting hepatitis C from a single injection with a contaminated needle in a medical facility is minimal, since the concentration of viruses in small amounts of contaminated blood is insufficient. In this case, the size of the needle lumen matters. Thus, small-section needles that are used for intramuscular injections, are much less dangerous than wide bore IV cannulas.

Until the end of the last century, the main route of transmission of hepatitis C was the introduction of the pathogen with contaminated blood and its components during transfusion. Currently, the number of such cases of infection has decreased significantly thanks to testing. donated blood for the presence of antibodies. Diagnostics give errors in the case of examining patients and donors in initial stage diseases when it is difficult to detect markers of the pathogen.

In economically developed countries, where sterilization standards for medical instruments are strictly observed, only disposable needles are used and donated blood is checked, the likelihood of contracting hepatitis C by hematogenous and parenteral routes is minimal.

FEATURES OF VERTICAL TRANSMISSION

The method of transmission of the pathogen from mother to child is called vertical. The hepatitis C virus is transmitted in different ways.

Vertical transmission path:

• during childbirth;
• when breastfeeding;
• when caring for a child.

The main thing on this list is practical significance is infected with hepatitis C during childbirth, since at the time the child passes through the birth canal there is a high probability of contact of the child’s blood with the mother’s blood. Unfortunately, methods to prevent transmission of infection during childbirth have not been developed.

Such cases are recorded in 6% of patients, but with a low viral load in the mother, vertical transmission is observed in extremely rare cases. The risk of a child becoming infected increases to 15% when the mother is simultaneously diagnosed with hepatitis C and the immunodeficiency virus.

Cases of child infection in postpartum period are quite rare. The pathogen is found in the breast milk of a nursing woman, but when it enters the baby’s stomach, the virus is broken down by digestive juices and does not pose a threat of infection. For this reason, women with hepatitis C breast-feeding not contraindicated.

When HCV and HIV are combined, the frequency of infection of newborns increases significantly, therefore, women who are carriers of HIV infection are not recommended to breastfeed their children.

FEATURES OF SEXUAL INFECTION

The role of sexual transmission of hepatitis C is small compared to the likelihood of infection with hepatitis B or HIV and accounts for about 5–10% of the total number of cases of the disease.

The study of the composition of liquid media such as saliva, seminal fluid and vaginal secretions indicates the presence of a pathogen in them in rare cases and in low titers. For this reason, episodes of sexual transmission are relatively rare.

Factors contributing to hepatitis C infection through sexual contact:

• violation of the integrity of the internal surface of the genital tract and oral cavity, their bleeding;
• inflammatory diseases of the genital organs;
• sexual intercourse during menstruation;
• concomitant urinary and reproductive diseases, HIV infection;
• promiscuity;
• practice of anal sex;
• traumatic sex in an aggressive form.

The risk of transmission of infection from one spouse to another is less than 1% per year, but with concomitant pathologies it increases significantly.

All of the above factors are a good reason to use condoms, as well as have both sexual partners tested annually to detect markers of hepatitis C.

OTHER WAYS OF TRANSMISSION OF HEPATITIS C

A number of unusual and rare cases of how hepatitis C is transmitted have been described. Thus, with regular nasal inhalation of cocaine, trauma to the nasal mucosa and blood vessels occurs, which are the gateway for the virus to enter.

In addition, no one is immune from infection during accidents, fights, or injuries associated with increased blood loss. Through open wounds the carrier’s blood can penetrate and the infection virus can be transmitted, and its quantity may be sufficient to initiate the development of pathology.

RE-INFECTION

Treatment of hepatitis C is a long and expensive process. Despite this, many people managed to get rid of the destructive disease and return to healthy life. Approximately 15% of patients in whom the disease was diagnosed have a chance of complete recovery. acute stage.

However, there is a possibility of re-infection, since humans do not develop protective factors against the HCV virus. In addition, the variety of pathogen varieties does not allow us to develop a unified tactic preventive measures and create a vaccine.

HOW NOT TO GET INFECTED WITH HEPATITIS C

The issue of transmission of the HCV virus has been well studied. Specialists in the field infectious diseases claim that hepatitis C can only be transmitted directly from a person to another person. Intermediate hosts in the form of animals and blood-sucking insects are excluded.

There have been no cases of infection from pets through cuts or bites. Researchers paid special attention to mosquitoes from hot countries, which could become a reservoir of infection.

More than 50 species of mosquitoes have been studied. The following results were obtained: 24 hours after infection of the insects, the pathogen was isolated only in the abdomen of the mosquito; the virus was not detected in the thoracic part of the insect. These data suggest that the possibility of infection through mosquito bites is excluded.

Hepatitis C cannot be transmitted through household contact. Patients suffering from this disease pose no danger to others, family members, friends and work colleagues.

There is a certain risk when using personal hygiene items that can cut the skin or retain the patient’s physiological fluids on their surface. This probability is extremely small, but it must be taken into account.

Hepatitis C is one of the most dangerous viral diseases today. It spreads through blood, so patients at dental clinics, blood donors, and medical workers are at risk. Early diagnosis and therapy help to cope with the disease and stop the spread of this virus.

What is the hepatitis C virus

Statistics show: about 150 million people in the world are chronic carriers of the virus, and every year more than 350 thousand die from the consequences of this disease. The trend towards infection is not abating; 3-4 million people acquire hepatitis C every year.

The hepatitis C virus is a small particle that consists of genetic material (RNA) in its core, and is also surrounded by a protective protein and lipid coat.

Thanks to the discovery of viral RNA in the blood of an infected person in 1989, doctors were able to identify the disease and begin to develop ways to combat it. Today, there are 6 genotypes of this virus, as well as 90 subtypes. The genotype of the virus is very important in determining the type of treatment.

Types of the virus tend to mutate and, over time, become resistant to treatment and develop immunity to even the most powerful antibiotics. This explains why a single working vaccine has not yet been created to combat this dangerous virus.

Hepatitis C belongs to a group of viruses that cause acute inflammation liver. It is characterized by a diffuse distribution pattern. The basis of its distribution is the parenteral mechanism. This means that the main route of transmission is through blood and its components.

Virus, disease-causing, primarily affects the liver. Its functional responsibilities are vital: removing harmful substances from the body, ensuring digestion processes, processing vitamins, useful substances from food, as well as participation in blood thickening processes, for example, with cuts or wounds. Therefore, early diagnosis of hepatitis C is extremely important.

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Ways of spread and infection of hepatitis C

The hepatitis C virus spreads and is transmitted in the following ways:

• In medical institutions when using non-sterile syringes for intravenous or intramuscular injections.
• In tattoo parlors when applying tattoos, piercing procedures using non-sterile needles.
• During a blood transfusion procedure.
• Sexually. The likelihood of transmitting the hepatitis C virus in this way is much lower than that of hepatitis B. In order for a person to become infected during sexual intercourse, there must be special conditions, namely “blood” contact (ulcers, wounds, cuts or during menstruation).

In addition to those described above, there are also atypical ways of contracting the virus. For example, when kissing, if the integrity of the mucous membranes was violated. Or during a fight, when the integrity of the skin is damaged, and an infected person took part in the fight itself. When injuries, cuts and abrasions occur, infection occurs.

It is important to know that hepatitis C is not transmitted:

1. By airborne droplets;
2. When eating together;
3. When using the same cutlery;
4. With tactile contact.

Clinical picture of hepatitis C development

It has been clinically documented that 80% of those infected with the hepatitis C virus acquire a chronic form of the disease. This means that the disease can be asymptomatic for many years. Over the course of 15-20 years, a person may experience headaches, insomnia, and fatigue from time to time. But gradually the functions of the liver weaken, which leads to the development of diseases and other body systems: cardiovascular, genitourinary, and also gastrointestinal tract.

During its development, hepatitis C causes:

• Steatosis, that is, the accumulation of fat cells in the liver. Develops in 50% of infected people.
• Fibrosis is the formation of scar tissue in the liver.
• Cirrhosis, which causes irreversible changes in organ tissue. Hepatitis C in men most often causes this form of liver dysfunction.

Liver cirrhosis due to hepatitis C is dangerous due to its complications, which threaten not only health, but also human life:

1. Causes significant liver failure.
2. May cause bleeding. Blood clotting is reduced, so even the slightest cuts, wounds or bruises can cause serious bleeding.
3. Causes encephalopathy, that is, brain damage. This is due to impaired liver function in the outlet dangerous products vital activity of the body.
4. May cause primary liver cancer.

Symptoms of developing cirrhosis of the liver in patients with hepatitis C are: pain under the right rib, darkening of the urine, whitish stool, the whites of the eyes and the skin acquire a yellowish tint.

Risk groups for hepatitis C infection

There are certain risk groups that are primarily susceptible to infection with hepatitis C. These include:

• People leading chaotic sex life. Ignoring contraception (condoms) also increases the risk of infection.
• Drug addicts. This social group are especially at risk of getting chronic hepatitis C, since unsterile needles are often used to inject drugs.
• Persons who are regular sexual partners of an infected person.
• People who need frequent transfusions of blood or its components.
• Patients who desperately need dialysis or an artificial kidney.
• Children whose mothers are infected with hepatitis C.
• Healthcare workers who are constantly in contact with blood.

There are also groups for whom the course of the disease is especially severe: HIV-infected people, people who abuse alcohol, drug addicts, people living with chronic liver disease, the elderly, children.

Symptoms of hepatitis C in adults

Hepatitis C in women, as in men, has the same incubation period. From the moment of infection to the appearance of the first symptoms, it can take only a few weeks, or maybe six months. It has been recorded that most often clinical manifestations begin to appear after one and a half to two months.

During primary infection, a person, without having characteristic symptoms until a certain time, may not even be aware of his illness. General weakness the body, fatigue, and insomnia can be attributed to a seasonal drop in immunity, especially during the cold periods of the year. This condition is very dangerous for the infected person himself, as well as for those around him. Being unaware, he himself is the source of the spread of hepatitis C.

Most often, people find out about their illness while undergoing tests during a standard medical examination or when attempting to donate blood. Clinical medicine has recorded cases where patients were carriers of the virus for twenty or even forty years. However, they did not get sick and they never had liver problems.

Most infected people experience the following symptoms of hepatitis C: loss of appetite, sudden loss weight, nausea and vomiting, upset stomach, yellowing of the skin and eyeballs(which is why people call hepatitis “jaundice”), change in the color of urine, up to dark brown, change in the color of feces (whitish feces).

• Read what exist

The danger of hepatitis C in pregnant women

Hepatitis C poses a great danger to infants of infected mothers. A newborn has a risk of becoming infected from the mother during childbirth. On average, this probability is 5%. In most cases, the uteroplacental barrier protects the baby from bacteria and viruses. Infection occurs mainly at the last stage of childbirth, when the child passes through the birth canal, during contact with the mother’s blood.

It is worth noting that if more than 2 million copies of hepatitis C virus RNA are detected in the mother’s blood, then the probability of intrauterine infection is 30%. If less than a million are detected, the chances of transmitting the virus to a child are minimal. If a pregnant woman has antibodies to this virus, then the likelihood of infecting the baby is zero. In addition, antibodies remain in the child’s body for two years.

The risk of contracting hepatitis C is much higher if the baby's skin was damaged during childbirth (for example, when forceps were used by a midwife). At the same time, the risk of infection when caesarean section much lower.

It is very important that a woman takes responsibility for her health not only throughout pregnancy, but also during the period of preparation for it. Testing for the presence of hepatitis C is done six months before planning a pregnancy.

Signs of hepatitis C in children

The development of hepatitis C in children is slightly different from the typical development of the disease in adults. A child can become infected in two ways: from mother to fetus (vertical mechanism), or through direct contact with the patient’s blood (parenteral mechanism).

Hepatitis C infection in children most often occurs at a dental appointment, when medicines by injection, blood transfusion or hemodialysis. Teenagers have a chance of becoming infected through drug use, poor skin hygiene, tattooing, and piercing with undisinfected instruments.

The incubation period in this case ranges from two weeks to six months. Symptoms of hepatitis occur in less than 50% of cases of infection. They are expressed as follows: yellowing of the skin, yellowing of the whites of the eyes, nausea, vomiting and diarrhea. They arise due to general intoxication of the body due to inflammation of the liver.

The acute form of the disease begins slowly. Symptoms increase gradually. In this case, dyspeptic disorders develop (disruption of normal stomach activity, painful digestion), as well as asthenovegetative syndrome (consequence vascular pathologies brain, is expressed in the failure of nerve impulses).

Symptoms of “jaundice” in children may also be accompanied by fever and headache. The feces become whitish, the urine, on the contrary, acquires a brownish tint.

Video about hepatitis C virus, symptoms, diagnosis and treatment:

Knowing how hepatitis C is transmitted, risk groups and the main symptoms of the disease in adults and children, you will be able to correctly diagnose it in the early stages of the disease and, by consulting a doctor, begin therapy. Early diagnosis of this dangerous disease is the key to successful fight against the hepatitis C virus.

• Article

Hepatitis C- This viral disease liver. He is also called the “gentle killer.” This disease sneaks up on the sly, proceeds without clear signs and leads to severe consequences: liver cancer or cirrhosis.

The virus was discovered in 1989; before that, the disease was called “non-A, non-B hepatitis.” Both drug addicts who use the same needle and absolutely healthy people can become infected with hepatitis C. After all, you can “catch” the virus in the dentist’s office or in a nail salon.

After infection, hepatitis behaves very secretly. Viruses multiply in the liver, gradually destroying its cells. However, in most cases, a person does not feel any signs of the disease. And if there are no complaints and visits to the doctor, there is no treatment. As a result, in 75% of cases the disease becomes chronic, and serious consequences. Often a person feels the first signs of the disease only when cirrhosis of the liver has developed, which cannot be cured.

How common is hepatitis C? There are more than 150 million chronic patients on the planet; in Russia their number is 5 million. Every year the disease is detected in 3-4 million people. And the mortality rate from the consequences of hepatitis C is 350 thousand per year. Agree, impressive numbers.

The disease is unevenly distributed. In some countries with poor sanitary standards, 5% of the total population is infected. Men and women are equally susceptible to this disease, but treatment is more successful in women. In children, hepatitis responds better to treatment; only in 20% of cases does it become chronic. While in adults, 20% of patients are successfully cured, 20% become carriers of the virus, and 60% have chronic diseases liver.

Where can I get information support on hepatitis C treatment in 2018?

How is hepatitis C transmitted?

The disease is transmitted through blood. The source of infection is humans. This can be a patient with acute or chronic form of hepatitis C, as well as a carrier - someone who has the virus in his blood, but is not sick himself.

There are many situations in which you can become infected with the hepatitis C virus.

1. For blood transfusions and organ transplants. Approximately 1-2% of donors have the virus and are unaware of it. People who are forced to undergo repeated blood transfusions are especially at risk. In the past, this was the main route of disease transmission. But now blood and donated organs are checked more carefully.
2. When drug addicts share the same needle. Up to 40% of patients become infected this way. The small fragments of blood that remain on the needle are enough to cause many serious diseases. Including AIDS and hepatitis C viruses.
3. When using non-sterile instruments. Many medical and cosmetic procedures may be accompanied by skin damage. If the instruments have not been properly disinfected, then infected blood particles with the virus remain on them. This danger lurks in the dentist's office, during acupuncture sessions, as well as for those people who get piercings, tattoos, or just a manicure.
4. During childbirth– “vertical” transmission path. The mother can pass the virus to her baby during childbirth. Especially if at this moment she has an acute form of hepatitis or she suffered from the disease in the last months of pregnancy. Milk does not contain the virus, so breastfeeding completely safe.
5. During sexual intercourse. During sex without a condom, you can pick up the virus from your sexual partner. However, the risk of such infection with hepatitis C is not very high.
6. When providing medical care . Health care workers who give injections, treat wounds, or work with blood and blood products are also at risk of becoming infected. Especially if infected blood gets on damaged areas of the skin.

Hepatitis C is not transmitted through shared utensils, food and water, towels, washcloths, kissing and hugging. The virus is also not released when talking, sneezing or coughing.

What is the hepatitis C virus?

Hepatitis C virus (HCV) is a small, round virus that belongs to the Flaviviridae family. Its main part is one chain of ribonucleic acid (RNA). It is responsible for transmitting genetic information to descendant viruses. The chain is covered by a shell of protein molecules – the capsid. The outer protective layer of the capsule consists of fats. On their surface there are elevations similar to volcanoes - these are protein molecules that serve to penetrate human cells.

The virus has an interesting feature. It is constantly changing. Today there are 11 of its variants - genotypes. But after infection with one of them, the virus continues to mutate. As a result, up to 40 varieties of one genotype can be identified in a patient.

It is this property of the virus that allows it to remain in the body for so long. While the human immune system learns to produce antibodies to fight one variant, the virus has already managed to change. Then the immune system has to start producing “defenders” all over again. From such a load, the human immune system is gradually depleted.

What happens in the body when a virus gets there?

Intoxication that occurs due to the activity of the virus also has a bad effect on the human condition. The condition also worsens because the liver, which is supposed to cleanse the blood of toxins, does not perform its functions.

Will vaccination help prevent hepatitis C?

Today there are vaccinations against hepatitis A and B. There is no vaccine that would prevent hepatitis C. This is explained by the fact that the virus has a huge number of varieties and it is very difficult to create a drug that would contain an element common to all genotypes. But developments are constantly underway. Perhaps such a tool will appear in the future.

In the meantime, prevention measures include abstaining from drugs and using condoms during sexual intercourse. Healthcare workers should wear rubber gloves to protect their hands. Sanitation stations constantly monitor how instruments that come into contact with blood are processed. But only you can decide where to get your teeth treated, manicures and piercings done.

What can be the blood result for hepatitis C?

If there is a suspicion that a person may have become infected with hepatitis, a number of tests are prescribed:

• Coagulogram (test for blood clotting)
• Test for determination of hepatitis C virus RNA by PCR (for HCV-RN) qualitative, quantitative, genotyping
• Antibody test to the hepatitis C virus(anti-HCV, ELISA, enzyme immunoassay)
• Test for the presence of class M antibodies to the hepatitis C virus (anti-HCV IgM)
• Test for the presence of class G antibodies to the hepatitis C virus (anti-HCV IgG)

Let's take a closer look at each type of research:

1. General blood analysis . A decrease in platelet levels is detected in the blood. At the same time, the number of leukocytes increases. This is a sign of an inflammatory process in the liver.


2. Blood chemistry. During hepatitis C, enzymes and other substances appear in the blood that are not found in tests healthy person.
   • Alanine aminotransferase (ALT) is an enzyme found in hepatocytes. If it is found in the blood, this indicates liver damage. This test is considered very sensitive for detecting acute hepatitis in the early stages.
   
   
   • Aspartate aminotransferase (AST) is also an enzyme found in liver tissue. If both enzymes (AST and ALT) are found in the blood, this may indicate that the death of liver cells has begun - necrosis. If the amount of AST is much higher than ALT, it is possible that connective tissue has begun to grow in the liver (liver fibrosis). Or this indicates damage to the organ by toxins - medications or alcohol.
   
   
   • Bilirubin- one of the components of bile. If it is detected in the blood, this indicates disturbances in the functioning of liver cells and their destruction by viruses.
   
   
   • Gamma-glutamyl transpeptidase (GGT)- an enzyme found in liver tissue. Increased level may indicate liver cirrhosis.
   
   
   • Alkaline phosphatase (ALP)- an enzyme found in bile ducts liver. If it is present in the blood, it means that hepatitis has disrupted the flow of bile.
   
   
   • Protein fractions - proteins that appear in the blood during liver damage. There are quite a lot of proteins, but if the liver suffers, then the amount of 5 of them increases: albumins, alpha1-globulins, alpha2-globulins, beta-globulins and gamma-globulins.


3. Coagulogram is a set of tests for studying blood clotting. With hepatitis, blood clotting decreases and clotting time increases. This occurs because the level of prothrombin protein, which is synthesized in the liver and is responsible for stopping blood during bleeding, decreases.


4. Test for determination of hepatitis C virus RNA using PCR qualitative, quantitative, genotyping (PCR for HCV-RNA) is a blood test that determines the presence of the hepatitis C virus (HCV) and its component - the RNA chain. The study is carried out using the polymerase chain reaction (PCR) method. It allows you to determine the amount of virus in the blood and its genotype. This information will help you choose the right treatment and predict how the disease will progress.

   If the test is positive, this indicates that the body is infected with the hepatitis C virus and the pathogen is actively multiplying. Knowing the amount of virus can determine how contagious a person is and whether the disease is easy to treat. The lower the amount of virus in the blood, the better prognosis.



5. Antibody test for hepatitis virus WITH (anti-HCV, ELISA, enzyme-linked immunosorbent assay) is an analysis that is aimed at identifying antibodies that are produced by the immune system to fight the hepatitis C virus. A test for total antibodies includes the determination of immunoglobulins, regardless of their type.

   A positive test result indicates that the body is infected with the virus, and the immune system is actively fighting it. Antibodies are produced in acute and chronic forms of the disease. They also remain in the blood of a person who has been ill and recovered on their own for another 5-9 years. Therefore, more is needed precise research to determine what processes occur during illness.



6. Test for the presence of class M antibodies to the hepatitis C virus(anti-HCV IgM) - immunoglobulins M appear in the blood 4 weeks after infection. They remain in large numbers while the disease rages in the body. After 6 months, when the condition improves, there are fewer of them. But they may appear again if the disease becomes chronic and an exacerbation begins.

   A positive test for M antibodies indicates that the patient has an acute form of hepatitis C or an exacerbation of the chronic form of this disease. If the IgM test is negative and there is no ALT in the blood, but there are traces of RNA or IgG, then the person is considered a carrier of the virus.



7. Test for the presence of class G antibodies to the hepatitis C virus(anti-HCV IgG) is the detection of immunoglobulins G, which neutralize the “nuclear” elements of viruses. This test will not show a recent case of the disease. After all, IgG appears only 2.5-3 months after infection. Their number decreases after six months if the treatment is successful. In patients with the chronic form, immunoglobulins G remain in the blood for the rest of their lives.

   A positive test result indicates that the acute stage is over. Either the healing process has begun or the disease has gone underground and a chronic form has appeared, without exacerbations.

   If the result of blood tests for hepatitis is negative, this means that there are no viruses or antibodies to them in your body. But in some cases, the doctor may advise you to take a repeat test in a few weeks. The fact is that signs of hepatitis C do not appear immediately.

In order for the analysis result to be as accurate as possible, you must adhere to simple rules. Blood for research is taken from the ulnar vein. It is necessary to take tests in the morning, before meals. The day before, you should not drink alcohol or actively engage in sports. Be sure to tell your doctor if you are taking any medications. They may affect test results.

Additional Research

Usually the doctor prescribes ultrasonography liver (ultrasound). It helps identify liver enlargement and areas affected by the virus. But the most accurate results are provided by a biopsy. This involves taking a sample of cells directly from the liver with a special needle. The procedure is carried out quickly. To ensure that the patient does not feel discomfort, he is given an injection with an anesthetic drug.

After conducting all the studies, the doctor determines the level of development of the disease and the degree of liver damage, and also selects the most effective and safe treatment.

What are the genotypes of the virus?

The hepatitis C virus is highly variable. It mutated, adapted to conditions for several thousand years and almost reached perfection. That is why the disease resists immune attacks well and often becomes chronic. To date, the World Health Organization has recognized the existence of 11 genotypes of the hepatitis C virus.

Virus genotypes are its variants, which differ from each other in the structure of the RNA chain. They are designated by numbers from 1 to 11. Each genotype differs from its fellows by about a third. But within each such group there are several options. The differences between them are not so great - these are subtypes. Numbers and letters (1a or 1b) are used to designate them.

Why is the genotype of the virus determined? The fact is that different genotypes cause different shapes diseases. Some subtypes may disappear on their own without treatment. Others, on the contrary, do not respond well to therapy. If you determine the type of virus, you can choose the right dose of the drug and duration of treatment. For example, genotypes 1 and 4 are more resistant to interferon treatment.

Genotypes have one more interesting feature– they affect people in different regions:

1a - in America and Australia;
1b - throughout Europe and Asia;
2a - on the islands of Japan and China;
2b - in the USA and Northern Europe;
2c - in Western and Southern Europe;
3a - in Australia, Europe and South Asian countries;
4a - in Egypt;
4c - in Central Africa;
5a - in South Africa;
6a - in Hong Kong, Macau and Vietnam;
7a and 7b - in Thailand
8a, 8b and 9a - in Vietnam
10a and 11a - in Indonesia.

In Russia, genotypes 1, 2 and 3 are more common than others. Genotype 1 is the most common in the world and is less amenable to treatment with modern drugs than others. This is especially true for subtype 1c, for which the prognosis for the course of the disease is worse compared to other varieties. Genotypes 1 and 4 are treated for an average of 48-72 weeks. For people with genotype 1, they require large doses medications and they depend on body weight.

While subtypes 2, 3, 5 and 6 produce a small amount of virus in the blood and have a more favorable prognosis. They can be cured in 12-24 weeks. The disease recedes quite quickly with the use of Interferon and Ribavirin. Genotype 3 causes serious complication– fat deposition in the liver (steatosis). This phenomenon greatly worsens the patient’s condition.

There is evidence that a person can simultaneously become infected with several genotypes, but one of them will always be superior to the others.

What antibodies indicate infectious hepatitis C?

As soon as foreign particles - viruses, bacteria - enter the body, the immune system begins to produce special proteins to fight them. These protein formations are called immunoglobulins. For each type of microorganism, special immunoglobulins are formed.

With hepatitis C, immune cells produce 2 types of “defenders,” which are indicated in tests by a label anti-HCV, which means against the hepatitis C virus.

Antibodies class M(immunoglobulins M or anti-HCV IgM). They appear a month after infection and quickly increase their numbers to a maximum. This occurs in the acute stage of the disease or during an exacerbation of chronic hepatitis C. This reaction of the body indicates that the immune system is actively destroying viruses. When the disease subsides, the amount of anti-HCV IgM gradually decreases.

Antibodies class G(immunoglobulins G or anti-HCV IgG). They are produced against the proteins of the virus and appear approximately 3-6 months after the pathogen has settled in the body. If only these antibodies are present in the blood test, it means that the infection occurred a long time ago, and the active stage is left behind. If the level of anti-HCV IgG is low and gradually decreases with repeated testing, this may indicate recovery. In patients with the chronic form, immunoglobulins G remain in the blood constantly.

Also in laboratories, antibodies to the proteins NS3, NS4 and NS5 are determined. These viral proteins are also called non-structural proteins.

Antibodies that are produced against the NS3 protein(Anti-NS3). They appear at the very beginning of the disease. This analysis allows you to detect the disease in the early stages. It is believed that the higher the Anti-NS3 score, the more virus there is in the blood. And the higher the likelihood that hepatitis C will become chronic.

Antibodies that are produced against the NS4 protein(Anti-NS4). Appear at a later stage. Allows you to find out how long ago the infection occurred. It is believed that the higher their number, the more severely the liver is affected.

Antibodies that are produced against the NS5 protein(Anti-NS5). These antibodies are present in the blood when the RNA of the virus is present there. In the acute period, they may indicate that there is a high probability of chronic hepatitis C.

How to treat hepatitis C with medications?

Can hepatitis C be completely cured?

Yes, since 2015, Hepatitis C has been officially recognized as a completely curable disease. What does this mean? Modern drugs do not just stop the reproduction of the virus - they completely kill the virus in the body and return the liver to healthy condition.

Currently there are very effective techniques treatment of hepatitis C. When used modern drugs cure occurs in 95-98% of cases. Given the good tolerability of the drugs used at present, hepatitis C can be classified as a completely curable disease.

Since 2015 wide application In the treatment of hepatitis C, drugs such as Sofosbuvir + Velpatasvir have been found. Complex application This combination of drugs lasting 12 weeks leads to almost 100% cure for the disease.

Sofosbuvir

This is a highly effective antiviral drug related to nucleotide analogues. Mechanism therapeutic effect This drug consists of blocking an enzyme involved in copying the genetic material of the virus. As a result, the virus cannot multiply and spread throughout the body.

Velpatasvir

It is a highly effective antiviral drug that targets a protein (protein coded as: NS5A) involved in the assembly of viral components. Thus, this drug prevents the reproduction and spread of the virus in the body.

Combinations of drugs Sofosbuvir and Velpatasvir used according to the treatment regimen provide double action for different types of hepatitis C virus, which is optimal treatment all 6 genotypes of hepatitis C.

The duration of treatment with the combination of Sofosbuvir and Velpatasvir is 12 weeks. The result is 98% cure for hepatitis C.

Previous treatment regimens for hepatitis C involved the use of Interferon drugs in combination with Ribavirin. Below are the treatment regimens and mechanisms of therapeutic action.

Interferon

It is a protein structure that is normally produced by human cells to fight viruses. To prepare the medicine, the corresponding section of human DNA is implanted coli using genetic engineering methods. Then the protein molecules are isolated and purified. Thanks to this technology, interferon is produced on an industrial scale.

Injectable interferon alpha 2a or 2b is suitable for the treatment of hepatitis C. Other forms, such as candles, do not help.

Mechanism of action of interferon:

• protects healthy cells from the penetration of the virus into them
• strengthens the cell wall so that pathogens cannot penetrate inside
• prevents the virus from multiplying
• slows down the production of virus particles
• activates the work of genes in the cell that fight viruses
• stimulates the immune system to fight the virus

Additional administration of interferon helps the body cope with the infection. In addition, it prevents the development of cirrhosis and liver cancer.

1. Simple interferons - are With the cheapest and therefore generally available drugs :
   • Roferon-A(interferon alpha-2a) Increases cell resistance to the virus. Strengthens the immune system so that it actively destroys the pathogen. Prescribe 3-4.5 million IU (international units) 3 times a week. The duration of treatment is from 6 months to a year.
   
   
   • Intron-A(interferon alpha-2b). Binds to receptors on the surface of the cell and changes its functioning. As a result, the virus can no longer reproduce in the cell. The drug also increases the activity of phagocytes - immune cells that absorb viruses. For the first 6 months, the dose is 3 million IU 3 times a week. The duration of treatment can last up to a year.
2. Peligated interferon - this is the same interferon, but it remains in the body for a longer period. This occurs due to the addition of polyethylene glycol, which enhances the effect of interferon. Types of drugs:
   • Pegasis(peginterferon alfa-2a). Stops the division of the virus RNA and its reproduction. Immune defense is strengthened. Liver cells reproduce correctly without losing their functions. Stimulates those genes in hepatocytes that can resist the attack of the hepatitis C virus. Dosage: 180 mcg once a week subcutaneously in the abdomen or thigh. Duration of treatment is 48 weeks.
   
   
   • Pegintron(peginterferon alfa-2b) Activates enzymes that are produced inside the cell to fight viruses. The dose of the drug depends on body weight. On average it is 0.5 ml once a week. The duration of treatment is from 6 months to a year.


3. Consensus interferon – a drug obtained thanks to the latest bioengineering technologies.
   • Infergen(interferon alfacon-1) It differs in that the sequence of amino acids in interferon is changed. Thanks to this, the effect of the drug is enhanced. It helps even those people for whom treatment with other medications has not produced results. Dose 15 mcg – 1 bottle. Injected daily or three times a week under the skin of the abdomen or thigh. The minimum treatment period is 24 weeks.

Ribavirin

This synthetic drug, which stimulates the immune system and greatly enhances the effect of interferon-based drugs. Used together with any of the interferons.

Arviron. The drug easily penetrates cells affected by the virus, stops the division of the virus and promotes the death of the pathogen. The dose depends on body weight. Take 2-3 tablets with meals in the morning and evening. The capsules must not be chewed. Duration of treatment is 24-48 weeks.

Rebetol. Gets inside liver cells affected by the disease. There, it prevents new viruses from forming a shell around the RNA and thus inhibits their reproduction. The number of capsules depends on body weight. Usually prescribed 2 in the morning and 3 in the evening with meals. Do not chew the capsules. Take in parallel with interferon for 24-72 weeks.

Hepatoprotectors

These are drugs that are designed to support the liver during a difficult period for it. They do not fight the virus, but help the affected cells recover faster. Thanks to these medicines is improving general state, weakness, nausea and other manifestations of intoxication are reduced.

Phosphogliv. Supplies phospholipids to the body. They are designed to “repair” the walls of damaged liver cells. Take 1-2 capsules each time you eat, 3-4 times a day. The duration of the course is six months or more.

Heptral. Performs many functions in the body: enhances the production of bile, improves the functioning of the gastrointestinal tract, accelerates the restoration of liver cells, relieves intoxication and protects nervous system. To enhance the effect, the drug is administered intravenously for the first 2-3 weeks using droppers. Then they prescribe pills. Take 1 tablet 2 times a day orally for 3-4 weeks. It is recommended to take the medicine on an empty stomach half an hour before meals. Better in the morning. The minimum treatment period is 3 months.

Ursosan. Most effective drug of all hepatoprotectors. Made from ursodeoxycholic acid. Protects cells from destruction, strengthens the immune system, reduces the amount of toxins, prevents fat from being deposited in hepatocytes, delays development connective tissue in the liver. Take 1 capsule 2-3 times a day with meals. The capsules must not be chewed. The dose may vary depending on body weight. The duration of treatment is from 6 months to several years.

Drugs to reduce side effects of treatment.

Antiviral drugs interferon is not always well tolerated. Young people quickly adapt to such therapy, but if the body is weakened, then it needs help.

Derinat. Immunomodulator – normalizes the functioning of the immune system, increases the number of protective cells: leukocytes, lymphocytes, phagocytes, granulocytes. Prescribed as intramuscular injections. Daily or 2-3 times a week. Course from 2 weeks.

Revolade. Designed to normalize blood functions. Increase its coagulability and prevent bleeding. Take 1 tablet per day for 1-2 weeks.

Neupogen. Normalizes blood composition (number of neutrophils) and helps reduce temperature. It is administered subcutaneously or intravenously in droppers. Prescribed by a doctor based on the results of blood tests.

Hepatitis C can be cured, but to do this you need to contact a specialist who has experience working with this disease. A person will have to be patient, strictly follow the doctor’s recommendations and follow a diet.