home Audience 3 Current problem: what is dangerous about the hepatitis C virus. Hepatitis C - symptoms and treatment, first signs. What is hepatitis C and is it dangerous?

Current problem: what is dangerous about the hepatitis C virus. Hepatitis C - symptoms and treatment, first signs. What is hepatitis C and is it dangerous?

Not all modern residents can answer why hepatitis C is dangerous. Meanwhile, the disease infectious nature extremely dangerous both for the patient himself and for those around him. In most cases, the pathology proceeds almost unnoticed, which is why among doctors the disease is called the “gentle killer.”

The consequences of hepatitis C in the form of cancer or cirrhosis of the liver clearly indicate that it is important for every person to know how terrible it is for others. The danger of the disease lies primarily in its asymptomatic course. As a rule, a serious illness is discovered by chance during an examination.

Despite the absence of signs of pathology and a long incubation period, the human carrier of the virus serves as an active spreader of a severe infection. Not knowing that he is sick, he puts his closest family members at risk of infection.

How can you become infected with hepatitis C?

The modes of transmission of hepatitis C are as follows:

The virus is transmitted parenterally (through blood in the case of using non-sterile medical instruments, syringes, etc.). Among drug addicts, the number of patients with hepatitis C is extremely high. The virus can also spread through household piercing and cutting objects (manicure utensils, razors, etc.)
Hepatitis C passes from one sexual partner to another (sexual transmission is also common; similar to sexually transmitted diseases, HIV infection is most often contracted by people leading an immoral lifestyle).
Intrauterine transmission of the hepatitis C virus (the disease passes from a pregnant woman to the fetus only if the disease was acute at the time of pregnancy).

The last variant of infection is considered the rarest - only in 5-10% of cases the baby acquires the disease in the mother’s womb. In addition, it is worth noting that the risk of transmitting a viral infection in a healthcare facility is low. As a rule, doctors use disposable syringes, and other instruments always undergo high-quality sterile processing, consisting of several stages (soap and soda solution, disinfectants and disinfectants, sterilizers, etc.).

Consequences of the disease and chances for a healthy life

In order to adequately assess the potential danger from hepatitis C infection, you need to understand what it threatens when it enters the human body. As already mentioned, in most carriers of the virus the disease proceeds as a chronic infection.

The likelihood of her rebirth into malignant tumor or liver cirrhosis without proper supportive therapy is quite high.

You can make a reliable forecast and answer the question of how long a patient with hepatitis C can live by assessing the rate of progression of the pathology.

The rate of development of the disease is largely determined by the patient’s lifestyle.

In addition to maintaining proper nutrition, a patient who is a carrier of the virus must completely eliminate bad habits. Sources of toxic liver damage, which include drugs, alcohol in any form, cigarettes, etc., serve as impetus for the accelerated progress of the pathology.
The psycho-emotional component of the patient’s lifestyle is also considered important. Stress, worries and worries be in his Everyday life shouldn't. Any nervous shock is a lever for triggering the mechanism of irreversible action.
In addition, systematic visits to a specialist in the field of infectious disease and routine examinations for patients with hepatitis C cannot be excluded in any case.

Thanks to medical examination, doctors will have a real idea of the condition of the liver and the body in general. When identifying only developing signs exacerbations, the patient has a chance to contain the progression of the disease through unquestioning compliance with medical prescriptions and nutritionist recommendations regarding nutrition and lifestyle.

Is there a risk of hepatitis from tactile contact?

The transition of the disease to severe stages (cirrhosis, cancer) may not occur at all, it all depends on the patient. With a responsible approach to treatment, the patient can live a long time happy life without bringing anyone serious problems.

Hepatitis C is absolutely not scary for others if they shake hands with a carrier of the virus.
The disease is also not transmitted through hugs or kisses. However, when infected with hepatitis C, the consequences for the patient can be very unpredictable.

Hiddenness and absence characteristic symptoms hepatitis C became the main reason for the rather late study of the virus and its characteristics.

Diagnosing it using an ordinary clinical blood test is problematic, and drawing up a treatment plan for it is no less difficult.

Spread of the virus

In Russia, doctors began to deal with hepatitis C issues a little over 20 years ago. Despite the fact that during this time to fight " gentle killer“A lot has been done; it is not yet possible to definitively cure patients from chronic hepatitis.

Definitely, even long-term remission, which can be observed in most cases of chronic hepatitis C, is considered an achievement.

By transferring the virus from the active to the inactive phase, doctors are able to minimize the risks of complications of the disease.

Many people mistakenly think that they are not at risk. Statistics show the opposite: the diagnosis can be confirmed in half of infected patients. The same number have no idea that they are a danger to the population.

We should not forget that:

The infection is widespread.
The absence of symptoms lulls people's vigilance.
Hepatitis C can only be detected by a blood test.

On early stages the detected disease can be completely cured. In severe and advanced forms of the pathology, often the only salvation for the patient is a liver transplant.

Hepatitis A, B, C: symptoms, diagnosis, prevention (vaccination), routes of transmission, incubation period, treatment (drugs, nutrition, etc.), consequences. Properties of the hepatitis C virus. Hepatitis C during pregnancy, is it possible to get pregnant? - video

Hepatitis C is an infectious disease liver caused by the blood-borne hepatitis C virus. Hepatitis can be acute or chronic, and is dangerous due to its complications in the form of cirrhosis and liver cancer. Chronic hepatitis C has a long course and may not manifest itself in any way for many years.

Some statistics!

The problem of viral hepatitis C among the world population is becoming more and more urgent every year. Thus, the World Health Organization (WHO) estimates that about 500 million people in the world are infected with hepatitis C, which is 10 times more than the number of HIV-positive individuals. Of the total, 150 million suffer from a chronic form of hepatitis C, with an annual increase in patients of more than 3 million people, and about half a million people die per year.

But, as you know, official statistics lag behind reality; there is still no specific count of cases of viral hepatitis detected in the world, and not everyone seeks medical help. So, according to some data, the official figure for the incidence of hepatitis C can be multiplied by 5-10 times.

A little history!

The hepatitis C virus was discovered relatively recently, in 1989, which is even later than HIV infection. Before this, hepatitis A and B viruses were already known, and they were described in detail. clinical picture. But doctors identified patients who had symptoms of hepatitis, but the hepatitis A and B viruses were not detected, and even for 2 decades this pathology was called “neither A nor B” hepatitis. Considering the relatively short period of observation of this pathology, doctors have not yet fully studied the hepatitis C virus, especially regarding effective treatment, but scientists all over the world are conducting intensive research in this direction.

July 28 is World Hepatitis Day.

Interesting Facts!

Hepatitis C is called the "gentle killer." This is due to the fact that the disease can be asymptomatic or minimally symptomatic, but irreversible changes occur in the patient’s liver, leading to the death of the person.
Hepatitis C is the most common blood-borne disease.
Prevention of hepatitis C – prevention is easier than cure. So preventing this disease is a priority all over the world.
More than half of cases of hepatitis C lead to the development of chronic hepatitis, which in 15-50% ends in liver cirrhosis.
Chronic hepatitis C is diagnosed in 75% of patients with liver cancer.
Modern antiviral drugs can cure hepatitis C.
Despite the fact that doctors combine hepatitis A, B, C, D, E and others into one group of diseases, all these viruses differ significantly in their structure and belong to different genera and families, the only thing they have in common is the ability to damage the liver.
Hepatitis C can be infected in a hospital, beauty salon or dental office, so few people are 100% insured against this disease.

The causative agent is hepatitis C virus (HCV or HCV)

Place of the hepatitis C virus in the kingdom of living organisms:

Kingdom: RNA virus;
Family: Flaviviruses (Flaviviridae), from Latin "yellow";
Genus: Hepavirus (Hepacivirus);
Type: Hepatitis C virus.

Characteristics of the hepatitis C virus

Characteristic	Hepatitis C virus
Dimensions	30-60*10 -9 m
Where does the virus multiply?	In liver cells - hepatocytes.
Genotypes – types of viruses that differ in the set of certain genes. Each genotype has its own subtypes - quasi-species, which are constantly subject to mutation.	Genotype 1 - a, b, c; genotype 2 - a, b, c, d; genotype 3 - a, b, c, d, e, f; genotype 4 - a, b, c, d, e, f, g, h, i, j; genotypes 5 a and 6 a. Worldwide, the most common genotypes are 1, 2 and 3. *In Russia, genotypes of the virus C 1a and b are more common, less often 2 and 3.* Genotypes 4, 5, 6 are often found in African and Asian countries.
Who is affected?	Only human.
Antigens or proteins of the virus – protein molecules that make up the virus.	*Shell proteins:* E1 and E2; *core proteins:* HCV cor antigen; *non-structural proteins:* NS 2, 3, 4, 5; *other proteins:* F, P7 and others. In laboratory diagnostics, the determination of antibodies to HCV cor, NS 3, 4, 5 antigens is used.
Antibodies or immunoglobulins – specialized immune cells that are produced in the body in response to the introduction of a virus.	The body produces antibodies to each of the proteins (antigens) of the virus. In laboratory diagnostics, the total amount of antibodies is determined.
How long does the virus live on the surfaces of objects?	The virus can survive exclusively in drops of blood, including dried ones. At room temperature and moderate lighting, the virus lives from 16 to 96 hours, meaning it is relatively stable in the environment. Freezing blood does not kill HCV.
Under what conditions does the hepatitis C virus die?	Boil for at least 5 minutes; at a temperature of 60 o C – at least 30 minutes; the use of chlorine-containing disinfectants, 70% alcohol and some other antiseptics must be combined with boiling; The virus is partially resistant to ultraviolet radiation, so it cannot be used for disinfection.
How much blood infected with hepatitis C must enter the body of a healthy person to infect him?	1/100 – 1/10000 ml, this is less than 1 drop.

Routes of transmission of hepatitis C virus

Parenteral route - through the blood

This is the main route of transmission of hepatitis C. This does not always require an infusion of infected blood; a drop of blood on various objects, including household ones, is enough.

Conventionally, several risk groups for hepatitis C infection can be distinguished:

1. People who inject drugs drugs are the main group of people infected with hepatitis C, which is why it is also called “drug addicts’ hepatitis”. This is due to the fact that the drug addict does not always use individual syringes. In addition, some “drug chemists,” when preparing a drug, add their own blood to it to cleanse the resulting solution from sediment. That is, a drug addict, buying a dose of the solution, can receive hepatitis viruses or even HIV as a “bonus”.

2. Clients of beauty salons. Unfortunately, beauty salon technicians do not always conscientiously disinfect their tools, spreading blood-borne diseases, especially hepatitis B, which can live on objects for months and even years.
Procedures during which you can become infected with hepatitis C:

manicure and pedicure for cuts;
tattoo;
shaving;
haircut for damaged skin;
some cosmetic procedures, which can lead to damage to the integrity of the skin.

3. Patients receiving medical services(medical hepatitis):

Transfusion of donor blood products that have not undergone proper testing, including from a donor who at the time of blood donation had the hepatitis C virus, but has not yet developed antibodies to it (seronegative window). For your information, until 1992 donor blood have not been tested for hepatitis C, so people who received a blood transfusion before this period are considered high risk for hepatitis C (unless the person is tested).
Treatment at the dentist, unfortunately, often causes infection with hepatitis, especially hepatitis B.
People on hemodialysis have average risk hepatitis infection.
Surgical operations and dental treatment cause the transmission of hepatitis C quite rarely, but this route of infection is possible, especially in underdeveloped countries and among unscrupulous medical workers.

4. People providing health services(medical workers) – have a relatively low risk of infection. The most common patients with hepatitis C are surgeons, pathologists, dentists, laboratory assistants and nursing staff.
Accordingly, the risk group includes manicurists and pedicurists and other beauty salon workers.

5. Other persons at risk of becoming infected with hepatitis C through blood:

Police officers, prison staff, military personnel who may become infected during the detention of criminals, providing first aid for injuries and in other situations.
In everyday life: if there are patients with hepatitis C in the family. Household way transfer possible in in rare cases, with non-individual use of a toothbrush, blades, razors and other hygiene products.

Sexual tract

Transmission of the hepatitis C virus through unprotected sexual contact is possible, but in practice this occurs quite rarely, only in 1-3% of contacts, in the presence of injuries to the vaginal and penile mucosa. Such conditions can arise from rough sexual intercourse, anal sex, or the presence of inflammatory diseases of the external genitalia, which contribute to the formation of ulcers, cracks, and microtraumas.

Can you get hepatitis C through semen?

The hepatitis C virus lives only in the blood. The virus may be present in other biological fluids, but in a very small concentration, which is not enough for infection. That is, semen and vaginal discharge cannot cause transmission of the virus.

Can you get hepatitis C through sex during your period?

Menstruation is the release of blood from the vessels of the uterus, which can be infected with hepatitis C, so a woman during menstruation can easily infect her sexual partner with hepatitis, but only if there are injuries to the penis or skin in contact with menstrual blood.

Also during menstruation, the risk of hepatitis infection increases in women.

Is it possible to get hepatitis C through oral sex?

Oral sex, like vaginal sex, can cause the transmission of hepatitis C, but subject to the simultaneous presence of microtraumas or cracks in the mucous membranes.

Transplacental route - from mother to child

Transmission of the hepatitis C virus can occur during childbirth and while caring for the baby. But this risk is regarded as low, since infection of a baby is possible on average only in 5% of cases. The risk of mother-to-child transmission of hepatitis C increases significantly if the mother has HIV infection, if she acquires the virus during pregnancy, or if the mother has a high viral load during childbirth.

How is hepatitis C not transmitted?

By airborne droplets;
by everyday means;
when communicating;
through saliva and kisses;
with hugs and handshakes;
when using shared utensils;
through toys;
when using shared towels;
other contacts that do not involve contact with blood.

Therefore, there is no need to be afraid of a patient with hepatitis C. During normal communication, cooperation, visiting children’s groups and cohabitation You cannot become infected with the hepatitis C virus. Only in the case of various injuries that lead to disruption of the integrity of the skin, precautions are necessary.

Pathogenesis of the disease

Much in the mechanism of development of disease and liver damage by the hepatitis C virus has not yet been studied. The problem is that the virus is constantly mutating, and it is currently impossible to trace all stages of pathogenesis under such conditions. Perhaps, by discovering all the development processes of this infection, the world will open up new opportunities in the treatment of the disease and the possibility of creating an effective vaccine for prevention.

What happens with viral hepatitis C?

1. Incubation period– from 14 days to six months or more, on average 49-50 days.

The virus enters the blood and is delivered with it to liver cells - hepatocytes.
In the hepatocyte, the virus multiplies - RNA replication.
The virus releases toxin proteins (antigens) into the blood, including those that destroy the cell wall of the hepatocyte (cytotoxic proteins).
Hepatitis sets in and liver cells are gradually destroyed.
The immune system begins to respond to the virus only after 1 month or even more. First, lymphocytes, macrophages, NK killers and other cells come to the liver cells cellular immunity. Antibodies to the hepatitis C virus are not yet detected at this stage.

2. Period of clinical manifestations:

Liver enzymes are released from damaged liver cells, which further destroy hepatocytes.
In response to proteins and the reaction of cellular immunity, the body produces immunoglobulins (antibodies) specific to hepatitis C. As a result, the amount of virus in the blood decreases sharply.
Involved in the process autoimmune reactions, that is, when the immune system perceives its cells as foreign. In this case, immunoglobulins to hepatitis C destroy the hepatocyte along with the virus, aggravating the course of hepatitis.

3. Recovery period:

Spontaneous cure of hepatitis C may occur, while HCV RNA in the blood is not detected, but whether the virus persists in the human body or not has not yet been established. It is believed that it remains inactive throughout a person’s life. Recovery occurs only if there is a good immune response.

4. Transition to the chronic form of hepatitis C:

When hepatitis C becomes chronic, the virus constantly mutates, changes and multiplies unhindered, and the produced immunoglobulins do not have time to respond to new mutations. The immune response ceases to be effective.
In chronic hepatitis C, the death of liver cells occurs slowly and gradually, sometimes several decades may pass before cirrhosis of the liver occurs.
Against the background of hepatitis, fat metabolism in the liver is disrupted, which can lead to the development of fatty hepatosis (steatosis), that is, when normal liver tissue is replaced by fatty tissue.
Immunity is depleted and the liver is further destroyed. The cells that are primarily affected are T-lymphocytes. It is these cells that are damaged by HIV, so HIV and hepatitis C aggravate each other.
Remission may occur with the risk of further relapses. The liver can partially recover (regenerate), but only if liver cirrhosis has not occurred.

According to the results of pathological studies in people with HIV and HCV, it has been proven that the hepatitis C virus, in addition to liver cells, also affects other organs: the spleen, The lymph nodes, lungs and others.

What is hepatitis C carriage?

A person can be infected with the hepatitis C virus, but not get sick from it. That is, the virus multiplies in the body without destroying liver cells. A person lives with the virus for many years and even his whole life without harm to the body, but such carriage can also lead to the rapid development of cirrhosis at any time. Such people are dangerous because they can be a source of infection.

What happens in the patient's liver?

Acute course of hepatitis C. The liver slightly increases in size, fills with blood (bright purple color), the surface is smooth and even. Not detected in the liver a large number of foci of necrosis (destroyed tissue), foci of fatty degeneration are determined. Blood flow in the liver is not impaired.
For chronic hepatitis C the number of foci of necrosis increases, in place of the destroyed liver tissue, fibrosis is formed - the proliferation of connective tissue, which does not perform the function of hepatocytes. The liver continues to be enlarged. First, single fibrous cords are formed, then the connective tissue gradually replaces the liver tissue, that is, liver cirrhosis occurs. In this case, the liver decreases in size, shrinks, and becomes lumpy. A decrease in the number of normal hepatocytes leads to liver failure, the liver gradually or acutely ceases to perform its functions.
For cirrhosis of the liver blood circulation through the hepatic vessels is disrupted, portal hypertension syndrome and varicose veins of the hepatic vessels occur. In this case, additional vessels (anastomoses) are formed through which part of the blood circulates, bypassing the liver. The lack of blood and oxygen in the liver lobule contributes to further liver destruction, worsening liver failure.
Hepatitis C virus affects the genetic material of liver cells, which can result in the formation of a cancerous tumor.

What does the liver of a hepatitis C patient look like (photo)?

Photo of the liver of a patient with hepatitis C who died of cirrhosis of the liver. The liver is reduced in size and has a motley appearance. The capsule is thickened, light-colored, and gray-brown tubercles are visible underneath it. On section, the liver also has a spotted appearance (“spotted liver necrosis”). Bile ducts, blood and lymphatic vessels are fused.

Classification

Forms and types of hepatitis C

Acute course of HCV– is diagnosed only in one case out of five, this is due to the fact that the disease may not manifest itself clinically. In more than 70% of cases, acute hepatitis C becomes chronic.
Chronic course of HCV– the most common form of hepatitis C, characterized by slow and gradual destruction of the liver.
Fulminant (malignant or fulminant) hepatitis C– a variant of the acute course of hepatitis, in which rapidly progressive destruction of the liver occurs; in this form, liver failure develops 10-15 days from the onset of the first symptoms. This variant of hepatitis C, fortunately, develops quite rarely, less than 1% of all cases. Among the predisposing factors to the development of malignant hepatitis are infancy, characteristics of the genotype of the virus, infection with several types of hepatitis viruses (A, B, D), alcohol, drugs and other liver damage. The mortality rate is about 70%.

Activity of chronic hepatitis C

Previously, the terms “active” and “inactive (persistent) hepatitis C” were used. At the moment, these definitions are not relevant, since it is believed that any chronic hepatitis C is always an active process, to a greater or lesser extent.

Degrees of hepatitis C activity:

"Minimal" chronic hepatitis C;
“mild” (mild) chronic hepatitis C;
chronic hepatitis C with moderate activity;
severe chronic hepatitis C.

When determining a particular degree of hepatitis C activity, the following criteria are used:

the degree of liver damage according to the results of a histological examination of a liver biopsy;
the presence of fibrosis (connective tissue);
presence and severity of symptoms of the disease;
laboratory parameters of liver tests (namely ALT - alanine transferase).

Stages of liver fibrosis in hepatitis C:

liver fibrosis is absent;
weakly expressed;
moderately expressed;
severe liver fibrosis;
cirrhosis of the liver.

ICD-10 code

An ICD code is assigned to each type of disease, according to international classifications. Encryption of the diagnosis is necessary for easier processing of information and organization of medical and social assistance, for understanding the diagnosis by doctors around the world, as well as for hiding the pathology if the patient does not want to advertise it.

Acute viral hepatitis C: B 17.1.
Chronic viral hepatitis C: B 18.2.

Periods and phases of hepatitis C

1. Incubation period – this is the time from the moment of infection to the appearance of the first signs of the disease. With hepatitis C, this period can last from 14 days to six months, but on average 49-50 days.

2. Acute phase– symptoms of the disease in most cases may be absent or there are symptoms to which the patient does not pay particular attention and does not consult a doctor. Acute hepatitis C lasts up to 6 months.
Flow options acute phase hepatitis C:

Latent or hidden hepatitis - absence of symptoms or low symptoms - this is 8 out of 10 cases.
Manifest hepatitis C – vivid clinical manifestations, severity of symptoms – occurs only in 20% of cases. We can separately distinguish the pre-icteric period (lasting on average 10 days) and the icteric period.

3. The period of recovery (convalescence) of the acute phase of hepatitis C. Complete cure hepatitis C is possible without specific therapy, but subject to good immunity and absence accompanying pathologies liver. During this period, complete removal of the virus from the body (elimination) may occur, but this occurs only in 10-30% of cases.

4. The period of reactivation and transition to the chronic stage of hepatitis C , occurs with or without clinical manifestations. For most people, this period lasts for decades and can result in the development of cirrhosis or liver cancer.

5. Remission period of chronic hepatitis C , which is achieved as a result of a course of therapy with antiviral drugs. We can talk about remission when liver test results are normalized and the HCV RNA test results are negative. Any remission can result in a relapse.

The duration of each period may differ in each individual case.

Symptoms of acute and chronic hepatitis C

There are no symptoms of hepatitis C in most cases. In this case, only laboratory changes are detected. But with the manifest course of viral hepatitis C, a number of symptoms can be identified that are associated with changes in the liver and other organs. Compared to other types infectious hepatitis, manifestations of hepatitis C are less pronounced.

Possible symptoms and signs of viral hepatitis C

Group of symptoms	Symptom	Mechanism of symptom development	How does the symptom appear?
Intoxication syndrome	Weakness and malaise	Intoxication can be severe in acute hepatitis C, especially in the pre-icteric period. With chronic hepatitis C, the symptoms of intoxication are less pronounced, but are constant chronic nature. Intoxication is associated with the action of the toxins of the viruses themselves, as well as the decay products of destroyed liver tissue and unprocessed toxins formed in the body. Also a toxin is bilirubin, a bile pigment whose levels are elevated. Toxins affect the entire body, especially the central nervous system.	This is an early, almost constant and most common symptom of hepatitis C, both acute and chronic. The patient is constantly tired, wants to sleep, and has difficulty getting out of bed in the morning.
	Decreased appetite		There is no appetite, up to a complete refusal to eat. Some patients develop an aversion to food.
	Increased body temperature		IN acute period the temperature can rise to high numbers, above 38 o C, and for the chronic course of hepatitis, periodic subfibrility (temperature up to 38 o C) is more typical.
	Runny nose , cough		Reminds me of a regular ARVI. The cough is dry, infrequent, mucous discharge from the nose, nasal congestion. This symptom is mild and usually goes away quickly.
	Aches in joints, muscles, muscle weakness		Pain in the limbs can be aching or sharp.
	Skin rashes		Skin rashes are quite common symptom with hepatitis C, it may appear in the pre-icteric period or against the background of jaundice. The rash can be different, most often in the form of red spots. But this rash is almost always accompanied by itchy skin. By the way, itchy skin can occur without rashes.
	Sleep disturbance		More often observed with chronic HCV. Patients confuse day with night, during the day they want to sleep very much, and at night they experience insomnia.
Increased blood bilirubin levels	Yellowness of the skin and visible mucous membranes	Jaundice may appear in the acute period of the disease (rarely) or with the development of complications of hepatitis. Bilirubin is a bile pigment that is formed during the destruction of blood cells - red blood cells. Normally, this substance enters the liver, where reactions between bilirubin and glucoronic acid occur. With viral hepatitis, the binding process of bile pigment is disrupted, resulting in large quantities of unbound (direct) bilirubin entering the blood. It accumulates in all tissues and organs, giving them yellow, we see icteric mucous membranes and skin. Bilirubin normally colors stool and urine. With hepatitis, bile pigments do not reach the intestines, so the stool becomes light-colored. During this time, excess bilirubin is excreted by the kidneys, which leads to the formation of dark urine.	Jaundice with hepatitis C can be different intensities. In most cases, jaundice is mild; at first, patients notice only staining of the sclera. With further damage to the liver, the skin also becomes stained; with hepatitis C, the color first has a yellow-brown tint; in severe cases, it becomes greenish or lemon-colored.
	Darkening of urine		The color of urine in viral hepatitis is compared to the color of dark beer.
	Light chair		The stool becomes lighter than usual or completely discolored.
Complaints from the digestive system	Nausea, vomiting	These symptoms may be absent during the acute period of hepatitis or may be periodic. Disruption of digestive processes is associated with insufficient formation of bile and digestion of fats from food. As a result, the processes of fermentation, putrefaction and gas formation in the intestines intensify.	Nausea and vomiting may occur after eating food, especially fatty foods.
	Stomach ache		Usually the pain is in the right hypochondrium or in the umbilical region. They can be acute or spasmodic in nature.
	Belching		Belching of something rotten some time after eating.
	Stool disorders		Constipation is the most common concern, although diarrhea is also possible.
	Bloating		Feeling of fullness in the abdomen, increased release of gases.
	Increased liver size	The liver enlarges as a result of the inflammatory process in it and stagnation of blood in the hepatic vessels.	Determined by the doctor during examination and ultrasound.
Symptoms indicating fibrosis and cirrhosis of the liver, manifestations of liver failure	Liquid in abdominal cavity(ascites)	Varicose veins blood vessels portal vein compress the lymphatic ducts, which normally contribute to the drainage of fluid from organs and tissues. This causes water retention in the abdominal cavity.	The size of the abdomen increases significantly, like that of a pregnant woman. When puncturing the abdominal cavity with ascites, you can get 10 liters of fluid or more.
	Spider veins	Spider veins are additional small vessels or anastomoses that pathologically form between larger vessels as a result of obstruction of blood circulation through the portal vessels.	Spider veins in such patients are detected to a greater extent on the abdomen and shoulders.
	Muscle weakness and weight loss	Muscles are formed from glycogen, which is formed from glucose in the liver. This function is impaired in liver fibrosis; the muscles lack building material.	There is flabbiness and weakness of the muscles, they decrease in size, the patient cannot cope even with small physical activities.
	Reduction in liver size	With complete replacement of liver tissue with connective tissue, the size of the organ decreases significantly. And given the fluid in the abdominal cavity, doctors describe such a liver as “floating.”	Changes in the size of the liver and spleen can be detected by a doctor when examining and palpating the abdomen, as well as when examining the abdominal organs using ultrasound, CT or MRI diagnostics.
	Enlarged spleen (splenomegaly)	The spleen deposits blood; when there is stagnation in the portal vessels, a larger amount of blood collects in it. Also, the spleen is loaded with additional work that the liver does not perform, namely, it participates in the processes of destruction of spent red blood cells and hemoglobin.
	Increasing symptoms of intoxication, jaundice and digestive disorders	All symptoms that could be observed in a patient with chronic hepatitis, are aggravated, which is associated with an increase in liver failure (“liver failure”). Symptoms of damage to the central nervous system toxins that are not utilized by the liver.	Constant weakness and fatigue; tremor of the limbs; disturbance of mental activity; mental disorders (depression, apathy, mood swings); persistent sleep disturbance; convulsions are possible; jaundice becomes permanent, skin color becomes sallow; the patient cannot perform even minor physical activity; any meal is accompanied by nausea, bloating, frequent vomiting, food preferences are distorted.
	Impaired blood clotting, bleeding	The liver is involved in the formation of some blood clotting factors. As liver fibrosis increases, this function is impaired and the blood becomes too thin. The situation is aggravated varicose veins portal vessels.	The patient develops bleeding from varicose veins of the esophagus, gastric, and intestinal bleeding. In addition, small hemorrhages and bruises (petechiae and hemorrhages) can be seen on the skin.
	"Liver palms"	This symptom also develops due to poor circulation and the formation of anastomoses.	The palms and feet become bright red.
	Atrophic glossitis (death of filiform papillae of the tongue)	Atrophy of the tongue papillae is a consequence of poor circulation and nutritional deficiency.	The tongue becomes bright red and shiny - “varnish tongue”.
	Pulmonary heart failure	Poor circulation in the portal vessels and swelling lead to changes in general blood circulation. At the same time, “excess” fluid also accumulates in the lungs, which can lead to pulmonary edema. Cardiac and respiratory failure develops.	An increase in blood pressure is replaced by a sharp decrease; shortness of breath, observed even at rest, possible development of suffocation; hacking cough; swelling of the limbs and face.

The first signs of hepatitis C

In acute hepatitis C with a manifest course, the first signs are symptoms of intoxication (fever, weakness, joint pain, headaches, etc.), that is, a flu-like condition, against which jaundice appears after 7-10 days.

But in most cases, the first manifestations of hepatitis C are symptoms of liver cirrhosis and liver failure, that is, many years after the onset of the disease.

Signs of chronic hepatitis C:

regular increase in body temperature to 37.5-38 o C;
nagging pain in the right hypochondrium;
periodic nausea, bloating after eating;
spider veins on the skin of the body.

Features of the course of hepatitis C depending on the genotype of the virus

Scientists have proven the relationship between the course of hepatitis C and the genotype of the virus that affects the liver. Of course, there is still a lot of unknowns in this direction, but some data have already been obtained.

HCV genotype 1, especially 1b – more often than other genotypes, it causes a severe and malignant course of the disease. Hepatitis caused by HCV genotype 1 requires more long-term treatment and large doses of drugs. Genotype 1b carries a poor prognosis. It is this genotype that is most common in Russia.

HCV genotype 2– more often cause a mild or moderate course of hepatitis C, such hepatitis is easier to treat, in most cases there is a favorable outcome (recovery and restoration of the liver).

HCV genotype 3– such hepatitis also in most cases is milder and has good forecasts, however, most often it is this genotype that contributes to the development of fatty hepatosis.

The characteristics and patterns of other genotypes are still being studied.

However, there are cases when hepatitis C is caused not by one, but by several genotypes of the virus, then such a disease is much more severe and dangerous due to its complications.

What do people with hepatitis C look like?

Photo: eyes of a patient with hepatitis C, yellowness of the sclera.

Photo: jaundice.

Photo: dark urine with hepatitis C.

Photo: this is what a patient with cirrhosis of the liver may look like (increase in abdominal volume, dilation of blood vessels on the anterior abdominal wall, atrophy of the muscles of the upper shoulder girdle, yellowness of the skin).

Photo: liver palms.

Features of the course of hepatitis C in men and women

Scientists have proven that hepatitis C in women is much more favorable than in men. The fair half of humanity produces antibodies to HCV faster and has a lower risk of developing chronic hepatitis and liver cirrhosis.

Just why this happens is still not known. Perhaps men lead a more irregular lifestyle, more often allow themselves to drink a glass or two with or without a reason, love to eat, work a lot, and listen less to their body.

What is the hepatitis C virus, how does it penetrate and multiply in liver cells - video

Diagnosis of the disease

Data from laboratory and instrumental studies are the main criteria for diagnosing hepatitis C, and sometimes the only signs of the disease.

Blood test for antibodies (markers) to hepatitis C

Detection of antibodies refers to serological reactions. This is a blood test to determine the presence and state of immunity to the hepatitis C virus.

To diagnose viral hepatitis C, the level of the following antibodies is determined:

Total class G antibodies to HCV (Ig G anti HCV);
Immunoglobulins M and G to HCV nuclear antigens (Ig M anti HCV core, Ig G anti HCV core);
Antibodies to non-structural antigens (anti HCV NS).

Markers also include a study to identify the genetic material of the virus, that is, PCR diagnostics.

Table. Interpretation of the results of a blood test to determine antibodies to hepatitis C.

Diagnosis	Result
Diagnosis	Ig G *anti* *HCV*	*Ig M anti HCV core*	*Ig G anti HCV core*	*anti* *HCV* *N.S.*	*RNA* *HCV*
Healthy (normal)	-	-	-	-	-
Carriage or previous history of hepatitis C	+	-	+	-	-
Acute hepatitis C	- or +*	+	- or +	-	+
Reactivation of chronic hepatitis C	+	+	+	+	+
Remission of chronic hepatitis C	+	-	+	+ or -	+ or -**
HCV + HIV at the AIDS stage (4 cell stage)	-	-	-	-	+

* Class G immunoglobulins for hepatitis C appear only 2-4 months after infection.
** During remission of chronic hepatitis C, the virus can remain in the patient’s body or be eliminated (disappear).

"-" Negative result, that is, no antibodies or RNA of the virus were detected.
“+” Positive result, HCV antibodies or RNA detected.

PCR diagnostics (RNA determination) and hepatitis C viral load

Unlike the previous serological test for hepatitis C, PCR does not detect immunity, but the genetic material of the virus itself - RNA.

There are two types of PCR diagnostics of hepatitis C:
1. Qualitative determination of HCV RNA – the hepatitis C virus is detected or not detected. For primary diagnosis, this type of PCR is used.
2. Quantitative determination of HCV RNA, or viral load – used to determine the concentration of the virus in the blood. The viral load allows us to assess the dynamics during treatment and indicates how infectious the patient is. The higher the viral load, the greater the likelihood of infection of a person in contact with his blood.

PCR is the most accurate method for diagnosing any infectious disease (over 98-99%), but only if it is carried out correctly.

In addition to identifying the virus itself, PCR can be used to determine the genotype of the virus, which affects the course of the disease and treatment tactics.

What does doubtful, false positive and false mean? negative result test for hepatitis C?

About a false positive they say when, in the presence of class M immunoglobulins for hepatitis C, the hepatitis C virus is not detected by RNA PCR.

This result requires a retake of the analysis.

False negative test for hepatitis C usually received in incubation period diseases, doctors call this period the immunological window. During this period, a person is already infected with HCV, but does not yet have immunity to it, and there are no symptoms of the disease.

Can a hepatitis C test be wrong?

Yes, any laboratory diagnostics has an error rate. But such incidents are possible in relation to only ELISA or only PCR. Therefore, when diagnosing hepatitis C, it is necessary to conduct both types of research. By the way, PCR for HCV can give false result if the cleanliness in the laboratory is violated or the laboratory technician is inexperienced.

How can hepatitis C be detected immediately after infection (for example, after a blood transfusion or needle stick)?

It will be possible to accurately answer the question of whether infection with viral hepatitis occurred or not earlier than after 3 months, then the blood will be examined for markers of HCV. A preliminary result is possible after 2 months, but there is a high probability of error.

Before donating blood for hepatitis C

Preparing for this species no study is required; this analysis, unlike liver tests, does not require the patient to be on an empty stomach. As with other types of ELISA tests, it is not advisable to eat fried, fatty, spicy and salty foods the day before, or drink alcohol.

How long does it take to test for hepatitis C?

Often markers for hepatitis C are ready the next day after the test, no later than 7 days. It all depends on the laboratory, the need to deliver the material and results, and diagnostic methods.

Where can I get tested for hepatitis C and how much does it cost?

A test for hepatitis can be taken at any medical institution, both public and private, where only blood is drawn. The diagnosis itself is carried out in laboratories of infectious diseases institutions, immunological and private laboratories.

In clinics and hospitals, a doctor's referral is required. Laboratories can do analysis without a referral and even anonymously.

The average cost of the study ranges from 15 to 60 USD. e.*

*price is indicated in US dollars due to instability of exchange rates.

Rapid test for hepatitis C. Where to buy, what is the price?

Nowadays, there is a huge number of tests that can be carried out without leaving home, a kind of “laboratory in your pocket.” These are various rapid tests, which are mostly presented in the form of litmus soaked special reagents. You can examine blood, urine, saliva.

Such a rapid test also exists for the diagnosis of hepatitis C. It is based on the determination of total antibodies to HCV (Ig G anti HCV) in the blood.

Such a test can be bought in pharmacies, ordered on official websites on the Internet or in special medical equipment stores. The price averages 5-10 USD. e.

Technique for performing a rapid test for hepatitis C:

wash and treat your hands with an alcohol wipe;
Use a special needle (scarifier), which is included in the package, to pierce the fingertip treated with a napkin;
use a pipette to collect 1 drop of blood;
drop the blood into a special test window marked S, then add 2 drops of the reagent there;
the result is assessed after 10-20 minutes, no later.

Evaluation of the results of a rapid test for hepatitis C:

negative result – the presence of one red stripe opposite mark C;
a positive result is the presence of two red stripes opposite the C and T marks, while the second strip may be of less intensity;
the test is invalid - if there are no stripes or if there is one strip opposite the T mark, such a test must be redone.

If there is a positive result, you should immediately consult a doctor for additional research. No diagnosis is made based on express diagnostics.

General blood analysis

With hepatitis C, a general blood test may be completely normal. But in most cases, the following changes can be detected in a blood test:
A biochemical blood test allows you to assess the condition of the liver and its functions. After all, the liver is the “laboratory” of our body; if its functioning is disrupted, the metabolism of many chemicals suffers. Therefore, monitoring blood biochemistry parameters for hepatitis C is mandatory. For this study, venous blood is taken.

Liver tests for hepatitis C

Index	Norm	Changes that may occur with hepatitis C
Alanine aminotransferase (ALT)	Up to 40 IU (from 0.1 to 0.68 µmol/l)	*Aminotransferases* (ALT and AST) are enzymes released during the destruction of hepatocytes. In acute hepatitis C and reactivation of chronic hepatitis, liver destruction occurs, therefore *ALT and AST are elevated* , and tens of times. This is the most consistent indicator for hepatitis C, even in the absence of any symptoms of the disease. If, against the background of reactivation of chronic HCV, aminotransferases decrease, this may indicate the development of liver cirrhosis, in which there is nothing left to be destroyed.
Aspartate aminotransferase (AST)	Up to 40 IU (from 0.1 to 0.45 µmol/l)
Bilirubin	Total bilirubin: up to 20 µmol/l: straight: up to 5; indirect: up to 15.	When hepatocytes are destroyed, a large amount of unbound bilirubin enters the blood, which is manifested by jaundice. Wherein *total bilirubin increases due to the direct fraction* . Bilirubin can be increased 10-100 times. With an indicator of *200 µmol/l* the central nervous system is damaged, this is the so-called hepatic encephalopathy and coma.
Thymol test	Up to 5	Reflects the state of protein metabolism. With increasing liver failure *thymol test increases* .
Gammaglutamate transferase (GGT)	For women: 6-42 U/l, For men: 10-71 U/l.	GGT is an enzyme involved in protein metabolism in the liver. This indicator *increases significantly* (up to 50 and above) with the development of liver cirrhosis.
De Ritis coefficient	1,3 – 1,4	This *ratio of ALT to AST levels.* In acute hepatitis C, this indicator decreases below 1, and in chronic hepatitis, on the contrary, it increases to 2 and above.

The ALT indicator reflects the dynamics of the course of hepatitis C; it is used to determine the severity of the disease.

Determination of the degree of HCV hepatitis depends on the ALT level

Changes in other biochemical blood parameters in hepatitis C:

decreased albumin levels (normal 20-36 mmol/l);
increased levels of gamma globulins (normal 30-65 mmol/l);
increased cholesterol levels (normal 3.4-6.5 mmol/l);
increased iron concentration in the blood (normal 10-35 µmol/l).

reduction or increase in size;
surface roughness;
deformation of the liver shape;
the structure of the liver in the form of a mosaic;
thickening of the walls of the portal vessels, disruption of blood flow through them;
increase in the size of the spleen;
the presence of fluid in the abdominal cavity.

Liver biopsy

Liver elastography

new method

Immunogenetic studies

In this case, immunogenetic markers are identified:

fibrogenesis factors;
immunoregulatory proteins.

Hepatitis C: prevalence of the disease, complications, mechanism of infection, symptoms, diagnosis, risk groups - video

What is the hepatitis C virus? The mechanism of hepatitis C disease, diagnosis, treatment (drugs, diet) - video

Hepatitis C: which organs does HCV affect? Complications of hepatitis C. Diagnosis (where to get tested for hepatitis C), treatment - video

Before use, you should consult a specialist.

Among viral diseases, hepatitis C is one of the most dangerous pathologies. This viral infection attacks the liver and gradually destroys it. How dangerous is hepatitis C? Hidden Current disease leads to the development of a chronic inflammatory process in the liver tissues. This makes timely diagnosis difficult and complicates treatment.

But the greatest danger of hepatitis C is high probability development of cirrhosis and liver cancer.

According to the World Health Organization published in 2016, hepatitis C virus (HCV or systemic HCV infection) is considered a pandemic. The virus has infected about 150 million people worldwide, and the annual mortality rate is about 670 thousand people.

Development and characteristics of the virus

Once in the body, HCV spreads throughout the bloodstream and invades liver cells, which mutate. The immune system identifies its own hepatocytes as harmful and destroys them.

Hepatitis C has an incubation period that can last from 2 weeks to several months. Then comes the acute phase, in which the immune system tries to fight the virus. But the body rarely copes on its own. After the acute phase, the chronic course of the disease begins.

The disease is dangerous because it is almost impossible to recognize it at an early stage.. Its signs appear at the stage of chronicity of the inflammatory process.

Patients infected with systemic HCV infection exhibit the following characteristic symptoms:

The peculiarity of VSG is that the virus, capturing new liver cells, constantly mutates. The immune system does not have time to respond to changes in a timely manner with adequate antibody production. As a result, infected cells multiply faster than T lymphocytes, and widespread liver damage occurs.

Hepatitis C is called the “gentle killer” due to the latent course of the pathology.

Hepatitis C is the most dangerous of hepatitis because it is difficult to cure, and in some cases treatment is not possible. Also, the danger of this infectious pathology is that there is no vaccine against it. A person who has had HCV and is completely cured does not acquire immunity and is susceptible to re-infection.

Routes of infection and danger to others

There are several ways of becoming infected with the hepatitis C virus. It is transmitted through direct contact with infected blood when:

The infection can also be transmitted sexually through unprotected sexual contact. Also at risk are children who can be infected during the prenatal period if the mother has the virus.

Carriers of the virus can pose a potential threat to others if the disease is not diagnosed.

Is hepatitis C contagious through household contact? HCV infection can pose a threat if the rules for using personal belongings are violated. In the immediate environment or in one’s own family, a person with hepatitis C can be a source of danger only if the rules of personal hygiene are not observed.

Infection is possible if you use personal items of a sick person with traces of his blood ( Toothbrush, razor).

Hepatitis C is not transmitted through tactile contact, such as hugging, kissing, shaking hands, or touching the skin.

The danger of hepatitis C for the patient

Viral hepatitis is a complex disease with multiple complications and difficult treatment. In most cases, HCV is diagnosed when the disease is already chronic. During the chronic stage of the inflammatory process caused by hepatitis C, the liver is subject to many pathological changes.

Hepatitis C has several genotypes, of which genotypes 1b and 3a are the most dangerous.

Hepatoses

Primary liver damage during HCV infection is various hepatoses (fibrosis). As a result of inflammation of the parenchyma and massive death of hepatocytes, liver tissue is partially replaced by adipose connective tissue. Liver functionality decreases, which negatively affects all dependent systems of the body. Hepatoses are precursors of liver cirrhosis.

Cirrhosis

The final stage of fibrosis caused by the viral form of hepatitis is cirrhosis of the liver, which is an incurable disease.

The course of cirrhosis is complicated by such clinical manifestations as:

All cirrhotic manifestations pose a threat to life, as they can lead to internal bleeding, toxic poisoning the whole body, liver failure, etc. All these consequences are fraught with death.

Liver cancer

A particularly dangerous consequence of hepatitis C is. This is a type of liver cancer that develops in 3% of patients with this form of hepatitis. Carcinoma is characterized by rapid growth with extensive metastasis to adjacent organs. Most often, metastases penetrate the diaphragm and lungs.

Treatment of liver cancer is possible only in the early stages. For this purpose, chemotherapy, radiation exposure or.

In addition to hepatic pathologies, HCV infection is accompanied by extrahepatic manifestations. Hepatitis C affects peripheral nerves and can cause cryoglobulinemic vasculitis (destruction of blood vessels) and glomerulonephritis (damage to renal tubules). Infection for the digestive, endocrine and reproductive systems is also dangerous.

One possible consequence of hepatitis C may be malignant B-cell lymphoma.

Treatment and prevention

Hepatitis C can be completely cured only in the early stages. In its treatment, combination therapy with antiviral drugs (Ribavirin) and interferons is used. But more modern and effective is DAA or direct antiviral therapy using direct-acting drugs (Daclatasvir, Narlaprevir), without the addition of interferons.

In the stage of decompensation, with a chronic course of the disease, it is required complex treatment . Therapy is aimed at both stopping the causative agent of the disease and treating secondary diseases caused by a virus.

Preventive measures that help prevent the occurrence of pathology or minimize its consequences are as follows:

invasive procedures should only be performed using sterile instruments;
compliance with sanitary and hygienic requirements;
preventing unprotected sexual intercourse.

What are the dangers of HCV if there is no timely treatment? In this case, the consequences of hepatitis develop very quickly and lead to the death of the patient.

Forecast

A favorable prognosis for the life of patients with the hepatitis C virus can only be if timely treatment is carried out in compliance with all the requirements of the attending physician. In the chronic stage of the disease, preventive maintenance treatment, diet, refusal bad habits allow patients to lead a full life.

The high cost of treatment is an obstacle to recovery for a large number of patients. Lack of medical care and ignoring doctor’s orders leave no doubt about the unfavorable outcome of the disease.

Judging by the fact that you are reading these lines now, victory in the fight against liver diseases is not yet on your side...

Have you already thought about surgery? This is understandable, because the liver is very important organ, and its proper functioning is the key to health and well-being. Nausea and vomiting, yellowish tint to the skin, bitterness in the mouth and bad smell, dark urine and diarrhea... All these symptoms are familiar to you firsthand.

But perhaps it would be more correct to treat not the effect, but the cause? We recommend reading the story of Olga Krichevskaya, how she cured her liver...

Today the relevant questions are: what is the danger of hepatitis C, how to defeat it. This problem worries many people around the world, it is extremely important for those diagnosed with hepatitis. Hepatitis C is mortal danger, the sooner you start therapy, the greater the likelihood of getting a successful result, the chances of defeating the disease are quite good.

Hepatitis C is a viral disease caused by a virus belonging to the Flaviviridae family (HCV), which contains RNA (ribonucleic acid). In this case, the liver becomes infected with an infection that mainly affects people young. The Hepatitis C virus is dangerous for the development of fibrosis, subsequent cirrhosis of the liver, and death. In most countries of the world, the disease represents a huge medical, social and economic problem.

Features of a dangerous disease

To understand why hepatitis C is dangerous, it is necessary to define it. Hepatitis C refers to inflammation of the gland caused by a virus. There are 7 different hepatitis viruses: A, B, C, D, E, F, G. The most common viruses are A, B, C. The HCV viral disease consists of 6 types (genotypes), which consist of 30 subtypes. The peculiarity of Hepatitis C disease lies in its ability to constantly change, which makes it impossible to develop an effective vaccine against the disease. When an infection enters the bloodstream, viruses are distributed throughout all parts of the body. Liver cells provide ideal conditions for infection to multiply, as a result of which they begin to decompose.

An inflammatory infection is the body's attempt to fight disease. Without treatment, HCV disease becomes chronic. When shrinkage of the gland occurs with loss of its functions, this characterizes the development of cirrhosis as a consequence of the Hepatitis C virus, hepatocellular carcinoma, an irreversible process as a result of malignant degeneration of hepatocytes (liver parenchyma cells). The only way to save life is a gland transplant, its transplantation from a donor to a recipient.

If you carry out quality treatment With the help of highly effective medications, therapy will slow down the progression of the harmful process, leading to good remission. Infection with the Hepatitis C virus occurs through direct contact through blood or tissue containing the infection. The most common routes of infection are:

intravenous injection of narcotic substances; blood transfusion; contact with infected blood; transmission routes through dried blood, for example, on razor blades, dressing materials; sexual contact with an infected person.

The ability to infect others is acquired at the time of infection and lasts as long as the Hepatitis C virus is present in the blood. After introduction into the body, the virus multiplies quickly, the liver tissue degenerates into connective tissue, and the functions of the gland are limited.

Natural history of Hepatitis C

There may be an incubation period of 1-6 months from infection to the onset of the first symptoms. After this, acute hepatitis develops. The likelihood of an accurate diagnosis at this time is low, since the disease is asymptomatic.

Hepatitis C can be acute or chronic. The acute form often turns into a chronic form; it is diagnosed extremely rarely, since the disease does not manifest itself in this form, and patient complaints during this period are uncharacteristic. Most patients are asymptomatic; 15-20% of patients complain of fatigue, decreased performance, anorexia, and jaundice. When symptoms appear acute infection healing occurs, but this happens extremely rarely.

In medical practice, extrahepatic manifestations of hepatitis occur. These include: lesions peripheral nerves, membranoproliferative glomerulonephritis, Sjogren's syndrome. Possible symptoms - diabetes, lichen planus, immune thyropathy. As the disease progresses, the mood of those infected decreases and their general physical condition worsens. The immune system of sick people cannot fight the virus on its own without effective outside support.

Detecting a viral liver infection

Few of those infected know that they are carriers of the virus. They observe:

fast fatiguability; bad feeling; loss of appetite; loss of performance; joint pain.

These symptoms cannot accurately diagnose hepatitis C; they are not specific. To find out the presence of the virus in the body, they are tested for markers of infection with the Hepatitis C virus. Markers are total antibodies to Hepatitis C antigens.

Antibodies are protein substances produced when foreign substances, for example, the hepatitis virus, penetrate and influence the body. For every foreign substance human body produces specific antibodies.

Antibodies to the Hepatitis C virus can only be detected 5-6 weeks after infection. When antibodies are detected, it is difficult to describe the nature of the disease (acute, chronic, past - cured).

For detection, a PCR test is used, which is the most sensitive method for detecting RNA virus. The test can detect viral load, which reflects the amount of viruses in the blood. To treat an infection, it is very important to determine the viral load.

A complete characterization of the Hepatitis C virus is impossible without determining its genotype. Genotyping makes it possible to determine the duration of therapy. A complete picture of a patient’s liver damage to the HCV virus is impossible without ultrasound examination and sonography of the upper abdomen. The analysis allows you to assess the size, structure, shape of the gland, record signs of developing cirrhosis, examine blood flow in the portal vein, identify signs of portal hypertension and other symptoms of a progressive dangerous disease.

For a more detailed assessment of the condition, a biopsy of the gland is performed. To carry it out, the patient takes a lying position, the puncture site is fixed with ultrasound, and local anesthesia is administered. The liver is pierced with a long needle and a sample of liver tissue is taken. The analysis is sent for further research, for example, to the Institute of Pathology. The results are sent to the attending physician. The non-invasive fibroscanning procedure is an alternative to biopsy, giving an idea of the density of the liver tissue and the development of fibrosis. Detection of early stages of fibrosis by fibroscanning is impossible.

Modern therapy for those infected with the virus

The earlier this disease is diagnosed, the greater the patients' chances for a complete cure. If studies confirm the suspicion of HCV, the doctor decides to start therapy. It can be performed on an outpatient basis and is based on the nature of the liver damage. Indications for therapy are bridging fibrosis and compensated cirrhosis of the liver. The goal of antiviral therapy is the prevention of adverse outcomes of chronic viral hepatitis C, hepatocellular carcinoma, and liver cirrhosis. Today, it is possible to treat hepatitis C with a combination of interferon and ribavirin.

The main factors for successful therapy include the optimal dosage and duration of treatment. Doses of some drugs depend on the patient’s body weight, are calculated by the doctor for each patient individually, or are fixed. The duration of therapy is determined by the genotype of the virus. For infection with genotype 1, treatment lasts 48 weeks, for genotypes 2 and 3 - 24 weeks, for genotypes 4 and 6 the course of treatment is 48 weeks, for genotype 5 the recommendations are insufficient. In the Russian Federation, combination therapy with standard Interferon subcutaneously or intramuscularly in combination with Ribavirin, also an inhibitor of hepatitis C virus protease, is common.

Not all modern residents can answer why hepatitis C is dangerous. Meanwhile, a disease of an infectious nature is extremely dangerous both for the patient himself and for those around him. In most cases, the pathology proceeds almost unnoticed, which is why among doctors the disease is called the “gentle killer.”

Dangerous hidden illness

How can you become infected with hepatitis C?

The modes of transmission of hepatitis C are as follows:

The virus is transmitted parenterally (through blood in the case of using non-sterile medical instruments, syringes, etc.). Among drug addicts, the number of patients with hepatitis C is extremely high. The virus can also pass through household piercing and cutting objects (manicure utensils, razors, etc.) Hepatitis C passes from one sexual partner to another (sexual transmission is also common; similar to sexually transmitted diseases, HIV infection is most often contracted by it people leading an immoral lifestyle). Intrauterine transmission of the hepatitis C virus (the disease passes from a pregnant woman to the fetus only if the disease was acute at the time of pregnancy).

Consequences of the disease and chances for a healthy life

The likelihood of its degeneration into a malignant tumor or cirrhosis of the liver without the lack of proper maintenance therapy is quite high.

You can make a reliable forecast and answer the question of how long a patient with hepatitis C can live by assessing the rate of progression of the pathology.

The rate of development of the disease is largely determined by the patient’s lifestyle.

In addition to maintaining proper nutrition, a patient who is a carrier of the virus must completely eliminate bad habits. Sources of toxic liver damage, which include drugs, alcohol in any form, cigarettes, etc., serve as impetus for the accelerated progress of the pathology. The psycho-emotional component of the patient’s lifestyle is also considered important. There should be no stress, anxiety or worry in his daily life. Any nervous shock is a lever for triggering the mechanism of irreversible action. In addition, systematic visits to a specialist in the field of infectious disease and routine examinations for patients with hepatitis C cannot be excluded in any case.

Thanks to medical examination, doctors will have a real idea of the condition of the liver and the body in general. If only developing signs of exacerbation are detected, the patient has a chance to contain the progression of the disease by unquestioningly following medical orders and nutritionist recommendations regarding nutrition and lifestyle.

Is there a risk of hepatitis from tactile contact?

The transition of the disease to severe stages (cirrhosis, cancer) may not occur at all, it all depends on the patient. With a responsible approach to treatment, the patient can live a long, happy life without causing serious problems to anyone.

Hepatitis C is absolutely not scary for others if they shake hands with a carrier of the virus. The disease is also not transmitted through hugs or kisses. However, when infected with hepatitis C, the consequences for the patient can be very unpredictable.

The secrecy and absence of characteristic symptoms of hepatitis C became the main reason for the rather late study of the virus and its characteristics.

Diagnosing it using an ordinary clinical blood test is problematic, and drawing up a treatment plan for it is no less difficult.

Spread of the virus

In Russia, doctors began to deal with hepatitis C issues a little over 20 years ago. Despite the fact that during this time a lot has been done to combat the “gentle killer,” it is still impossible to completely cure patients from chronic hepatitis.

Definitely, even long-term remission, which can be observed in most cases of chronic hepatitis C, is considered an achievement.

By transferring the virus from the active to the inactive phase, doctors are able to minimize the risks of complications of the disease.

We should not forget that:

The infection is widespread. The absence of symptoms lulls people's vigilance. Hepatitis C can only be detected by a blood test.

In the early stages, the disease detected can be completely cured. In severe and advanced forms of the pathology, often the only salvation for the patient is a liver transplant.

Caused by the blood-borne hepatitis C virus. Hepatitis can be acute or chronic, and is dangerous due to its complications in the form of cirrhosis and liver cancer. Chronic hepatitis C has a long course and may not manifest itself in any way for many years.

Some statistics!

A little history!

The hepatitis C virus was discovered relatively recently, in 1989, which is even later than HIV infection. Before this, hepatitis A and B viruses were already known, and their clinical picture was described in detail. But doctors identified patients who had symptoms of hepatitis, but the hepatitis A and B viruses were not detected, and even for 2 decades this pathology was called “neither A nor B” hepatitis. Considering the relatively short period of observation of this pathology, doctors have not yet fully studied the hepatitis C virus, especially with regard to effective treatment, but scientists around the world are conducting intensive research in this direction.

Interesting Facts!

Hepatitis C is called the “gentle killer.” This is due to the fact that the disease can be asymptomatic or asymptomatic, but irreversible changes occur in the patient’s liver, leading to the death of a person. Hepatitis C is the most common blood-transmitted disease. Prevention of hepatitis C is easier to prevent than to treat. So the prevention of this disease is a priority all over the world. More than half of cases of hepatitis C lead to the development of chronic hepatitis, which in 15-50% ends in cirrhosis of the liver. In 75% of patients with liver cancer, chronic hepatitis C is diagnosed. Modern antiviral drugs can cure hepatitis C. Despite the fact that doctors combine hepatitis A, B, C, D, E and others into one group of diseases, all these viruses differ significantly in their structure and belong to different genera and families, the only thing that unites them is the ability to infect liver. Hepatitis C can be infected in a hospital, beauty salon and dental office, so few people are 100% insured against this disease.

The causative agent is hepatitis C virus (HCV or HCV)

Place of the hepatitis C virus in the kingdom of living organisms:

Kingdom: RNA virus; Family: Flaviviruses (Flaviviridae), from the Latin “yellow”; Genus: Hepavirus (Hepacivirus); Species: Hepatitis C virus.

Characteristics of the hepatitis C virus

Characteristic	Hepatitis C virus
Dimensions	30-60*10 -9m
Where does the virus multiply?	In liver cells - hepatocytes.
Genotypes – types of viruses that differ in the set of certain genes. Each genotype has its own subtypes - quasi-species, which are constantly subject to mutation.	Genotype 1 - a, b, c; genotype 2 - a, b, c, d; genotype 3 - a, b, c, d, e, f; genotype 4 - a, b, c, d, e, f, g, h, i, j; genotypes 5 a and 6 a. Worldwide, the most common genotypes are 1, 2 and 3. In Russia, genotypes of the virus C 1a and b are more common, less often 2 and 3. Genotypes 4, 5, 6 are often found in African and Asian countries.
Who is affected?	Only human.
Antigens or proteins of the virus – protein molecules that make up the virus.	Shell proteins: E1 and E2; core proteins: HCV cor antigen; non-structural proteins: NS 2, 3, 4, 5; other proteins: F, P7 and others. In laboratory diagnostics, the determination of antibodies to HCV cor, NS 3, 4, 5 antigens is used.
Antibodies or immunoglobulins – specialized immune cells that are produced in the body in response to the introduction of a virus.	The body produces antibodies to each of the proteins (antigens) of the virus. In laboratory diagnostics, the total amount of antibodies is determined.
How long does the virus live on the surfaces of objects?	The virus can survive exclusively in drops of blood, including dried ones. At room temperature and moderate lighting, the virus lives from 16 to 96 hours, meaning it is relatively stable in the environment. Freezing blood does not kill HCV.
Under what conditions does the hepatitis C virus die?	Boiling for at least 5 minutes; at a temperature of 60oC - at least 30 minutes; the use of chlorine-containing disinfectants, 70% alcohol and some other antiseptics must be combined with boiling; the virus is partially resistant to ultraviolet radiation, so it cannot be used for disinfection.
How much blood infected with hepatitis C must enter the body of a healthy person to infect him?	1/100 – 1/10000 ml, this is less than 1 drop.

Routes of transmission of hepatitis C virus

Parenteral route - through the blood

This is the main route of transmission of hepatitis C. This does not always require an infusion of infected blood; a drop of blood on various objects, including household ones, is enough.

Conventionally, several risk groups for hepatitis C infection can be distinguished:

1. People who inject drugs drugs are the main group of people infected with hepatitis C, which is why it is also called “drug addicts’ hepatitis”. This is due to the fact that the drug addict does not always use individual syringes. In addition, some “drug chemists,” when preparing a drug, add their own blood to it to cleanse the resulting solution of sediment. That is, a drug addict, buying a dose of the solution, can receive hepatitis viruses or even HIV as a “bonus”.

Procedures during which you can become infected with hepatitis C: manicure and pedicure for cuts; tattooing; piercing; shaving; haircut for damaged skin; some cosmetic procedures that can lead to damage to the integrity of the skin.

3. Patients receiving medical services (medical hepatitis):

Transfusion of donor blood products that have not undergone proper testing, including from a donor who at the time of blood donation had the hepatitis C virus, but has not yet developed antibodies to it (seronegative window). For your information, until 1992, donated blood was not tested for hepatitis C, so people who received a blood transfusion before this period are considered to be at high risk for hepatitis C (if the person is not examined). Treatment at the dentist, unfortunately, often becomes the cause of hepatitis infection , especially hepatitis B. People undergoing hemodialysis have an average risk of infection with hepatitis. Surgeries and dental treatment cause transmission of hepatitis C quite rarely, but this route of infection is possible, especially in underdeveloped countries and among unscrupulous medical workers. 4. People providing health services(medical workers) – have a relatively low risk of infection. The most common patients with hepatitis C are surgeons, pathologists, dentists, laboratory assistants and nursing staff. Accordingly, the risk group includes manicurists and pedicurists and other beauty salon workers.

5. Other persons at risk of becoming infected with hepatitis C through blood:

Police officers, prison officers, military personnel who may become infected during the detention of criminals, providing first aid for injuries and in other situations. At home: if there are patients with hepatitis C in the family. Household transmission is possible in rare cases, with non-individual use of a toothbrush, blades, razors and other hygiene products.

Sexual tract

Can you get hepatitis C through semen?

The hepatitis C virus lives only in the blood. The virus may be present in other biological fluids, but in a very small concentration, which is not enough for infection. That is, sperm and vaginal discharge cannot cause transmission of the virus.

Can you get hepatitis C through sex during your period?

Also during menstruation, the risk of hepatitis infection increases in women.

Is it possible to get hepatitis C through oral sex?

Oral sex, like vaginal sex, can cause the transmission of hepatitis C, but subject to the simultaneous presence of microtraumas or cracks in the mucous membranes.

Transplacental route - from mother to child

How is hepatitis C not transmitted?

By airborne droplets; by household contact; by communication; through saliva and kisses; by hugging and shaking hands; by using shared dishes; through toys; by using shared towels; other contacts that do not involve contact with blood. Therefore, there is no need to be afraid of a patient with hepatitis C. It is impossible to become infected with the hepatitis C virus through normal communication, cooperation, visiting children's groups and living together. Only in the case of various injuries that lead to disruption of the integrity of the skin, precautions are necessary.

Pathogenesis of the disease

What happens with viral hepatitis C?

1. Incubation period– from 14 days to six months or more, on average 49-50 days.

The virus enters the blood and is delivered with it to liver cells - hepatocytes. In the hepatocyte, the virus multiplies - RNA replication. The virus releases toxin proteins (antigens) into the blood, including those that destroy the cell wall of the hepatocyte (cytotoxic proteins). Hepatitis sets in, liver cells are gradually destroyed. The immune system begins to respond to the virus only after 1 month or even more. First, lymphocytes, macrophages, NK killers and other cellular immune cells come to the liver cells. Antibodies to the hepatitis C virus are not yet detected at this stage. 2. Period of clinical manifestations:

Liver enzymes are released from damaged liver cells, which further destroy hepatocytes. In response to proteins and the reaction of cellular immunity, the body produces immunoglobulins (antibodies) specific to hepatitis C. As a result, the amount of virus in the blood decreases sharply. Autoimmune reactions are involved in the process , that is, when the immune system perceives its cells as foreign. In this case, immunoglobulins to hepatitis C destroy the hepatocyte along with the virus, aggravating the course of hepatitis. 3. Recovery period:

Spontaneous cure of hepatitis C may occur, while HCV RNA in the blood is not detected, but whether the virus persists in the human body or not has not yet been established. It is believed that it remains inactive throughout a person’s life. Recovery occurs only if there is a good immune response.

4. Transition to the chronic form of hepatitis C:

When hepatitis C becomes chronic, the virus constantly mutates, changes and multiplies unhindered, and the produced immunoglobulins do not have time to respond to new mutations. The immune response ceases to be effective. With chronic hepatitis C, the death of liver cells occurs slowly and gradually, sometimes several decades can pass before cirrhosis of the liver. Against the background of hepatitis, fat metabolism in the liver is disrupted, which can lead to the development of fatty hepatosis (steatosis), that is when normal liver tissue is replaced by fatty tissue. Immunity is depleted and the liver is further destroyed. The cells that are primarily affected are T-lymphocytes. It is these cells that are damaged by HIV, so HIV and hepatitis C aggravate each other. Remission may occur with the risk of further relapses. The liver can partially recover (regenerate), but only if liver cirrhosis has not occurred. According to the results of pathological studies in people with HIV and HCV, it has been proven that the hepatitis C virus, in addition to liver cells, also affects other organs: the spleen, lymph nodes, lungs and others.

What is hepatitis C carriage?

What happens in the patient's liver?

Acute course of hepatitis C. The liver slightly increases in size, fills with blood (bright purple color), the surface is smooth and even. In the liver, a small number of foci of necrosis (destroyed tissue) are detected, and foci of fatty degeneration are identified. Blood flow in the liver is not impaired. For chronic hepatitis C the number of foci of necrosis increases, in place of the destroyed liver tissue, fibrosis is formed - the proliferation of connective tissue, which does not perform the function of hepatocytes. The liver continues to be enlarged. First, single fibrous cords are formed, then the connective tissue gradually replaces the liver tissue, that is, liver cirrhosis occurs. In this case, the liver decreases in size, shrinks, and becomes lumpy. A decrease in the number of normal hepatocytes leads to liver failure; the liver gradually or acutely ceases to perform its functions. For cirrhosis of the liver Blood circulation in the hepatic vessels is disrupted, portal hypertension syndrome and varicose veins of the hepatic vessels occur. In this case, additional vessels (anastomoses) are formed through which part of the blood circulates, bypassing the liver. Lack of blood and oxygen in the hepatic lobule contributes to further liver destruction, exacerbating liver failure. Hepatitis C virus affects the genetic material of liver cells, which can result in the formation of a cancerous tumor.

What does the liver of a hepatitis C patient look like (photo)?

Classification

Forms and types of hepatitis C

Acute course of HCV– is diagnosed only in one case out of five, this is due to the fact that the disease may not manifest itself clinically. In more than 70% of cases, acute hepatitis C becomes chronic. Chronic course of HCV– the most common form of hepatitis C, characterized by slow and gradual destruction of the liver. Fulminant (malignant or fulminant) hepatitis C– a variant of the acute course of hepatitis, in which rapidly progressive destruction of the liver occurs; in this form, liver failure develops 10-15 days from the onset of the first symptoms. This variant of hepatitis C, fortunately, develops quite rarely, less than 1% of all cases. Among the predisposing factors to the development of malignant hepatitis are: infancy, features of the genotype of the virus, infection with several types of hepatitis viruses (A, B, D), alcohol, drug and other liver damage. The mortality rate is about 70%.

Activity of chronic hepatitis C

Degrees of hepatitis C activity:

“Minimal” chronic hepatitis C; “mild” (mild) chronic hepatitis C; chronic hepatitis C with moderate activity; severe chronic hepatitis C.

When determining a particular degree of hepatitis C activity, the following criteria are used:

the degree of liver damage according to the results of a histological examination of a liver biopsy; the presence of fibrosis (connective tissue); the presence and severity of symptoms of the disease; laboratory parameters of liver tests (namely ALT - alanine transferase).

Stages of liver fibrosis in hepatitis C:

liver fibrosis absent; mild; moderate; severe liver fibrosis; liver cirrhosis.

ICD-10 code

An ICD code is assigned to each type of disease, according to international classifications. Encryption of the diagnosis is necessary for easier processing of information and organization of medical and social care, for understanding the diagnosis by doctors around the world, as well as for hiding the pathology if the patient does not want to advertise it.

Acute viral hepatitis C: B 17.1. Chronic viral hepatitis C: B 18.2.

Periods and phases of hepatitis C

1. Incubation period– this is the time from the moment of infection to the appearance of the first signs of the disease. With hepatitis C, this period can last from 14 days to six months, but on average 49-50 days.

Options for the course of the acute phase of hepatitis C: Latent or latent hepatitis - absence of symptoms or few symptoms - this is 8 out of 10 cases. Manifest hepatitis C - clear clinical manifestations, severity of symptoms - occurs only in 20% of cases. We can separately distinguish the pre-icteric period (lasting on average 10 days) and the icteric period. 3. The period of recovery (convalescence) of the acute phase of hepatitis C. Complete cure of hepatitis C is possible without specific therapy, but provided there is good immunity and the absence of concomitant liver pathologies. During this period, complete removal of the virus from the body (elimination) may occur, but this occurs only in 10-30% of cases.

4. The period of reactivation and transition to the chronic stage of hepatitis C, occurs with or without clinical manifestations. For most people, this period lasts for decades and can result in the development of cirrhosis or liver cancer.

5. Remission period of chronic hepatitis C, which is achieved as a result of a course of therapy with antiviral drugs. We can talk about remission when liver test results are normalized and the HCV RNA test results are negative. Any remission can result in a relapse.

The duration of each period may differ in each individual case.

Symptoms of acute and chronic hepatitis C

There are no symptoms of hepatitis C in most cases. In this case, only laboratory changes are detected. But with the manifest course of viral hepatitis C, a number of symptoms can be identified that are associated with changes in the liver and other organs. Compared to other types of infectious hepatitis, the manifestations of hepatitis C are less pronounced.

Possible symptoms and signs of viral hepatitis C

Group of symptoms	Symptom	Mechanism of symptom development	How does the symptom appear?
Intoxication syndrome	Weakness and malaise	Intoxication can be severe in acute hepatitis C, especially in the pre-icteric period. With chronic hepatitis C, the symptoms of intoxication are less pronounced, but are permanently chronic. Intoxication is associated with the action of the toxins of the viruses themselves, as well as the decay products of destroyed liver tissue and unprocessed toxins formed in the body. Also a toxin is bilirubin, a bile pigment whose levels are elevated. Toxins affect the entire body, especially the central nervous system.	This is an early, almost constant and most common symptom of hepatitis C, both acute and chronic. The patient is constantly tired, wants to sleep, and has difficulty getting out of bed in the morning.
	Decreased appetite		There is no appetite, up to a complete refusal to eat. Some patients develop an aversion to food.
	Increased body temperature		In the acute period, the temperature can rise to high numbers, above 38oC, and for the chronic course of hepatitis, periodic subfibrillation (temperature up to 38oC) is more typical.
	Runny nose, cough		Reminds me of a regular ARVI. The cough is dry, infrequent, mucous discharge from the nose, nasal congestion. This symptom is mild and usually goes away quickly.
	Aches in joints, muscles, muscle weakness		Pain in the limbs can be aching or sharp.
	Skin rashes		Skin rashes are a fairly common symptom of hepatitis C; it can appear in the pre-icteric period or against the background of jaundice. The rash can be different, most often in the form of red spots. But this rash is almost always accompanied by itchy skin. By the way, itchy skin can occur without rashes.
	Sleep disturbance		More often observed with chronic HCV. Patients confuse day with night, during the day they want to sleep very much, and at night they experience insomnia.
Increased blood bilirubin levels	Yellowness of the skin and visible mucous membranes	Jaundice may appear in the acute period of the disease (rarely) or with the development of complications of hepatitis. Bilirubin is a bile pigment that is formed during the destruction of blood cells - red blood cells. Normally, this substance enters the liver, where reactions between bilirubin and glucoronic acid occur. With viral hepatitis, the binding process of bile pigment is disrupted, resulting in large quantities of unbound (direct) bilirubin entering the blood. It accumulates in all tissues and organs, giving them a yellow color; we see icteric mucous membranes and skin. Bilirubin normally colors stool and urine. With hepatitis, bile pigments do not reach the intestines, so the stool becomes light-colored. At this time, excess bilirubin is excreted by the kidneys, which leads to the formation of dark urine.	Jaundice with hepatitis C can vary in intensity. In most cases, jaundice is mild; at first, patients notice only staining of the sclera. With further damage to the liver, the skin also becomes stained; with hepatitis C, the color first has a yellow-brown tint; in severe cases, it becomes greenish or lemon-colored.
	Darkening of urine		The color of urine in viral hepatitis is compared to the color of dark beer.
	Light chair		The stool becomes lighter than usual or completely discolored.
Complaints from the digestive system	Nausea, vomiting	These symptoms may be absent during the acute period of hepatitis or may be periodic. Disruption of digestive processes is associated with insufficient formation of bile and digestion of fats from food. As a result, the processes of fermentation, putrefaction and gas formation in the intestines intensify.	Nausea and vomiting may occur after eating food, especially fatty foods.
	Stomach ache		Usually the pain is in the right hypochondrium or in the umbilical region. They can be acute or spasmodic in nature.
	Belching		Belching of something rotten some time after eating.
	Stool disorders		Constipation is the most common concern, although diarrhea is also possible.
	Bloating		Feeling of fullness in the abdomen, increased release of gases.
	Increased liver size	The liver enlarges as a result of the inflammatory process in it and stagnation of blood in the hepatic vessels.	Determined by the doctor during examination and ultrasound.
Symptoms indicating fibrosis and cirrhosis of the liver, manifestations of liver failure	Fluid in the abdomen (ascites)	Varicose blood vessels of the portal vein compress the lymphatic ducts, which normally contribute to the drainage of fluid from organs and tissues. This causes water retention in the abdominal cavity.	The size of the abdomen increases significantly, like that of a pregnant woman. When puncturing the abdominal cavity with ascites, you can get 10 liters of fluid or more.
	Spider veins	Spider veins are additional small vessels or anastomoses that pathologically form between larger vessels as a result of obstruction of blood circulation through the portal vessels.	Spider veins in such patients are detected to a greater extent on the abdomen and shoulders.
	Muscle weakness and weight loss	Muscles are formed from glycogen, which is formed from glucose in the liver. This function is impaired in liver fibrosis; the muscles lack building material.	There is flabbiness and weakness of the muscles, they decrease in size, the patient cannot cope even with small physical activities.
	Reduction in liver size	With complete replacement of liver tissue with connective tissue, the size of the organ decreases significantly. And given the fluid in the abdominal cavity, doctors describe such a liver as “floating.”	Changes in the size of the liver and spleen can be detected by a doctor by examining and palpating the abdomen, as well as by examining the abdominal organs using ultrasound, CT or MRI diagnostics.
	Enlarged spleen (splenomegaly)	The spleen deposits blood; when there is stagnation in the portal vessels, a larger amount of blood collects in it. Also, the spleen is loaded with additional work that the liver does not perform, namely, it participates in the processes of destruction of spent red blood cells and hemoglobin.
	Increasing symptoms of intoxication, jaundice and digestive disorders	All symptoms that could be observed in a patient with chronic hepatitis are aggravated, which is associated with an increase in liver failure (“liver failure”). Symptoms of damage to the central nervous system by toxins that are not utilized by the liver appear.	Constant weakness and fatigue; dizziness; tremors of the limbs; impaired mental activity; mental disorders (depression, apathy, mood swings); persistent sleep disturbance; convulsions are possible; jaundice becomes permanent, skin color becomes sallow; the patient cannot perform even minor physical activity ;any meal is accompanied by nausea, bloating, frequent vomiting, and food preferences are distorted.
	Impaired blood clotting, bleeding	The liver is involved in the formation of some blood clotting factors. As liver fibrosis increases, this function is impaired and the blood becomes too thin. The situation is aggravated by varicose veins of the portal vessels.	The patient develops bleeding from varicose veins of the esophagus, gastric, and intestinal bleeding. In addition, small hemorrhages and bruises (petechiae and hemorrhages) can be seen on the skin.
	"Liver palms"	This symptom also develops due to poor circulation and the formation of anastomoses.	The palms and feet become bright red.
	Atrophic glossitis (death of filiform papillae of the tongue)	Atrophy of the tongue papillae is a consequence of poor circulation and nutritional deficiency.	The tongue becomes bright red and shiny - “varnish tongue”.
	Pulmonary heart failure	Poor circulation in the portal vessels and swelling lead to changes in general blood circulation. At the same time, “excess” fluid also accumulates in the lungs, which can lead to pulmonary edema. Cardiac and respiratory failure develops.	An increase in blood pressure is replaced by a sharp decrease; shortness of breath, observed even at rest, suffocation may develop; frequent dry cough; arrhythmia, increased heart rate; swelling of the limbs and face.

The first signs of hepatitis C

But in most cases, the first manifestations of hepatitis C are symptoms of liver cirrhosis and liver failure, that is, many years after the onset of the disease.

Signs of chronic hepatitis C:

chronic fatigue; regular increase in body temperature to 37.5-38oC; poor appetite; nagging pain in the right hypochondrium; periodic nausea, bloating after eating; spider veins on the skin of the torso.

Features of the course of hepatitis C depending on the genotype of the virus

HCV genotype 1, especially 1b – more often than other genotypes, it causes a severe and malignant course of the disease. Hepatitis caused by HCV genotype 1 requires longer treatment and higher doses of drugs. Genotype 1b carries a poor prognosis. It is this genotype that is most common in Russia.

HCV genotype 2– more often cause a mild or moderate course of hepatitis C, such hepatitis is easier to treat, in most cases there is a favorable outcome (recovery and restoration of the liver).

HCV genotype 3– this type of hepatitis also in most cases proceeds more easily and has a good prognosis, but most often it is this genotype that contributes to the development of fatty hepatosis.

The characteristics and patterns of other genotypes are still being studied.

However, there are cases when hepatitis C is caused not by one, but by several genotypes of the virus, then such a disease is much more severe and dangerous due to its complications.

What do people with hepatitis C look like?

Photo: eyes of a patient with hepatitis C, yellowness of the sclera.

Features of the course of hepatitis C in men and women

What is the hepatitis C virus, how does it multiply in the liver, what are the symptoms and complications of hepatitis C - video

Diagnosis of the disease

Data from laboratory and instrumental studies are the main criteria for diagnosing hepatitis C, and sometimes the only signs of the disease.

Blood test for antibodies (markers) to hepatitis C

Detection of antibodies refers to serological reactions. This is a blood test to determine the presence and state of immunity to the hepatitis C virus.

To diagnose viral hepatitis C, the level of the following antibodies is determined:

Total antibodies of class G to HCV (Ig G anti HCV); Immunoglobulins M and G to nuclear antigens of HCV (Ig M anti HCV core, Ig G anti HCV core); Antibodies to non-structural antigens (anti HCV NS). Markers also include a study to identify the genetic material of the virus, that is, PCR diagnostics.

Table. Interpretation of the results of a blood test to determine antibodies to hepatitis C.

Diagnosis	Result
Diagnosis	IgGantiHCV	Ig M anti HCV core	Ig G anti HCV core	antiHCVN.S.	RNAHCV
Healthy (normal)	-	-	-	-	-
Carriage or previous history of hepatitis C	+	-	+	-	-
Acute hepatitis C	- or +*	+	- or +	-	+
Reactivation of chronic hepatitis C	+	+	+	+	+
Remission of chronic hepatitis C	+	-	+	+ or -	+ or -**
HCV + HIV at the AIDS stage (4 cell stage)	-	-	-	-	+

* Class G immunoglobulins for hepatitis C appear only 2-4 months after infection.

** During remission of chronic hepatitis C, the virus can remain in the patient’s body or be eliminated (disappear).

“-” Negative result, that is, no antibodies or RNA of the virus were detected.

“+” Positive result, HCV antibodies or RNA detected.

PCR diagnostics (RNA determination) and hepatitis C viral load

Unlike the previous serological test for hepatitis C, PCR does not detect immunity, but the genetic material of the virus itself - RNA.

There are two types of PCR diagnostics of hepatitis C:

1. Qualitative determination of HCV RNA– the hepatitis C virus is detected or not detected. For primary diagnosis, this type of PCR is used. 2. Quantitative determination of HCV RNA, or viral load– used to determine the concentration of the virus in the blood. The viral load allows us to assess the dynamics during treatment and indicates how infectious the patient is. The higher the viral load, the greater the likelihood of infection of a person in contact with his blood.

PCR is the most accurate method for diagnosing any infectious disease (over 98-99%), but only if it is carried out correctly.

In addition to identifying the virus itself, PCR can be used to determine the genotype of the virus, which affects the course of the disease and treatment tactics.

What does a questionable, false positive and false negative test result for hepatitis C mean?

About a false positive they say when, in the presence of class M immunoglobulins for hepatitis C, the hepatitis C virus is not detected by RNA PCR.

This result requires a retake of the analysis.

False negative test for hepatitis C usually obtained during the incubation period of the disease; doctors call this period the immunological window. During this period, a person is already infected with HCV, but does not yet have immunity to it, and there are no symptoms of the disease.

Can a hepatitis C test be wrong?

Yes, any laboratory diagnostics has an error rate. But such incidents are possible in relation to only ELISA or only PCR. Therefore, when diagnosing hepatitis C, it is necessary to conduct both types of research. By the way, PCR for HCV can give a false result if the cleanliness in the laboratory is not maintained or the laboratory technician is inexperienced.

How can hepatitis C be detected immediately after infection (for example, after a blood transfusion or needle stick)?

Before donating blood for hepatitis C

Preparation for this type of study is not required; this analysis, unlike liver tests, does not require the patient to be on an empty stomach. As with other types of ELISA tests, it is not advisable to eat fried, fatty, spicy and salty foods the day before, or drink alcohol.

How long does it take to test for hepatitis C?

Often markers for hepatitis C are ready the next day after the test, no later than 7 days. It all depends on the laboratory, the need to deliver the material and results, and diagnostic methods.

Where can I get tested for hepatitis C and how much does it cost?

In clinics and hospitals, a doctor's referral is required. Laboratories can do analysis without a referral and even anonymously.

The average cost of the study ranges from 15 to 60 USD. e.*

*price is indicated in US dollars due to instability of exchange rates.

Rapid test for hepatitis C. Where to buy, what is the price?

Nowadays, there is a huge number of tests that can be carried out without leaving home, a kind of “laboratory in your pocket.” These are various rapid tests, which are mostly presented in the form of litmus soaked in special reagents. You can examine blood, urine, saliva.

Such a rapid test also exists for the diagnosis of hepatitis C. It is based on the determination of total antibodies to HCV (Ig G anti HCV) in the blood.

Such a test can be bought in pharmacies, ordered on official websites on the Internet or in special medical equipment stores. The price averages 5-10 USD. e.

Technique for performing a rapid test for hepatitis C:

wash and treat your hands with an alcohol wipe; use a special needle (scarifier) that is in the package to pierce the finger pad treated with the wipe; use a pipette to take 1 drop of blood; drop the blood into a special test window marked S, then add 2 drops of the reagent there; the result is assessed after 10-20 minutes, no later. Evaluation of the results of a rapid test for hepatitis C:

negative result - the presence of one red stripe opposite the C mark; positive result - the presence of two red stripes opposite the C and T marks, while the second stripe may be of less intensity; the test is invalid - if there are no stripes or if there is one strip opposite the T mark, such a test needs to be redone. If there is a positive result, you should immediately consult a doctor for additional research. No diagnosis is made based on express diagnostics.

General blood analysis

With hepatitis C, a general blood test may be completely normal. But in most cases, the following changes can be detected in a blood test:

moderate increase in the number of leukocytes (the norm is up to 9*109); an increase in the number of lymphocytes (the norm for adults is 19-37%); acceleration of ESR (the norm for men is up to 10, for women – up to 15 mm/h); with developing cirrhosis of the liver: decrease in the level of red blood cells, hemoglobin and platelets. Read more about blood tests

General urine analysis

A general urine test for hepatitis C may change against the background of jaundice, while a large amount of urobeline, a breakdown product of bilirubin, is detected in the urine. In general, a urinalysis may be normal.

The appearance of protein in the urine against the background of liver cirrhosis is an unfavorable sign indicating the onset of renal failure.

More about urine testing

Biochemical blood test for hepatitis C

A biochemical blood test allows you to assess the condition of the liver and its functions. After all, the liver is the “laboratory” of our body; if its functioning is disrupted, the metabolism of many chemicals suffers. Therefore, monitoring blood biochemistry parameters for hepatitis C is mandatory. For this study, venous blood is taken.

Liver tests for hepatitis C

Index	Norm	Changes that may occur with hepatitis C
Alanine aminotransferase (ALT)	Up to 40 IU (from 0.1 to 0.68 µmol/l)	Aminotransferases(ALT and AST) are enzymes released during the destruction of hepatocytes. In acute hepatitis C and reactivation of chronic hepatitis, liver destruction occurs, therefore ALT and AST are elevated, and tens of times. This is the most consistent indicator for hepatitis C, even in the absence of any symptoms of the disease. If, against the background of reactivation of chronic HCV, aminotransferases decrease, this may indicate the development of liver cirrhosis, in which there is nothing left to be destroyed.
Aspartate aminotransferase (AST)	Up to 40 IU (from 0.1 to 0.45 µmol/l)
Bilirubin	Total bilirubin: up to 20 µmol/l: direct: up to 5; indirect: up to 15.	When hepatocytes are destroyed, a large amount of unbound bilirubin enters the blood, which is manifested by jaundice. Wherein total bilirubin increases due to the direct fraction. Bilirubin can be increased 10-100 times. With an indicator of 200 µmol/l The central nervous system is damaged, this is the so-called hepatic encephalopathy and coma.
Thymol test	Up to 5	Reflects the state of protein metabolism. With increasing liver failure thymol test increases.
Gammaglutamate transferase (GGT)	For women: 6-42 U/l, For men: 10-71 U/l.	GGT is an enzyme involved in protein metabolism in the liver. This indicator increases significantly(up to 50 and above) with the development of liver cirrhosis.
De Ritis coefficient	1,3 – 1,4	This ratio of ALT to AST levels. In acute hepatitis C, this indicator decreases below 1, and in chronic hepatitis, on the contrary, it increases to 2 and above.

The ALT indicator reflects the dynamics of the course of hepatitis C; it is used to determine the severity of the disease.

Determination of the degree of HCV hepatitis depends on the ALT level

Changes in other biochemical blood parameters in hepatitis C:

decreased albumin levels (normal 20-36 mmol/l); increased gamma globulin levels (normal 30-65 mmol/l); increased cholesterol levels (normal 3.4-6.5 mmol/l); increased iron concentration in the blood (norm 10-35 µmol/l). Biochemical changes during the development of liver fibrosis and cirrhosis:

1. Decrease in indicators:

glucose less than 3.3 mmol/l; urea less than 2.5 mmol/l; total protein less than 65 g/l; cholesterol less than 3.4 mmol/l; fibrinogen less than 2 g/l. 2. Increasing performance:

alkaline phosphatase above 240-270 units/l; ammonia above 60 µmol/l.

Ultrasound of the liver for hepatitis C

Acute hepatitis C:

increase in size; increased liver density; heterogeneity of structure. Chronic hepatitis C:

all changes characteristic of acute hepatitis; the pattern of the hepatic vessels is not clearly visible.

Ultrasound signs of liver cirrhosis:

decrease or increase in size; tuberosity of the surface; deformation of the shape of the liver; the structure of the liver in the form of a mosaic; thickening of the walls of the portal vessels, impaired blood flow through them; increase in the size of the spleen; the presence of fluid in the abdominal cavity.

Liver biopsy

To collect biopsy material, a laparoscopic operation is performed, in which a puncture is made in the liver area and a “piece” of the organ is taken with special forceps. Next, the biopsy material is examined under a microscope and the degree of liver destruction and the formation of connective tissue (fibrosis) in it is assessed.

Liver elastography

This is a new diagnostic method that is based on ultrasound scanning of liver tissue. A special range of ultrasound waves makes it possible to assess the distribution of connective tissue in the liver, that is, the degree of fibrosis. This method allows you to avoid the procedure of liver biopsy for hepatitis C.

Immunogenetic studies

These are new research methods that determine the risk factors for the formation of fibrosis (cirrhosis) of the liver against the background of hepatitis C. These studies help assess the prognosis of the disease, which is necessary to determine treatment tactics.

In this case, immunogenetic markers are identified:

fibrogenesis factors; cytokines; immunoregulatory proteins. All patients with suspected hepatitis C or with confirmation of the diagnosis must be tested for hepatitis B and HIV! These diseases are also transmitted through blood, and a combination of viral hepatitis and HIV infection is often found.

Hepatitis C: prevalence of the disease, complications, mechanism of infection, symptoms, diagnosis, risk groups - video

What is the hepatitis C virus? The mechanism of hepatitis C disease, diagnosis, treatment (drugs, diet) - video

Hepatitis C: which organs does HCV affect? Complications of hepatitis C. Diagnosis (where to get tested for hepatitis C), treatment - video

Viral hepatitis C is dangerous due to its asymptomatic. 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 find therapy for successful treatment diseases. 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 left untreated, hepatitis develops severe complications. 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 markers of hepatitis.

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 performed due to the lack of characteristic complaints and timely diagnosis. Therefore, hepatitis becomes chronic.

The pathology progresses, with visible changes and special unpleasant symptoms the infected person does not experience it. 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, constant elevated temperature bodies;
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 doesn't always work desired effect. If complex therapy is not carried out, then the chances of developing unpleasant consequences.

Complications of hepatitis C:

hepatosis;
cirrhosis of the liver;
liver failure;
carcinoma.

Without treatment for chronic hepatitis C, the chance of developing cirrhosis is 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, its functionality decreases. Are developing different types hepatosis. 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:

Proliferation of connective and adipose tissue in place of the parenchyma (main functional fibers) of the liver.
Deformation hepatic arteries, as well as gastric veins. Under the influence of an enlarged gland, they change their structure and size.
Impaired blood supply due to narrowing of the lumen of the arteries, thrombosis.
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 - malignant formations 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). Oncological pathology can be cured with timely therapeutic methods. Doctors use surgery to remove the tumor, 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);
pathology 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 your doctor’s lifestyle recommendations 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:

Using non-sterile instruments. In this way you can become infected in beauty salons, dental offices, clinics, if the rules for using and processing instruments are violated.
Sexual contact with an infected partner. There is a greater chance of transmitting the virus if you do not use protective equipment.
During a blood transfusion. There are situations when donor blood is needed urgently, and there is no way to check for its presence. viral infections.
Injection syringes. If several people use the same syringe, the risk of infection increases.
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.
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.

Except 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, 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 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 fatal outcome.

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 rate of development, complications of hepatitis, individual characteristics 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:

Normalization of the diet. It is necessary to exclude fatty, fried and spicy foods.
Rejection of bad habits. Toxins found in alcohol, nicotine, and drugs increase the load on the liver and destroy it.
Improvement 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, slow down metabolic processes.
Regular examinations by specialized specialists. Taking liver tests, instrumental examinations, and examining a doctor will help to detect an exacerbation in time chronic form, start 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, 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 were unaware of 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.