This disease is called the "silent killer" for the lack of characteristic signs and a high risk of complications. Chronic hepatitis C is the most difficult to treat. Modern therapy, thanks to direct-acting antiviral agents, often saves the patient's life or significantly prolongs it.

What is hepatitis C, a general characteristic

This is a “silent” or “affectionate” killer. This is what they say about hepatitis C, implying an asymptomatic course, a high risk of developing cirrhosis and hepatocellular cancer. It is difficult to recognize what kind of disease this person has in the early stages of infection. But if you know the symptoms, choose the most effective treatment option, you can minimize the negative health effects.

Symptoms of hepatitis C may initially resemble flu. The virus carrier does not suspect that it is infected, but already spreads the infection and poses a danger to others.

The incubation period varies from 14 days to six months, basically it lasts about 8 weeks.

Viruses penetrate into healthy hepatocytes (liver cells), “reprogram” them to reproduce their own ribonucleic acid (RNA). White blood cells of the immune system attack infected hepatocytes, and destroy them along with the "invaders." With mass death of liver cells, normal organ tissue is replaced by connective tissue.

Forms and stages of the virus

The causative agent of the disease is a special form of genetic material and proteins. Viruses do not have a cellular structure; they multiply only in the cells of the host organism.To distinguish pathogens of hepatitis C from previously discovered A and B, they are designated by the first letters of the Latin or Russian name - HCV, HCV.

Types of virus

Science knows 11 HCV genotypes that cause infectious hepatitis. Proteins in the composition of the envelope and chains of RNA viruses have a similar structure. The differences between the genotypes and serotypes of the pathogen are due to the unequal nucleotide sequence encoding the hereditary traits. HCV 1–4 is predominantly found in Russia and in Europe.

Forms and stages

The incubation period, the absence of signs of the presence of hepatitis C virus in the body - this is the preclinical stage. Then it is possible to develop acute inflammation of the liver. About 6 months after this, chronic hepatitis develops. Initial symptoms are mild, barely noticeable to the patient. There is heaviness and dull pain in the upper right, weakness, bitterness in the mouth, and nausea are felt.

In the future, the symptoms increase. Edema, neuropathy, hepatic encephalopathy appear. The absence of treatment leads to the development of liver cirrhosis in 20% of those infected.

A special form is fulminant hepatitis

Symptoms increase at lightning speed - within 10 days from the moment of occurrence. The first stage is characterized by sleep disturbances, increased anxiety, a sharp change in mood. In the second stage of liver failure, psychomotor agitation, yellowness of the eyes and skin are noted. At the third stage, a coma develops with the preservation of unconditioned reflexes. It is followed by a fourth - a coma with a high risk of death.

How is the disease transmitted?

The main danger is the blood of the carrier of HCV or the patient. Pathogens of hepatitis C can penetrate into other body fluids. This happens with a high viral load. In this case, infection is possible if saliva or sweat infected with HCV gets on the skin of a healthy person. But such situations in medical practice are rare.

How is hepatitis C transmitted:

  • with transfused blood;
  • when performing injections;
  • through unsterilized medical instruments;
  • when using unprocessed piercing devices, tattoos;
  • with a gynecological examination or dental procedures;
  • when using a contaminated razor patient or carrier;
  • to the fetus in the womb - from an infected mother;
  • newborn - during childbirth;
  • with unprotected sex.

Until 1990, the HCV was unknown. Blood products were not tested for this virus. And in those years, there were much more cases of hepatitis C after transfusion than now.

The first signs in men and women

Men are more likely to tolerate hepatitis C, as they often combine alcohol and smoking. Bad habits worsen the condition of the liver, the body loses its ability to self-repair. The appearance of nonspecific symptoms (increased fatigue, dry mouth) is usually not alarming.

Later, the picture of hepatitis C is supplemented by nosebleeds, a feeling of heaviness in the right hypochondrium, dull pain in the liver. A man complains of loss of appetite, nausea and vomiting, skin itching. Characteristic symptoms of hepatitis appear - darkening and foaming of urine, ascites (fluid accumulation and an increase in the size of the abdomen). Sexual attraction is absent due to hormonal imbalance.

A woman with hepatitis C feels unexplained weakness and fatigue, even with small loads. After resting, the patient still feels overwhelmed. Drowsiness overcomes during the day, and insomnia torments at night. Menstruation becomes longer than before HCV infection.

If a woman does not know that she is sick with hepatitis, she takes joint pain for signs of arthritis, and considers an increase in temperature a manifestation of ARVI. Symptoms of chronic hepatitis C may include abdominal pain, flatulence, changes in stool.

HCV in a child’s body develops slowly.The incubation period varies from 2 weeks to 5 months, averaging 8 weeks. After infection, external signs may be absent, although the child is sick. Often the symptoms resemble the flu. Jaundice appears only in 20% of cases.

Symptoms of Hepatitis C

With a mild form of the disease, intoxication is weak. The characteristic symptoms of hepatitis C (C) may be absent for a long time, although the infectious and inflammatory process in the liver is on. General weakness appears, heaviness in the head, the condition worsens in the evening. The appetite is bad.

Signs of hepatitis C:

  • enlarged liver and spleen;
  • vascular "spiders" on the skin;
  • darkened urine;
  • a lightened stool;
  • jaundice
  • itchy skin;
  • dyspepsia.

Jaundice syndrome in a typical form of the disease persists for 3 weeks. Atypical hepatitis C occurs without jaundice.

Intoxication is increasing gradually. The liver parenchyma slowly loses its ability to perform functions, since normal tissue is replaced by fibrous. Hemorrhage (increased bleeding of blood vessels) develops, pain syndrome intensifies. There are accumulations of fluid, swelling.

Diagnostic measures

Clinical and laboratory examination before prescribing medication makes it easier to choose the most effective therapy. Specific antibodies to HCV antigens can be determined using an enzyme-linked immunosorbent assay 4–8 weeks after infection. Markers of the infectious and inflammatory process are IgG and IgM immunoglobulins. Detecting antibodies is only the first step.

A PCR study can give a negative result, which means that new viral particles are not reproduced by the cells of the body.

The diagnosis is confirmed by the results of a clinical and laboratory examination:

  • increased content of bile pigment bilirubin;
  • increased concentration of liver enzymes, alkaline phosphatase;
  • detection of virus RNA in the blood using the PCR method;
  • liver enlargement (determined by ultrasound of the abdominal cavity).

A liver tissue sample is taken to evaluate inflammatory changes in chronic hepatitis. The procedure is called puncture biopsy.

How to treat hepatitis C

Previously, standard immunotherapy was used - Peginterferon-alpha (Pegasis) + Ribaverin. The effectiveness of the technique was low, rarely exceeding 50%. The first remedy activates the synthesis of enzymes in the patient’s body that impedes the reproduction of the genetic material of viruses. Ribaverine enhances this action. The duration of standard therapy is up to 12 months. Very often severe side effects occur.

Self-treatment of hepatitis C (C) with the help of folk remedies is not only useless, but can also seriously harm the liver.

The treatment of infectious hepatitis has undergone significant changes due to the creation of new direct-acting antiviral agents. Drugs of this group inhibit enzymes (proteases) involved in the synthesis of viral proteins. The breeding process is disturbed, there is no increase in virions in the liver.

Names of drugs based on viral protease inhibitors: Daclatasvir, Sofosbuvir, Ledipasvir. Apply new drugs for 3-6 months. Interferon is not used or is prescribed as part of complex therapy. Hepatoprotective treatment will be required to reduce liver inflammation. Assign to the patient Essential N, Karsil, enzyme preparations with pancreatin and bile acids.

The effectiveness of modern antiviral therapy for acute hepatitis C is higher than 95%, combined treatment - up to 99%.

An obstacle to the use of new drugs can serve:

  • intolerance to antiviral drugs available to doctors;
  • the absence of a positive effect of the use of this group of drugs;
  • the presence of contraindications in a particular patient;
  • high price.

The difficulty lies not so much in how to treat hepatitis, but in the problem of getting rid of an infection that has already penetrated into the liver cells.Viruses quickly adapt, do not respond to the use of existing drugs. Using even the latest and most expensive drugs is not always effective.

Therapeutic diet

Combating viral infection is combined with treatment of liver inflammation and prolonged adherence to diet No. 5. Table 5A in the acute period of the disease is considered the most sparing.

The basic rules of the diet for hepatitis C:

  1. The amount of carbohydrate proteins in accordance with the age norm.
  2. Exclusion of foods with coarse fiber.
  3. Prohibition of alcohol.
  4. Salts - not more than 10 g / day.
  5. Fat restriction.

Fatty meats, poultry and fish, broths from these products and fat should not be consumed. The same rule applies to legumes, radishes and radishes, garlic, onions, sour fruits and vegetables. It is necessary to remove high-fat dairy products, margarine from the diet. Pickles, marinades, smoked meats and canned foods are prohibited.

Two methods of cooking food should be used - boiling and steaming. Frying and stewing are excluded. Food should be taken 5 times a day in small portions.

Predictions of how much you live with the disease

In the acute form of hepatitis C, spontaneous disposal of the body from HCV is possible without treatment and without liver damage. A strong immune system suppresses hepatitis C. During the first months after HCV infection, with an early start of therapy, the probability of cure is almost 100%.

How much they live with the disease depends on its form, the time of initiation of therapy and the presence of complications.

Pathology can progress quickly. Fulminant hepatitis develops at lightning speed, the functions of the liver and the whole body are disrupted. Rapidly increasing liver failure. The outcome in most cases is fatal. A liver transplant is required.

If HCV circulates in the blood of an infected person for more than 6 months, then the disease takes a chronic course. Treatment can be done on an outpatient basis. Therapy is considered successful in the absence of cirrhosis, a normal level of liver enzymes and a negative PCR analysis 12 months after the end of the course.

HCV 2, 3a, and 3b are relatively well treated. The duration of drug therapy is 2 years. Hepatitis C virus 1 and its subtypes 1a and 1b are highly adaptable to drugs. 50% of infected adults and up to 60% of children recover.

If fibrosis progresses, then areas of the hepatic parenchyma are replaced by connective tissue. Cirrhosis is an irreversible lesion of the entire organ. This complication develops in 10–20% of patients with hepatitis C 20–30 years after infection in the absence of specific therapy. If the patient has an alcoholic dependence, then it separates from cirrhosis about 10-15 years.

Already existing fibrous areas in the liver are not restored to normal parenchyma. However, in the early stages of the disease, liver function can be maintained through proper treatment and diet.

Preventive measures

A vaccine that would prevent HCV infection has not yet been created. It is important to avoid any contact with other people's blood. If a person is infected, other biological fluids (saliva, sweat, sperm) are also dangerous.

Protection, mostly indirect, provides careful personal hygiene, disinfection of skin and mucous membranes. It is necessary to treat with antiseptics even small scratches.

Hepatitis C virus may not detect its presence in the body for a long time. The first symptoms of the disease often resemble a cold or flu. It is necessary to pay attention to the combination of these signs with darkening of the urine, lightening of the stool, heaviness and dull pain in the right hypochondrium.

A medical institution should donate blood to determine the antibodies, and if necessary, undergo a full examination to identify the genotype of the hepatitis virus.Timely prescribed drug therapy can inhibit pathological changes, reduce the risk of developing cirrhosis and increase the life expectancy of a patient with hepatitis C.

Similar:More from the author: