What are the first symptoms of hepatitis C? What are the signs of hepatitis C in women? Acute and chronic hepatitis

Hepatitis is an inflammatory disease of the liver. According to the nature of the course, acute and chronic hepatitis are distinguished. Acute cases occur with severe symptoms and have two possible outcomes: complete cure, or transition to a chronic form.

Different types of hepatitis differ from each other in different ways of infection, rate of progression, severity of clinical manifestations, treatment methods and prognosis for the patient. Hepatitis is characterized by a specific set of symptoms, which, depending on the type of disease, may be more severe than others.

What is hepatitis?

Hepatitis is an acute or chronic inflammatory disease of the liver that occurs due to infection with specific viruses or the influence of toxic substances on the parenchyma of the organ (for example, alcohol, drugs, drugs, poisons).

Viral hepatitis is a group of common and dangerous infectious diseases for humans, which differ quite significantly from each other, are caused by different viruses, but still have a common feature - it is a disease that primarily affects the human liver and causes its inflammation.

The main signs of hepatitis are– abdominal pain, loss of appetite with frequent nausea and vomiting, headache, general weakness and increased body temperature up to 38.8°C, and in severe cases, yellowing of the skin and eyes.

Types of viral hepatitis

Hepatitis is classified:

due to development - viral, alcoholic, medicinal, autoimmune hepatitis, specific (tuberculosis, echinococcal, etc.), secondary hepatitis (as complications of other pathologies), cryptogenic (of unclear etiology);
along the course (acute, chronic);
according to clinical signs (icteric, anicteric, subclinical forms).

According to the mechanism and routes of infection, they are divided into two groups:

Having an oral-fecal transmission mechanism (A and E);
Hepatitis, for which blood contact (hemopercutaneous), or, more simply, the path through the blood, is the main one (B, C, D, G - group of parenteral hepatitis).

Depending on the form of hepatitis, the disease can bother the patient for a long time, and in 45–55% of cases complete recovery occurs. The chronic (permanent) form of viral hepatitis can bother the patient throughout his life.

Hepatitis A or Botkin's disease is the most common form of viral hepatitis. Its incubation period (from the moment of infection to the appearance of the first signs of the disease) ranges from 7 to 50 days.

During this period, a person can infect others. Most symptoms of viral hepatitis usually disappear after a few days or weeks, but the feeling of fatigue may last for months as the liver returns to normal. It takes several months to fully recover.

Viral hepatitis B

Jaundice occurs as a result of a disorder in the metabolism of bilirubin, which is toxic to the body. When liver function is impaired, it accumulates in the blood, spreads throughout the body, depositing in the skin and mucous membranes and giving them a yellowish color.

Most often, as a result of a violation of the outflow of bile from the liver, some of which enters the blood and spreads throughout the body, itching appears: bile acids, deposited in the skin, greatly irritate it.

In some cases, patients develop so-called fulminant acute hepatitis. This is an extremely severe form of the disease, in which there is massive tissue death and extremely rapid development of symptoms. If left untreated, such acute hepatitis ends in death.

Forms of development

During viral hepatitis, 4 forms are distinguished:

Mild, more often characteristic of hepatitis C: jaundice is often absent, low-grade or normal temperature, heaviness in the right hypochondrium, loss of appetite;
Moderate severity: the above symptoms are more pronounced, joint pain, nausea and vomiting appear, appetite is practically absent;
Heavy. All symptoms are present in a pronounced form;
Fulminant (fulminant), not found in hepatitis C, but very characteristic of hepatitis B, especially in the case of coinfection (HDV/HBV), that is, a combination of two viruses B and D that cause superinfection.

Complications and consequences for the body

Both acute and chronic hepatitis can lead to very serious consequences. Among them it is worth especially noting:

inflammatory diseases of the biliary tract;
hepatic coma (ends in death in 90% of cases);
Liver cirrhosis – occurs in 20% of patients with viral hepatitis. Hepatitis B and its derivatives most often lead to cirrhosis;
liver cancer;
dilation of blood vessels and subsequent internal bleeding;
accumulation of fluid in the abdominal cavity - ascites.

Treatment of hepatitis

Treatment of hepatitis depends on the etiological factor that caused the inflammatory process in the liver. Of course, hepatitis of alcoholic or autoimmune origin usually requires only symptomatic, detoxification and hepatoprotective treatment.

Standard treatment tactics for hepatitis include:

eliminating the cause of the disease by destroying the virus and detoxifying the body;
treatment of concomitant diseases;
restoration of liver function;
maintaining normal functioning of the organ;
compliance with a special diet and certain sanitary and hygienic protective measures.

Treatment of acute hepatitis

Treatment must be carried out in a hospital. Besides:

diet No. 5A is prescribed, semi-bed rest (in severe cases - bed rest);
For all forms of hepatitis, alcohol and hepatotoxic drugs are contraindicated;
intensive detoxification infusion therapy is performed to compensate for this
liver function;
prescribe hepatoprotective drugs (essential phospholipids, silymarin, milk thistle extract);
prescribe a daily high enema;
carry out metabolic correction - potassium, calcium and manganese preparations, vitamin complexes.

Diet

In addition to drug therapy, the patient must follow a diet. Nutrition should be based on the following rules:

complete exclusion of alcohol (including beer);
ban on marinades, smoked meats, spicy and fatty foods;
lean meat and fish are recommended;
You can consume low-fat dairy products.

Antiviral therapy in tandem with diet and bed rest can lead to complete recovery. However, it should be noted that adherence to dietary nutrition and therapy is required even after recovery. Otherwise, relapse and transition of the disease to chronic viral hepatitis are practically not excluded.

What to eat:

various teas based on herbs and berries, juices and compotes with a small sugar content;
ground, well-cooked porridge;
various soups and vegetable purees;
low-fat dairy products;
meat and fish should be low-fat varieties, steamed;
steam omelette;
bran bread, rye bread, biscuits.

For sweets, you can eat dried fruits, not too sweet jam, honey. Baked apples, bananas and berries in small quantities are useful.

What not to do:

very strong tea, chocolate, coffee;
legumes, mushrooms;
sour, salty, too sweet;
baked goods, puff pastry products, pancakes, pies;
sausages and canned meats;
pork;
hard-boiled and fried eggs.

Prevention

Prevention is necessary so that viral hepatitis does not return, and in the case of chronic manifestations, it does not worsen or become complicated. Prevention consists of observing the following rules:

exclusion of alcohol from the diet (completely);
compliance with all doctor’s recommendations (do not skip appointments, take prescribed medications correctly);
diet (exclude fried and fatty, salty and spicy foods, canned food and preserves);
exercise caution when in contact with contaminated biomaterials (applies to healthcare workers), namely, use PPE (protective equipment).

How to protect yourself from hepatitis?

Viral hepatitis often leads to serious and dangerous complications, and their treatment is not only lengthy, but also expensive.

Prevention is as follows:

Wash your hands before eating
Boil water before drinking
Always wash fruits and vegetables and heat-treat food
Avoid contact with other people's body fluids, including blood
Protect yourself during sexual intercourse (including oral)
Do piercings and tattoos only with sterile instruments in trusted centers
Get vaccinated against hepatitis.

This is all about hepatitis (alcoholic, viral and others): what kind of disease it is, how it gets infected, what are the first signs and main symptoms, what drugs are effective in exacerbations.

Good day, dear readers!

In today's article we will continue to consider hepatitis in all its aspects and next in line - hepatitis C, its causes, symptoms, diagnosis, treatment and prevention. So…

What is hepatitis C?

Hepatitis C (hepatitis C)– an inflammatory infectious disease of the liver, caused by the hepatitis C virus (HCV) entering the body. The main danger that lies in hepatitis C is a pathological process that provokes the development of liver cancer.

Due to the fact that the cause of this disease is a virus (HCV), it is also called - viral hepatitis C.

How does hepatitis C become infected?

Infection with hepatitis C usually occurs through microtraumas on the surface of the skin or mucous membranes after contact with contaminated (virus-infected) objects. The hepatitis virus itself is transmitted through blood and its components. When any infected object comes into contact with human blood, the virus enters the liver through the bloodstream, where it settles in its cells and begins to actively multiply. The virus does not die for a long time, even if the blood on cosmetic and medical instruments dries out. Also, this infection is resistant to improper heat treatment. Thus, it can be revealed that hepatitis infection occurs in places where blood may be present in some way - beauty salons, tattoo shops, piercing shops, dental clinics, hospitals. You can also become infected by sharing hygiene items - toothbrushes, razors. Most people infected with hepatitis C are drug addicts, because... they often use one syringe for several people.

During sexual contact, infection with hepatitis C is minimal (3-5% of all cases), while there remains an increased risk of infection with the hepatitis B virus. However, with promiscuous sexual activity, the risk of infection increases significantly.

In 5% of cases, an infant is infected with HCV when he is breastfed by a sick mother, but this is possible if the integrity of the breast is damaged. The woman herself sometimes gets infected during childbirth.

In 20% of cases, the method of infection with the HCV virus cannot be determined.

Hepatitis C is not transmitted by airborne droplets. Talking with saliva at close range, hugging, shaking hands, sharing utensils, and eating are not causes or factors for HCV infection. In domestic conditions, one can become infected only through microtrauma and its contact with an infected object that contains remnants of infected blood and its particles.

Most often, a person learns about his infection during a blood test, whether it is a routine medical examination, or when he acts as a blood donor.

A very important preventive measure is to avoid visiting untested and little-known organizations that provide certain beauty and health services.

Development of hepatitis C

Unfortunately, hepatitis C has a name – the “gentle killer”. This is due to the possibility of its asymptomatic development and course. A person may not even be aware of his infection, even living 30-40 years. But, despite the absence of obvious signs of the disease, he is a carrier of the infection. At the same time, the virus gradually develops in the body, provokes the development of chronic liver disease, slowly destroying it. The liver is the main target of hepatitis viruses.

Direct acting drugs against HCV

Since 2002, Gilead began developing the newest drug against hepatitis C - sofosbuvir (TM Sovaldi).

All tests were completed by 2011, and already in 2013 the US Department of Health approved the use of sofosbuvir in all hospitals in the country. Until the end of 2013, sofosbuvir began to be used in clinics in a number of countries: Germany, Israel, Switzerland, France, Denmark, Finland.

But unfortunately the price was unaffordable for most of the population. One tablet had a price of $1000, the entire course cost $84,000. In the USA, 1/3 of the cost was covered by the insurance company and the government. subsidies.

In September 2014, Gilead announced that it would issue production licenses to certain developing countries. In February 2015, the first analogue was released in India by Natco Ltd under the trade name Hepcinat. The 12-week course is sold in India at a suggested retail price of $880-$1200 depending on region.

The main components of the drugs are sofosbuvir and daclatasvir. These drugs are prescribed by a doctor according to a regimen, depending on the genotype of the virus and the degree of fibrosis, and also allow you to completely get rid of the hepatitis C virus in 96% of cases, compared to the traditional interferon treatment regimen, which has only 45-50% success.

When treated with these drugs, there is no need to be in the hospital, as before. The medicine is taken orally.

The course of treatment is from 12 to 24 weeks.

One of the first companies to deliver the drug from India to Russia and other countries of the world was the company owned by the large Indian retailer Hepatitis Life Group.

Direct-acting antiviral drugs are prescribed by a doctor according to the scheme, depending on the genotype of the hepatitis C virus.

Direct acting antiviral drugs for acute hepatitis C:"Sofosbuvir"/"Ledipasvir", "Sofosbuvir"/"Velpatasvir", "Sofosbuvir"/"Daklatasvir".

The course of treatment is from 12 to 24 weeks. The combinations are effective against various HCV genotypes. There are no contraindications, if any.

Direct-acting antiviral drugs for chronic hepatitis C:"Sofosbuvir"/"Ledipasvir", "Sofosbuvir"/"Velpatasvir", "Sofosbuvir"/"Daklatasvir", "Dasabuvir"/"Paritaprevir"/"Ombitasvir"/"Ritonavir", "Sofosbuvir"/"Velpatasvir"/"Ribavirin" "

The course of treatment is from 12 to 24 weeks. The combinations are effective against various HCV genotypes. Sofosbuvir has no contraindications for HIV infection, as well as for individuals who are interferon-resistant by the IL28B gene.

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Immune System Support

To strengthen the immune system, as well as to enhance the body’s adequate response to a viral infection, immunomodulators are additionally used: “Zadaxin”, “Thimogen”.

Diet for hepatitis C

For hepatitis C, a therapeutic nutrition system according to Pevzner is usually prescribed -. This diet is also prescribed for liver cirrhosis and.

The diet is based on dietary restrictions on fats, as well as spicy, salty, fried foods, preservatives and other foods that can enhance the secretion of digestive juices.

Signs and symptoms of hepatitis A have been described since ancient Greece. The reasons for its occurrence, spread and pathogenesis remained unknown for a long time.

For the first time, Russian clinician S.P. spoke about the viral nature of the disease. Botkin in 1888. Only by the middle of the twentieth century. It was reliably established that, as this disease was then called - jaundice, is an independent infectious disease that affects the liver.

The modern name of the disease took shape relatively recently. It was formed from the Greek word “hepar”, meaning liver - hepatitis (A). The symptoms of the disease are well known and are typical for all hepatitis that occurs in an acute form.

The disease is a viral infection that enters the body through the mucous membranes of the mouth, pharynx and digestive system. Having penetrated the blood, viral particles spread throughout the body, but settle in the liver, because in the cells of this particular organ they are adapted for replication. You can read about the modes of transmission of hepatitis A in.

Like most viral infections, hepatitis A sequentially goes through several stages:

incubation;
active replication, characterized by an increase in hepatitis A symptoms;
the height of the inflammatory process, in which the signs of hepatitis A become most obvious (“jaundice”);
recovery (convalescence stage).

The incubation stage lasts from 10 days to 1.5 months. There are no symptoms of hepatitis A in adults or children at this stage.

The first signs appear acutely in the generalization phase of the infection (prodromal period), which usually lasts about 1 week. Extremely rarely - up to 2-3 weeks.

The icteric period at the height of the disease has a variable duration - from several days to several weeks, depending on a number of factors, including:

severity of the disease;
the presence of concomitant pathologies of the liver, gallbladder and ducts;
addition of a secondary infection;
adequate and timely treatment;
age of the patient.

Symptoms of hepatitis A at the recovery stage reduce their intensity, the virus is completely eliminated.

It should be noted that the indicated stages of the disease are largely arbitrary. The symptomatic manifestation of the infectious process is determined by a number of factors, the main of which are: the activity of the virus and the level of response of the immune system aimed at suppressing it.

A significant number of cases are asymptomatic, or with mild signs of hepatitis A, which may resemble ARVI or intestinal poisoning (especially in children).

Jaundice develops in no more than 30% of cases.

The first signs of hepatitis A

The stage of generalized infection (initial, or prodromal) manifests itself with the following first signs of hepatitis A:

increased body temperature (38-40 degrees C);
weakness;
malaise;
headache;
nausea;
decreased appetite;
vomiting not associated with food intake;
flatulence;
constipation

As a rule, the first signs of hepatitis A include pain or a feeling of heaviness in the right hypochondrium. Sometimes the pain is localized in the epigastrium and spreads to the entire abdominal region, down the abdomen on the right side. The nature of the pain in most cases is dull, paroxysmal.

Symptoms of hepatitis A in adults in the pre-icteric stage

The severity of the first signs listed above indicates the degree of infectious toxicosis, which, in turn, reflects the level of viremia (generalization of infection).

The more pronounced the initial signs of intoxication, the more severe the course of the disease.

The first symptoms, if they appear, remain throughout the entire prodromal pre-icteric period. With the exception of body temperature, which in most cases decreases within 3 days.

The return of body temperature to normal levels leads to a decrease in the severity of intoxication manifestations. However, they persist, as do dyspeptic disorders.

Simultaneously with the subsidence of intoxication symptoms, signs of impairment begin to increase.

During the infection stage, hepatitis A becomes a common symptom in men and women. The right hypochondrium is painful on palpation. However, in approximately 50% of patients the liver does not show any noticeable increase in size.

About a week after the first signs of hepatitis appear, the patient’s urine darkens and sometimes the stool becomes lighter, which indicates a disruption of metabolic processes in the liver and the approaching stage of “jaundice.”

Signs in adults in the icteric stage

As noted above, the prodromal period can occur with mild symptoms or asymptomatic. In the latter case, the disease manifests itself immediately in the icteric form.

Symptoms of hepatitis A in women and men in the “jaundice” stage are typical:

improvement of well-being (further reduction in symptoms of intoxication, until their complete disappearance);
yellowing of the skin, mucous membranes, sclera of the eyes;
enlarged liver.

Yellowing can occur within several hours or last for 1-2 days.

First, the mucous membranes and sclera turn yellow.
Then - the skin, starting with the face and torso.
The limbs turn yellow last.

Yellowing is associated with the deposition of bilirubin in the tissues, a substance that must be excreted from the body by the liver into the bile it secretes. However, viral infection of hepatocytes does not allow the liver to effectively perform its functions.

This sign of hepatitis A in adults, such as yellowing, increases over several days, reaches its peak, then gradually decreases. The entire cycle takes, depending on the severity of liver damage by the virus, an average of 7 to 14 days. During this time, the amount of virus in the blood invariably decreases, and at 2-3 weeks it ceases to be determined by available analytical methods.

Symptoms in the convalescent stage

As the virus is eliminated, the symptoms described above decrease in intensity and eventually disappear. The enlargement of the liver persists for some time, and liver test results are deviated from normal values.

During the recovery period, the liver returns to its normal size, and the biochemical composition of the blood normalizes.

However, some symptoms of hepatitis A in adults, such as fatigue, decreased tolerance to exercise and alcohol, and episodic ones, can persist for up to 3 months. You can read more about tests for hepatitis A in.

Symptoms of hepatitis A in children

Speaking about the signs of hepatitis A in a child, two features should be noted:

asymptomatic disease is much more common in children;
manifestations may be more varied.

In particular, infantile jaundice often begins with respiratory symptoms reminiscent of acute respiratory viral infection. This is due to the weakening of the immune system by the hepatitis virus and the development of a secondary respiratory infection against its background.

Body temperature indicators during the generalization of infection are usually higher than in adults.

Otherwise, the symptoms of hepatitis A in a child and the dynamics of the disease are similar to those described in the previous paragraphs.

Useful video

You can see what happens in the liver during hepatitis A and B in the following video:

Conclusion

In many cases, hepatitis A is asymptomatic.
Symptoms of hepatitis A are similar in women, men and children.
In the case of the standard course of the infectious process, the symptoms in children are more pronounced.
The disease begins with typical intoxication and dyspeptic symptoms, supported by pain in the right hypochondrium. Over time, intoxication decreases, giving way to “jaundice.”
Residual signs of hepatitis A may persist for up to 3 months.

This liver disease is extremely dangerous. In order to detect the disease in time and begin its treatment, you need to know what symptoms appear with hepatitis C. The disease is caused by the hepatitis C virus, which, upon entering the human body, firmly establishes itself in liver cells.

Due to the secretive behavior of the virus and its inactive effect on the human body, an immune response - the appearance of antibodies - can develop in a period of two weeks to six months. It depends on the:

Virus genotype;
The speed of its spread;
Lifestyle of the infected person (bad habits, physical activity);
The degree of natural defense of the body.

When the immune system is active, infected liver cells are attacked. Organ tissues die and are replaced by fatty and connective tissue. The larger part of the liver is affected, the more the remaining healthy cells of the organ are loaded. To fully perform their functions, liver cells have to increase in size. That is why, when an organ becomes inflamed, there is a significant increase in size.

If most of the hepatocytes are affected and the organ practically ceases to perform its functions, then cirrhosis of the liver occurs. This occurs when the disease is long-standing and there is no appropriate treatment. Cirrhosis is an almost extreme degree of liver disease, in which a person’s life can no longer be full. In this phase, the patient is prescribed a quiet lifestyle with many restrictions.

There are cases when patients recover on their own during the acute stage of the disease. And they will learn about the disease only after taking the appropriate tests for antibodies to the hepatitis C virus. Scientists still do not give an exact answer on this matter and motivate the self-healing process with a high degree of immune protection. It also remains unclear why antiviral therapy does not always help.

One thing remains unchanged - a correct lifestyle and the absence of bad habits such as drinking alcohol and smoking significantly influence the course of the disease. At the same time, it is important to constantly monitor your health, pay attention to malaise and accompanying symptoms. It is worth noting that the symptoms of viral hepatitis C in the acute stage are significantly different from the signs of a chronic disease.

Symptoms

During the acute stage of the disease, the symptoms are extremely similar to those of a common cold. The acute stage of a viral disease in adults is less noticeable than in children. This is due to a stronger body and fully formed systems. Symptoms of hepatitis C in adults:

General weakness;
Fast fatiguability;
A slight increase in body temperature, generally it does not exceed 37.5 degrees;
Pain in muscles and joints (which is also observed when infected with influenza);
Headache.

Most often, people do not pay attention to these symptoms, believing that it is a cold. If, in addition to these manifestations, there is a feeling of heaviness in the right hypochondrium, pain on palpation and darkening of the urine, then these are sure signs of viral liver damage. In this case, it is recommended to immediately contact a specialist, undergo an examination and take the appropriate tests.

If this stage is left without proper attention, then the disease most often becomes chronic. As a person continues to live quietly in ignorance and leads a normal lifestyle, the virus gradually destroys one of the most important organs.

Symptoms of chronic hepatitis C

Hepatitis is one of the most insidious diseases. The genotype of the virus mutates quite quickly, thereby reducing the tendency of the immune response. In the chronic or latent phase, the hepatitis C virus can be present in the human body for many years, and even decades. Periodically, it can become aggravated and take on an acute phase, and when the peak passes, it subsides again and exists quietly in the liver cells. The main symptoms of chronic hepatitis C:

Fatigue, decreased physical endurance;
Increased sleepiness, a person begins to devote more time to sleep and quiet rest;
Disorders of the digestive tract (nausea, vomiting, diarrhea, bloating, lack of appetite);
Changes in the color of the skin and mucous membranes;
Dark colored urine;
Discoloration of stool;
Feeling of heaviness and fullness in the right hypochondrium.

It is necessary to understand that all of the above symptoms together accompany the disease at quite late stages. When the liver has undergone significant changes and does not fully perform the necessary functions.

Mostly, patients experience a general deterioration in their condition, both physical and emotional. People tend to attribute such signs to problems at work, heavy workload, and not everyone turns to specialists for help. Therefore, they learn about their illness after a long time from the moment of infection.

With hepatitis C, women may experience irregularities in the menstrual cycle and pain in the lumbar region. In general, the weaker sex is much more attentive to their condition and well-being, which is why hepatitis C in women is detected at earlier stages. It is worth noting that the need to be examined during pregnancy plays a huge role in this. Also, some symptoms of hepatitis C in women encourage you to undergo testing for the presence of the virus in the blood:

Increased hair loss, hair fragility;
Brittle nails;
Changes in skin pigmentation;
Phlebeurysm.

Problems in the body appear due to metabolic disorders, improper functioning of the liver and digestive tract. As a result, the body does not receive the proper amount of vitamins and nutrients. These symptoms of hepatitis C in women are more noticeable because they take better care of their appearance than men, and with such manifestations they more often consult a doctor.

Diagnosis and treatment

Most often, people find out about the presence of a virus in the body completely by accident; antibodies are detected:

In preparation for operations;
When undergoing routine tests during pregnancy;
With a full medical examination;
When donating blood.

It is extremely rare for people to go on their own initiative and get tested for the presence of a particular disease. Although at this time they can be carriers of the virus and pose a threat to others. If antibodies to the hepatitis C virus were detected during testing, do not immediately panic.

There are cases of false-positive analysis, and in order to verify its correctness there is a need to repeat the study in another clinic. If the repeated analysis also gives a positive result, you should contact a specialist. You can use the services of a paid clinic or contact a therapist at your place of residence.

All viral diseases are dealt with by an infectious disease specialist, and hepatitis C is dealt with by a hepatologist. However, in order to see a specialist doctor directly, you will need to obtain a referral from a general practitioner in your area of residence. And only after that you will be able to make an appointment with an infectious disease specialist or hepatologist.

At the initial appointment, the doctor conducts an external examination and questioning of the patient, checking the condition of the mucous membranes and liver. The specialist must also write out directions to the patient for the following tests:

Hepatitis C markers;
Qualitative PCR of hepatitis C;
Determination of the virus genotype;
Ultrasound of the liver.

To confirm the diagnosis, the main test is PCR - polymerase chain reaction. It comes in two types - qualitative and quantitative. A qualitative reaction determines the presence of the virus in the blood, and a quantitative reaction, accordingly, its quantity. If a high-quality PCR test gives a negative result, this means that the patient once had the virus and successfully overcame it. In this case, you can breathe easy, and the antibodies in the blood can remain for many years, or even your whole life.

If the PCR is positive, the patient is registered and undergoes additional examinations and tests. After determining the genotype and amount of virus in the blood, the patient is prescribed appropriate therapy. Treatment for hepatitis C is quite expensive, but there is the option of treatment at government expense. The doctor puts the patient on a waiting list for treatment under the state program, but he has to wait for many years.

Knowing the symptoms of hepatitis C, you can easily suspect the presence of the virus in the body. A disease detected in the early stages will cause much less harm to the liver and the entire body as a whole. And it’s also much easier to deal with, because... The virus has not yet firmly settled in the liver cells and has not begun to destroy it. It is necessary to take care of your health and undergo regular examinations. Not only your health, but also that of your loved ones depends on this. Thus, mandatory testing for hepatitis C in women during pregnancy helps prevent infection of the fetus.

The liver is an organ that many people do not think about until it makes itself felt by some serious illness. And, perhaps, one of the most dangerous liver diseases is viral hepatitis C. However, this disease is not a death sentence, and it is quite possible to completely recover from it. So, hepatitis C - what is it and how does it appear, how to treat it and how to avoid the disease? How it is transmitted, the symptoms of the disease - every person needs to know all this about hepatitis C.

What is hepatitis C and how is it treated?

Hepatitis C is an infectious liver disease that has a mainly chronic course. Despite measures taken to combat the disease, the incidence of hepatitis C is currently increasing throughout the world. The risk of infection is approximately 21 per 100,000 people per year. Approximately 70 million people have been diagnosed with the disease. However, only 20% of them know about their disease, and 13% receive effective therapy. Many of the sick do not have information about the danger of their disease or do not know how to treat it. Hepatitis C kills approximately 400,000 people every year.

What causes hepatitis C, causes

This type of disease is caused by a special RNA virus, which was discovered only relatively recently, in the late 80s. Thus, hepatitis C cannot develop if a person has not had contact with this virus.

Hepatitis C viruses - who they are and how they kill the liver

Hepatitis C virus (HCV) is a small biological formation with a diameter of 30-60 nm. There are 11 genotypes of the virus and some genotypes may have multiple subtypes. Three types of the virus are most typical for Russia and other European countries, and some types are found only in tropical countries. In Russia, subtype 1b is the most common, followed in descending order by subtypes 3, 1a and 2.

Types of viruses differ in their aggressiveness and pathogenicity. The most incurable and dangerous disease is considered to be caused by 1 genotype of the virus. Subtype 1b most often enters the body through blood transfusion.

Hepatitis caused by genotype 3 virus is also dangerous. It is characterized by rapid progression of the pathology. In some cases, chronic hepatitis caused by this type of virus turns into cirrhosis in 7-10 years, and not in 20 years, as in the case of other types of virus. In addition, this genotype of the virus most often affects young people (under 30 years of age). Hepatitis subtype 3a is the most common type of disease among drug addicts.

In some cases, several varieties of the virus are detected in the patient’s blood. This circumstance can have two probable explanations - either the person was infected from a carrier of several types of viruses, or there were several episodes of infection.

The virus lives not only in liver cells, but also in other biological fluids of the body. The highest concentration of the virus is found in the blood. In saliva, semen, vaginal secretions and other fluids, the concentration of the virus is much lower. The virus does not pass into breast milk.

Penetrating into liver cells, the virus causes them to produce new viruses. One cell infected with a virus can produce up to 50 viruses per day, which ultimately leads to its death. While in the body, the virus constantly mutates, which makes it difficult for the immune system to fight it and leads to the depletion of its resources.

Development of the disease

After the virus enters the body, the immune system produces antibodies to the virus. Events after this can develop in several directions.

If a person’s immune system is strong enough and/or the virus has entered the body in insufficient quantities, then the immune system defeats the virus and it completely disappears from the body. However, antibodies to the virus can remain in the body for a long time. Such a development of events, however, occurs infrequently - in 10-15% of cases.

In another case, the virus can cause an attack of acute hepatitis C. This event occurs after an incubation period lasting from 2 days to 6 months. The average duration of acute hepatitis is 3 weeks. However, acute viral hepatitis is rarely diagnosed; usually its symptoms are also erased. However, although this form of hepatitis usually resolves quickly, it then becomes chronic.

Finally, a person can develop chronic hepatitis without a prior acute phase of the disease. This option is usually the most dangerous, since in such a case a person may not be aware of the disease for many years.

Basic principles of hepatitis C treatment

Treatment of hepatitis C is carried out mainly with the help of medications aimed at destroying the virus in the body. Other medications, such as hepatoprotectors, are of auxiliary value. Correction of the patient’s lifestyle, primarily his diet, is also practiced.

How is hepatitis C transmitted from person to person?

How is the disease transmitted? First of all, it is necessary to remember that hepatitis C is an anthroponotic disease. This means that the source of infection for one person can only be another person.

The hepatitis virus most often enters the body hematogenously (through the blood). Situations in which infection is possible:

blood transfusion;
surgical or dental procedures;
use of unsterilized reusable syringes;
use of unsterilized instruments in hairdressing salons, beauty salons, tattoo parlors, etc.;
sexual intercourse;
transmission from mother to newborn child during childbirth.

Thus, the mechanism of infection with hepatitis C is in many ways similar to the mechanism of infection. However, practice shows that hepatitis C is generally more typical for developed countries than AIDS. However, the bulk (approximately 50%) of those infected with the hepatitis C virus are drug addicts, as is the case with

The risk of infection is also high among medical workers who have constant contact with the blood of patients. The likelihood of transmission of the virus from mother to newborn baby is relatively low (5% of cases).

Transmission of the virus does not occur either by airborne droplets, or by oral-fecal routes, or through skin-to-skin contact (handshakes, etc.), or through the sharing of household items and utensils. The only exceptions are items that may get blood on them - toothbrushes, scissors, towels, razors.

Also, the virus does not penetrate into breast milk, so a mother infected with hepatitis can safely feed her baby milk.

The more severe a person’s symptoms of chronic hepatitis, the more contagious he is to others. Therefore, the chance of becoming infected from virus carriers is less than from people in whom the disease is actively progressing.

Symptoms

The disease is most often easier to recognize during its acute phase, which appears several weeks after infection.

Symptoms of acute hepatitis C:

weakness,
high temperature (uncommon),
loss of appetite,
nausea,
vomit,
stomach ache,
dark urine,
light feces,
jaundice (uncommon),
joint pain,
skin itching and rashes (uncommon).

Chronic hepatitis C

Hepatitis C is not called the “gentle killer” for nothing. The thing is that the manifestations of the chronic form of hepatitis are usually extremely scarce, and not every patient or even a doctor is able to recognize hepatitis or its viral form in time. This situation leads to the fact that many patients go to the doctor only when they begin to experience severe liver pathologies (for example, cirrhosis), and doctors are often no longer able to help the patient.

However, in most cases, patients with chronic hepatitis may experience:

increased fatigue, especially after physical activity;
autonomic disorders;
periodic pain or heaviness in the right side, especially after eating;
weight loss.

Decreased liver function leads to oversaturation of the blood with various toxins. First of all, the brain suffers from this, so patients with hepatitis C often experience:

depression,
apathy,
irritability,
sleep disorders,

and other negative neurological phenomena.

It goes without saying that few people consider such nonspecific manifestations to be signs of severe liver disease.

With severe liver dysfunction, the manifestations of the disease become much more noticeable:

bitterness in the mouth;
yellowing of the skin, mucous membranes;
constant dull pain or heaviness in the right hypochondrium;
swelling in the lower extremities;
ascites (accumulation of fluid in the abdominal cavity);
problems with blood vessels, including dilation of blood vessels in the upper body;
nausea;
decreased appetite;
dyspepsia;
changing the shape of the fingers (fingers in the form of drumsticks);
dark-colored urine and light-colored stool.

Mental and neurological disorders caused by severe liver failure include:

hallucinations,
episodic loss of consciousness,
decrease in intellectual abilities,
decreased coordination abilities.

First signs and symptoms in women

In fact, there are no signs of hepatitis that are specific to a particular gender - male or female. That is, in women, the acute form of hepatitis is manifested by the same symptoms as in men - signs of intoxication of the body, digestive disorders, dark urine and too light stool.

According to some experts, chronic disease in women is easier than in men. However, this is not due to the inherent “gallantry” of the virus, but rather to the fact that men more often have factors that negatively affect the liver - alcohol abuse, excessive consumption of heavy and fatty foods. However, this does not mean that women do not need to be treated for the disease.

Forecast

The disease usually progresses without treatment, although there is a certain percentage of people who do not experience deterioration in liver function while the virus is in the body. However, the progression of hepatitis means that liver tissue is destroyed.

The prognosis is worsened by many associated factors:

weakened immune system;
other liver diseases, including other viral hepatitis;
infection with several types of virus at once;
elderly age.

The disease usually develops faster in men than in women. The younger a person is, the more his body is able to resist the virus. Only 20% of infected children develop a chronic form of the disease, while for the rest it goes away on its own.

How long do people with hepatitis C live?

How long do patients live with hepatitis C is a question that worries everyone who has pathogens found in their blood. With a timely course of treatment, the patient completely gets rid of hepatitis, and if the virus has not had time to destroy the liver sufficiently, then the person can live as long as other people. Therefore, the only question that makes sense is how long a patient can live without treatment.

The answer to it depends on many factors - the genotype of the virus, the initial state of the immune system, the liver, the body as a whole, the patient’s lifestyle and the presence of negative factors affecting the liver. Much depends on the stage at which the disease was discovered. Some people can live for decades with hepatitis C, while others develop severe and often incurable complications after a few years - cirrhosis and liver cancer. In such a case, a person’s life expectancy can be a matter of years. Therefore, it is necessary to begin serious treatment of hepatitis C immediately after diagnosis, without waiting for consequences.

Complications

Hepatitis is a disease in which in most cases it is not the disease itself that leads to death, but its complications.

Within 20 years after infection, the patient is highly likely to develop cirrhosis (in 15-30% of cases). Another form of severe liver disease is possible - hepatosis (fatty degeneration of the liver tissue). In some cases, liver carcinoma (cancer) may result from disease progression.

The likelihood of complications largely depends on the type of virus. Similar phenomena are more typical for viruses of the first genotype.

Diagnostics

Hepatitis C can be clearly separated from other types of this disease only by checking the presence of the virus in the body. The presence of the virus is determined primarily by a blood test. There are several varieties of this analysis. Testing for antibodies to the virus is the most common of them. Antibodies are substances produced by the immune system to fight a virus. There are tests that can determine the level of antibodies of a certain class in the blood.

The presence of antibodies to the virus in the blood, however, does not always mean the presence of the virus itself in the body, since in some cases the body can defeat the virus. It should also be taken into account that antibodies to the virus may not appear in the blood immediately after infection, but after 1-1.5 months.

The PCR method is more informative, thanks to which the biochemical components of the virus itself can be detected in the blood. Such a study also helps to determine the degree of activity of the virus and the rate of its reproduction.

Other studies are also carried out - general and biochemical blood tests. However, other types of analysis are of an auxiliary nature. A decrease in platelet levels and an increase in leukocyte levels indicates inflammatory processes in the liver.

Biochemical analysis allows you to identify the level (bilirubin, AST, ALT, gamma-glutamyl transpeptidase, alkaline phosphatase) and use them to determine the degree of liver damage. The more of these substances in the blood, the further the process of destruction of liver tissue has gone. A coagulogram shows changes in the process of blood clotting. Usually, with liver disease, blood clotting decreases due to a decrease in prothrombin produced in the liver in the blood.

The biopsy method has high diagnostic accuracy. It involves taking a small piece of liver tissue for analysis. This procedure is usually performed under local anesthesia using a special thin needle.

Ultrasound is also often used. The degenerative process in the liver is usually accompanied by its enlargement and a change in the echogenicity of its individual sections. For the same purpose - determining the size of the liver and studying changes in its internal structure, CT, radiography, and MRI methods are used. Encephalography helps to identify encephalopathy concomitant with liver failure.

Treatment

Once hepatitis C is diagnosed, treatment should be carried out by a hepatologist. The chronic form of hepatitis is always treated on an outpatient basis.

Until recently, the disease was considered incurable, although it took a long time to develop. However, this situation has changed with the advent of a new generation of antiviral drugs.

The traditional treatment regimen for hepatitis C includes interferons and the drug ribavirin. Interferons are substances similar to those produced by immune cells to fight the virus. There are different types of interferons. The main functions due to which interferons fight the virus:

protecting healthy cells from virus penetration,
preventing the virus from reproducing,
activation of the immune system.

The duration of treatment with ribavirin and interferons is determined by the doctor. The daily dose of ribavirin is usually 2000 mg. Injections of interferon are usually carried out 3 times a week, and long-acting interferon - 1 time a week. However, the effectiveness of such therapy leaves much to be desired. Usually it does not exceed 50%.

Recently, a number of new antiviral compounds have been developed (sofosbuvir, velpatasvir, daclatasvir, ledipasvir). These compounds belong to the class of direct acting drugs (DADs). Often several active compounds are combined in one drug (sofosbuvir and ledipasvir, sofosbuvir and velpatasvir). The mechanism of action of PPD is based on integration into the RNA of the virus, due to which the synthesis of important proteins used in the process of its replication is disrupted.

You can use various types of PPD separately or by combining them with each other. Correctly selected treatment can destroy the virus in 95% of cases. The course of therapy with these drugs can take from a month to six months - it all depends on the type of virus, as well as the degree of development of the disease. However, a decrease in viral activity is observed from the first days of taking the drugs. For hepatitis not complicated by cirrhosis, the duration of treatment is usually 3 months. If it is not possible to quickly get rid of the virus, then interferon and ribavirin can be added to the treatment regimen.

The disadvantage of modern drugs is their high cost, and a course of treatment with original drugs is often comparable in price to the cost of a new imported car. Naturally, in our country not everyone can afford it yet. However, there are also a number of slightly cheaper generics made in India.

The use of drugs of the hepatoprotector class is aimed at supporting the liver and slowing down the processes of its degradation. Hepatoprotectors reduce the rate of formation of connective tissue in the liver, strengthen the walls of hepatocytes, prevent the accumulation of fat in the liver, and stimulate the formation of bile. However, hepatoprotectors are not able to cure hepatitis; this should be remembered. However, hepatoprotectors can slow down the progression of the disease if the patient does not have the opportunity to undergo etiotropic therapy.

The main classes of hepatoprotectors are:

ursodeoxycholic acid,
essential phospholipids,
milk thistle preparations,
artichoke extract.

Also, the doctor, along with antiviral drugs, can prescribe immunomodulators (including herbal ones), drugs that normalize functions and blood composition.

A properly selected diet can also slow down the progression of the disease. It is recommended to exclude foods that negatively affect the liver and contribute to bile stagnation. You need to eat little by little, in small portions, avoid overeating and overloading the liver. Drinking alcohol is also prohibited if you are ill. The use of hepatotoxic medications should be limited.

The effectiveness of the therapy will be assessed by a blood test. If the amount of virus has decreased, then the concentration of liver enzymes and bilirubin in the blood decreases. PCR analysis allows you to determine a quantitative reduction in the number of viral particles.

Prevention

It is perhaps impossible to completely avoid the risk of contracting hepatitis C, but everyone can significantly reduce it. First of all, you should avoid visiting beauty salons, dental and medical institutions with a dubious reputation, and ensure that disposable syringes and instruments are used in all situations.

Currently, all donors are tested for the presence of the virus in their blood. Therefore, the likelihood of infection through blood transfusion is close to zero. However, people who received blood transfusions before the mid-90s, when this test was introduced, could become infected during this procedure. Therefore, they should be tested for the virus.

The likelihood of infection through sexual contact is quite low (3-5%). However, it should not be discounted. Therefore, condoms should be used during intimacy.

People who regularly use reusable syringes need to ensure that they are not used by others. You should also not use other people's razors, toothbrushes or other objects that may have blood on them. There is currently no effective vaccine for the virus, although similar research is underway in many countries and significant progress has been made in some cases. The complexity of developing such a vaccine is explained by the presence of many genotypes of the virus. However, vaccination against hepatitis A and B is recommended, since simultaneous infection with these types of hepatitis significantly complicates the course of hepatitis C.