Chronic hepatitis C
Chronic hepatitis C is a complex infectious disease. In medical circles, this diffuse liver disease has been called the affectionate killer. This is due to the fact that very often group C hepatitis is asymptomatic (from 6 months or more) and is detected only during complex clinical blood tests.
According to existing statistics, in 70% of cases, hepatitis C becomes chronic. Currently, this form of the virus ranks first in the number of infected patients who have severe complications. When conducting studies in different countries of the world, it was found that 80% of patients were diagnosed with HCV infection.
- How long do people live with chronic hepatitis C?
- The causes of chronic hepatitis
- Chronic hepatitis symptoms
- Chronic hepatitis diagnostics
- Chronic hepatitis treatment
- Diet for chronic hepatitis
- Complications of chronic hepatitis
How long do people live with chronic hepatitis C?
The World Health Organization conducts regular research on the viral-infectious disease hepatitis C, data on which is regularly made public. According to data published in specialized media, as well as on medical Internet portals, to date, more than 500 million cases of infection with this form of hepatitis have been recorded in different countries of the world.
In the highest medical circles there is confidence that within 10 years the number of patients who develop complications against the background of hepatitis will increase several times:
- liver cancer will be detected in more than 70% of patients;
- cirrhosis of the liver will be diagnosed in more than 55% of patients;
- the number of cases in which the disease with hepatitis C will end in death will more than double (today 57% of patients die from cirrhosis, and 43% from hepatocellular carcinoma).
Many people are very concerned about the question: how many years can you live with chronic hepatitis C? The virus of this disease is not a direct "killer". It promotes the development and progression of various pathologies that have a detrimental effect on the patient's body and cause irreversible changes. The male half of the population is more susceptible to this disease - they develop complications several times more often against the background of hepatitis C.
The hepatitis C virus infection can be dormant in the human body for several years without causing any symptoms or discomfort. In some cases, the progression of the disease can occur 50 years after infection. Experts say that with the right supportive therapy, patients with chronic hepatitis C can live a long life.
At the same time, in some patients, cirrhosis of the liver or other dangerous complications can develop within a short period (10-15 years) after infection with the hepatitis C virus. Alcohol consumption significantly shortens the life of a patient with this form of the disease.
The causes of chronic hepatitis
Despite the active development of the medical industry, at present, most often people are infected with the hepatitis C virus in medical institutions or dental offices.
In most cases, infection occurs during various manipulations in which a healthy person comes into contact with an infected biological material:
- during injections (intramuscular, subcutaneous, intravenous, droppers);
- during blood transfusion;
- during dental treatment;
- during the hemodialysis procedure, etc.
The spread of the hepatitis virus in medical institutions occurs due to non-compliance with sanitary and epidemiological norms and rules. Modern medicine identifies the main causes of infection with hepatitis C, which include the following:
- the use of other people's personal hygiene products (toothbrushes, towels, shaving accessories, manicure devices, etc.);
- having unprotected sex with an unverified partner;
- the use of one syringe by intravenous drug users;
- visiting clandestine salons in which piercing or tattooing is done in unsanitary conditions;
- infection of the child by the mother during labor;
- visits to nail salons and beauty salons in which instruments are not sanitized properly.
Chronic hepatitis symptoms
Chronic hepatitis C can be asymptomatic in the patient's body for 15-25 years.
At the same time, this disease may be accompanied by the following symptoms:
- against the background of a decrease in immunity, patients develop colds and viral diseases;
- allergic reactions;
- general intoxication of the body;
- an increase in the temperature regime (in patients, the temperature may slightly rise, or there may be a strong fever);
- chronic fatigue, against the background of which disability occurs;
- increased fatigue (the patient gets tired even with little physical effort);
- headaches that often resemble migraine attacks;
- disruption of the organs of the gastrointestinal tract;
- diseases of the genitourinary system develop;
- weakening of liver function;
- development of diseases of the heart and blood vessels;
- general weakness;
- an increase in the size of the liver;
- loss of appetite;
- frequent nausea;
- vomiting reflex;
weight loss, etc.
Chronic hepatitis diagnostics
Due to the fact that chronic hepatitis C is often asymptomatic, in order to diagnose this disease, it is necessary to conduct a complete examination of the patient, which includes a whole range of manipulations. During the examination of the patient, the gastroenterologist or infectious disease specialist must first collect a history of the disease. The specialist should pay special attention to the method of infection of the patient, for this it will be necessary to collect information about his lifestyle. The presence of symptoms characteristic of this disease will help the attending physician to make a preliminary diagnosis, so that it will be possible to outline a set of upcoming diagnostic measures.
In domestic medical institutions, when diagnosing chronic hepatitis C, modern methods are used, the experience of leading specialists from around the world, innovative equipment and a whole range of clinical trials. Since 2000, special tests have been carried out in Russian clinics, the results of which can reveal the presence of the hepatitis C virus in the human body. One such test is "ELISA", which includes kits that contain HCV antigens isolated from non-structural genes. You can also note the recombinant immunoglobulin test "RIBA", which uses the same antigens. Both of these tests were designed specifically for the detection of HCV RNA.
Currently, when conducting diagnostics, ELISA methods are used, which are approved by the FDA and are recommended by them for use. These tests are affordable, so even people with modest financial support can pay for them. They are very often used for the primary diagnosis of group C hepatitis, since they are able to determine the presence of virus antibodies in the body of a patient who has clinical signs of this disease. Due to their high sensitivity to this viral infection, ELISA tests are used to examine patients at risk. A false result of such testing can be obtained when examining patients who are on hemodialysis, who are diagnosed with autoimmune disorders or immunodeficiency.
After testing, laboratory confirmation of the diagnosis must be obtained. For this, patients need to donate blood, which is carefully checked for antibodies to HCV, as well as for ALT activity. These studies are carried out using special reagents and high-tech medical equipment. To obtain an accurate clinical picture of the course of this disease, it is necessary to carry out dynamic monitoring of ALT indicators (experts recommend that such a study be carried out at least once a month). In the case when normal ALT activity is observed for several months, in the presence of HCV antibodies, such patients will be transferred to the group of carriers of the virus.
During laboratory studies of a patient's biological material, specialists use specific markers.
The results of clinical trials may have the following interpretation:
- indefinite (if such a result is obtained, patients are recommended to undergo a second laboratory examination after 2 months);
An accurate diagnosis, indicating the presence of chronic hepatitis C in a person's blood, can be made if HCV RNA is detected within 6 months.
A more accurate picture of the area of liver damage at the microcellular level can be obtained from a biopsy. This technique provides for surgical manipulation, during which the patient's biological material is taken. After that, the tissue samples are transferred to the laboratory, where a thorough histological examination will be carried out. Thanks to a biopsy, it is possible to identify cirrhosis, hepatic cancer and other diseases that are life-threatening to the patient at a very early stage of development. When diagnosing patients with chronic hepatitis
The following morphological manifestations are often revealed:
- there is a combination of hydropic and fatty degeneration with Kounsilman's acidophilic bodies;
- lymphoid infiltration is detected, against the background of which follicles are formed, the localization of which is the portal tracts;
- stepwise necrosis develops;
- bile ducts are affected, etc.
When carrying out a comprehensive diagnosis, a specialist can indicate the presence of chronic hepatitis C, the development of liver cirrhosis, which was preceded by intralobular group necrosis. The attending physician may suspect the presence of this form of the disease when palpating the area in which the organs of the gastrointestinal tract are located. With a change in the size of the liver and spleen, it can be argued that viral hepatitis C has become chronic.
It is possible to determine the exact size of the affected organs by means of hardware diagnostics:
- ultrasound examination;
- CT scan;
- Magnetic resonance imaging.
Chronic hepatitis treatment
After a comprehensive diagnosis and confirmation of chronic hepatitis C, patients should undergo a course of preparation for therapy.
To do this, you must pass:
- general and clinical blood test;
- general urine analysis;
- a blood test for thyroid hormones;
- blood test for HIV infection, syphilis, as well as other sexually transmitted and infectious diseases.
If, during laboratory tests, a patient has a high hemoglobin level, then he will need to pass an additional test, which allows him to determine the serum iron levels.
All patients who have been diagnosed with chronic hepatitis C must undergo antiviral therapy. In many medical institutions, when choosing a method for treating this form of the disease, they use the recommendations given by the National Institute of Health and the European Association for the Study of Liver Diseases. They are intended for the category of patients who have been diagnosed with severe to moderate necrotic inflammation. Etiopathogenetic therapy is indicated for patients who have developed liver fibrosis, against which there was an increase in the level of ALT.
The main task of specialists who carry out complex treatment of patients diagnosed with chronic hepatitis C is the eradication of the virus. Thanks to modern treatment methods and unique medicines, doctors are able to slow down the progression of this disease. Patients who exactly follow the recommendations of specialists begin to feel small improvements almost immediately after starting therapy. After completing the course of treatment, patients are sent for laboratory examination, due to which the histological picture of the liver is determined.
To achieve good results, therapy for patients with chronic hepatitis C should be carried out within the walls of a medical institution. Specialized clinics have the necessary equipment and medications that will improve the patient's overall well-being. The advantages of inpatient treatment include the fact that modern medical centers comply with all the rules of the sanitary and epidemiological regime. These patients are treated by highly qualified specialists - gastroenterologists, hepatologists and infectious disease specialists.
The medical course of therapy, intended for the treatment of chronic hepatitis C, involves the intake of various medications:
- interferons and other drugs with antiviral effects;
- azathioprine or prednisolone, as well as other drugs belonging to the category of immunosuppressants;
- combination drugs;
- pathogenetic agents, etc.
Numerous clinical studies conducted in different countries of the world have proven the benefits of interferons in the treatment of chronic hepatitis C. These drugs are used in the form of injections, which are administered either subcutaneously or intramuscularly. On average, the course of treatment is 12 months, provided that antibodies disappear from the patient's blood three months after the start of therapy.
The course of treatment with interferons is contraindicated in patients who have the following pathologies:
- mental disorders;
- depressive conditions;
- frequent epileptic seizures;
- tendency to form blood clots;
- decompiled cirrhosis of the liver;
- complex diseases of the heart and blood vessels;
- transplanted organs from donors.
In the treatment of chronic hepatitis C, monotherapy is carried out for women in the following cases:
- the patient has no problems with being overweight;
- the patient's age has not reached the 40-year mark;
- low concentration of virus antibodies in the blood;
- normal iron levels;
- minimal changes in the structure of the liver;
- increased ALT levels in the blood, etc.
In other cases, combination therapy is prescribed for patients with this disease. During the course of treatment, patients may experience various side effects: anemia, nausea, weakness, dizziness, etc. The course of combination therapy may take 6 or more months. The duration of treatment will directly depend on the results of a laboratory blood test, which must be carried out at least 1 time per month. In the event that after 3 months from the start of treatment, according to the test results, no changes for the better are seen, the doctor may change the course of therapy.
The course of treatment for chronic group C hepatitis involves taking antiviral drugs.
Such treatment may not be prescribed to all patients with such a diagnosis, since there are a number of contraindications:
- lactation period;
- renal failure;
- diseases of the heart and blood vessels.
In the case when a specialist chooses a treatment technique for patients who have diseases associated with hepatitis, a number of additional studies are necessary. It is very important to achieve the interaction of drugs used in the treatment of chronic hepatitis C and other equally serious diseases.
The current treatment strategy for chronic hepatitis C is a combination antiviral therapy.
Patients are prescribed drugs that interact perfectly with each other (as evidenced by numerous clinical studies):
- interferon alpha.
Despite the fact that individually these drugs do not have a strong therapeutic effect on the patient's body, in combination they perfectly cope with the hepatitis C virus. Separately, these drugs are prescribed only in case of serious contraindications to one of these drugs.
In the treatment of chronic hepatitis C, hepatoprotectors are often used to help restore liver function. Such drugs have a positive effect on the microcellular level, so each specialist includes them in the course of therapy.
Read More: List of Best Hepatoprotectors for Liver Repair
Thanks to the correctly selected drug treatment, specialists are able to prevent the progression of hepatitis. In some patients, after complex therapy, liver functions are fully restored. The duration of treatment depends on the stage of the disease, the general condition of the patient, and many other factors.
After the start of drug therapy, the patient needs to be tested regularly. The first laboratory blood test should be carried out 2 weeks after the start of the drug intake. The patient undergoes a biochemical and clinical analysis, according to the results of which it will be possible to determine the level of antibodies in the blood serum. The second time a laboratory study of the patient's biological material is carried out 4 weeks after the start of treatment. Subsequent delivery of tests should be carried out once a month. Once every 3 months, patients need to take a blood test to determine the indicators of thyroid hormones, on the correct functioning of which the work of many vital organs and systems of the human body directly depends.
If, during the treatment of chronic hepatitis C in the patient, chronic diseases begin to progress, he will need to consult narrowly specialized specialists. After that, the attending physician will have to correct the therapeutic therapy, taking into account the recommendations of other specialists.
On the subject: Is it possible to completely cure hepatitis C?
Diet for chronic hepatitis
In the presence of such a complex disease as chronic hepatitis C, patients need to follow a diet throughout their lives. Due to the forced dietary restrictions, it is possible to significantly facilitate the work of the liver. The patient should revise his daily schedule, and instead of the three main meals (breakfast, lunch and dinner), switch to fractional meals. In this case, the patient will have to eat 6-7 times a day, in limited portions. While following the diet, the patient must drink large amounts of water every day so that all toxins are removed from the body.
In most cases, patients who have been diagnosed with chronic hepatitis C have problems with the gastrointestinal tract, in particular, the pathology of the biliary tract develops. Against the background of such changes in the body, patients are strictly prohibited from drinking alcohol and alcoholic beverages. Experts strongly recommend getting rid of other addictions, such as nicotine and drug addiction.
With chronic hepatitis C, patients should follow a special diet (table number 5). Patients are prohibited from consuming the following foods:
- fatty meats and fish;
- smoked meats;
- canned meat and fish;
- fish caviar;
- fatty dairy products;
- chicken eggs in any form;
- animal fats;
- hot spices;
- meat broths;
- carbonated drinks and other products that contain dyes and preservatives.
The following products are allowed:
- dietary meats and fish;
- vegetables and fruits;
- vegetable oils;
- dried fruits;
- vegetarian soups;
- natural honey;
- unsweetened dried fruit compote;
- herbal teas, etc.
Read more: Diet for hepatitis C
Complications of chronic hepatitis
Group C hepatitis is a very dangerous disease, against the background of which serious diseases often develop:
- liver fibrosis (scars form in the liver tissue);
- steatosis (fat begins to accumulate in the liver cells);
- cirrhosis of the liver (irreversible changes occur in the liver);
- encephalopathy (brain damage occurs under the influence of toxins);
- ascites (fluid accumulates in the abdominal cavity);
- hepatocellular carcinoma, etc.
Most patients who have been infected with the hepatitis C virus develop dangerous complications:
- liver failure;
- decreased blood clotting;
- pain in the right hypochondrium;
- nausea and vomiting, etc.
All products that need to be heat treated must be cooked in a double boiler or oven with a minimum of vegetable oil.
On the subject: The most useful foods for the liver
Author of the article: Kletkin Maxim Evgenievich | Hepatologist
Education: Diploma in the specialty "General Medicine" received at the Military Medical Academy. S. M. Kirov (2007). At the Voronezh Medical Academy. NN Burdenko graduated from residency in the specialty "Hepatologist" (2012).