Hepatitis C Virus / Disease (HCV)
The incidence of hepatitis C virus antibodies varies between countries. This ratio ranges from 0.4% to 3.8%. In some studies, antibodies were found to be much more common in males than females. In societies with poor socio-economic conditions, contamination can be very high. The incidence of antibodies in high-risk groups such as homosexuals or HIV-positive patients is up to 10% higher than the equivalent average population.
Blood and blood products are a known route of transmission. Other ways have not been proven. The risk of accidental transmission by injections is as low as 3%, which is explained by the low number of Hepatitis C Virus in the blood. The risk of contamination during sexual contact is very low. The route of transmission is usually not clear. The incubation period is between 2 weeks and 6 months.
Structure, Diagnosis
Hepatitis C virus has no electron-optic images. This is due to the low number of viruses in the serum. The hepatitis C agent is in the group of single-stranded RNA viruses. Because the number of viruses in the serum of the infected person (germ-bearing) is very low, it is not possible to show the antigens directly because the immunological tests are below the sensitivity limit. However, 2nd and 3rd generation ELISA tests are used to show antibodies specific for Hepatitis C virus antigen. Antibodies can be shown after 4-6 weeks using 2nd and 3rd generation tests. However, in some cases, this may be delayed up to 4-9 months.
The clinical course of hepatitis C is manifested by chronicity in 30-90% of cases and cirrhosis of the liver in about 5-30%. The role of Hepatitis C virus in various chronic liver diseases has not yet been clarified. Anti-HCV (Hepatitis C Virus) has been observed in many types of liver cirrhosis. Even this rate was 27% in alcoholic liver cirrhosis.
No specific treatment. There is no active immunization. There are no reliable studies on the success rates of passive immunization.
WHAT IS HEPATITIS C? WHAT ARE PROTECTION METHODS?
Hepatitis C is a liver infection caused by hepatitis C virus (hcv). Formerly, neither C nor hepatitis A, which was called hepatitis B, was found in the mid-1970s. Since there was no test to detect specific antibodies (such as anti-hcv) until 1989, it was not known by existing tests, but neither A nor B was called hepatitis. It is thought that approximately 35,000 people in the United States encounter C hepatitis virus annually. (Sadly no such statistical information for Turkey). Chronic liver disease and cirrhosis are more common than B hepatitis. Previously, it was estimated that half of acute C hepatitis would become chronic (leading to chronic disease), but now it is estimated that this rate may exceed 80%. Cirrhosis may develop in some of them. Liver cirrhosis may develop in some of the patients with cirrhosis. Long-term studies are being conducted in a multi-centered way to determine the benefits of treatment.
Who are at risk for hepatitis C?
* Blood transfusions, blood products (plasma, erythrocyte suspension, etc.). (After July 1992, blood donors in many countries were investigated for C hepatitis virus and blood was given to people who needed blood before 1992. In our country, even in 1999, many hospitals still take blood without blood tests to detect C hepatitis virus.
* IV (intravenous) drug users, IV heroin use, (C used in a patient with hepatitis injector to another patient with the drug given.
* Hemodialysis patients (in the current routine, hemodialysis patients with hepatitis C and B - previously detected - undergo separate hemodialysis on special machines.
* Patients with hemophilia (blood and blood products must be given too often).
* Other: Those who have been cut with a piercing-piercing body (for example, a needle sticks to the hands of the operating physicians during surgery), tatuage and cocaine are among the risk factors.
Such persons should be tested for hepatitis c.
How is the hepatitis C virus transmitted?
The virus is found in the blood. Therefore it is transmitted through blood. However, there is also a risk of sexual transmission, so the use of condoms is recommended. This transmission is probably thought to be caused by skin lesions and wounds.
There is no conclusive evidence of whether the virus is actually transmitted by semen or saliva.
There is no evidence that HCV has passed through breast milk.
It is possible to infect HCV with razors, razors, even barber scissors, tattooing, body injury, acupuncture needles used in an infected person.
All persons with hepatitis C are potentially infectious. It is believed that there are 4 million carriers in America alone. Unlike hepatitis A and B, infection is not immune.
HCV is responsible for 90% of blood-borne hepatitis cases. However, it is not so easy nowadays because blood is given by testing (if done).
The transmission of HCV from a mother with hepatitis C to her baby is less than 5%. Transition is probably directly related to the amount of virus in the mother's blood. Babies born from infected mothers should be tested and checked.
* There is no vaccine for hepatitis C.
Vaccines for Hepatitis B and A do not immunize against Hepatitis C. There are many types of Hepatitis C viruses that are mutated. As a result, it will be difficult to develop a vaccine (as the virus constantly changes itself, it cannot benefit the altered virus even if the vaccine is administered). There is also no immune globulin (protective immunized serum) effective against hepatitis C.
What are the symptoms of hepatitis C?
Many people with hepatitis C do not have a good complaint and live a normal life. The incubation period is different. The average is 7-8 weeks. Liver function tests increased at different values from week to week throughout the year. Infected people, even if their liver function tests are normal, the virus is in their blood and can cause liver cell damage.
* If you have symptoms, it can even be very mild and similar to the flu.
(such as nausea, malaise, weakness, loss of appetite, fever, headache, abdominal pain)
* Many patients do not have jaundice.
How do I know if I have hepatitis C?
HCV infection can be detected by a simple and specific blood test (anti-HCV). But; whether acute or chronic infection is indistinguishable. This test is not routine (continuous and ordered absolute operations). Therefore, people should ask their doctor for an HCV test. If the first test is (+), a second test should be performed to confirm the diagnosis and liver function tests should be taken. In the currently used (eia) tests, approximately 95% of chronic hepatitis C patients have anti-HCV (+). So it is a sensitive test. Antibody (anti-hcv) may not be (+) in the first 4 weeks of infection in 30% of cases. Anti-HCV tests may be positive in 60% of cases as early as 5-8 weeks before encountering HCV.
Will I be okay?
Very few people with C hepatitis can remove the virus from their blood. The virus must be removed from the blood to fully heal. It is reported that more than 80% of the cases will become chronic (if there is a high level of liver enzymes (SGOT-SGPT) at least 6 months after the first acute infection, it can be said to be chronic).
SGOT and SGPT (sub - ast) are released when liver cell damage occurs. There are also tests indicating that the infection is chronic. Chronic hepatitis; chronic persistent hepatitis and chronic active forms of hepatitis. Chronic persistent hepatitis is a milder form. Sometimes it can progress to more severe liver disease such as cirrhosis.
What does chronic hepatitis C mean?
Chronic HCV means infection that is not cleared 6 months after an acute infection. The disease can progress gradually for more than 10-14 years. High SGOT and SGPT values are indicative of ongoing liver damage. Liver biopsy can be used to determine the type, severity and severity of the disease. Cirrhosis is believed to develop in 20% of patients with chronic hepatitis C. Cirrhosis of liver cells after the death of the liver scar (hard, useless, dysfunctional tissue) tissue occurs. Liver failure may occur in 25% of cirrhosis patients (5% of all cases) (even 30-40 years after infection). Patients with chronic hepatitis C who develop cirrhosis have a high risk of developing liver cancer. This may occur 10-40 years after the first infection.
What is the treatment of hepatitis C?
Recently; There are three interferon types and interferon + ribavirin treatment schemes. Biochemical, virological and liver biopsy findings are the determinants of treatment, not the presence or absence of disease symptoms.
Interferon can be used alone. Interferon has some side effects. Flu-like complaints, headache, fever, malaise, loss of appetite, nausea, vomiting, hair loss, as well as bone marrow depression may result in a decrease in white blood cells (leukocytes) and blood plaques (platelets). Therefore, the patient should be monitored with blood tests.
Sudden and severe anemia (anemia) may occur with ribavirin. Congenital anomalies may be seen and should not be used in pregnant women. Pregnancy should be prevented until 6 months after treatment. The severity and type of side effects vary from person to person. Treatment of HCV infection in children is currently under investigation.
In the first treatment of 50-60% of the cases, the response to treatment, in 10-40% of the virus can be cleared late. Therefore, the result of the treatment is not immediately decided. Treatment may be prolonged and a second treatment may be given in patients with recurrence after the first treatment.
Interferon use alone: after recurrence, 58% of the cases, including those who have been re-treated, have been reported to have cleared the virus. It has side effects but is well tolerated.
Interferon + ribavirin treatment: with side effects of both drugs, it is reported that 47% of the patients who have recurred have been treated again and viruses are cleared.
Re-infection occurs in 1/3 - 1/4 of patients with end-stage hepatitis C after liver transplantation. The risk of infection occurs in the newly transplanted liver (removal of the liver and insertion of the cadaver liver) is as high as possible. On the other hand, this usually does not require a second transplant.
Hepatitis A and hepatitis B vaccines should be given to patients with hepatitis C. They should not drink alcohol.
There is no special regimen that allows the disease to heal or worsen (except alcohol). To maintain a normal life, a balanced regimen is sufficient (liver failure is not included).
Work that will make people tired should be avoided and life should be planned to continue to the specified extent. The person should rest when he / she feels tired.
How is hepatitis C protected? How to prevent?
There is currently no vaccine for hepatitis C.
* Measures should be taken for the blood of infected persons and everything such as dishes, razors, razors, scissors, nail clippers, toothbrushes and cleaning papers.
* Spilled blood with bleach should be cleaned.
* Although HCV's sexual transmission is very rare, safe sex should be given. use of condoms, such as the abandonment of polygamy
* Patients with HCV should inform any physician and dentist that they are going to have HCV.
* Researches about this disease are increasing day by day, the search for remedy is continuing.mediko.boun.edu.tr
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