Hepatitis C symptoms and diagnosis , Hepatitis treatment

Hepatitis C symptoms

hepatitis C treatment

Currently, there is an increased incidence of hepatitis C, which is transmitted through contact with infected blood. In more than 85% of cases the infection has a chronic course with the risk of the formation of liver cirrhosis, identify, usually 20 years or more after infection. Transformation into cirrhosis in the natural course of infection occurs gradually without marked changes of the clinical picture and treatment of late stages of the disease is associated with considerable difficulties and is not always successful. For chronic hepatitis C patients the risk of developing hepatocellular carcinoma (HCC) after 20 years of infection is 1-5%.Considering the hepatitis C virus, we note that its main feature is the genetic variability and the ability to mutate, on this basis are 6 major genotypes. High activity of the virus mutation leads to the fact that the human body may be as many about four dozen subspecies of hepatitis C virus in a single genotype, so the immune system is unable to control the production of the desired antibody, because yet developed antibodies to one virus subtype, new subspecies with different antigenic properties. The latent period of the disease is about 50 days, with symptoms of hepatitis C may not even appear: often patients learn about the infection only when starts cirrhosis.In general, hepatitis C - an asymptomatic disease, which is often diagnosed incidentally. But in the meantime, you can select non-specific symptoms of hepatitis C, which can not indicate disease. These include asthenia, fatigue and weakness. In any case, it is necessary to periodically review for hepatitis, because early detection of disease is treated easily and quickly.Differentiation of individual stages of hepatitis C is of practical importance because of the need to define the indications for interferon:Acute phase of infection: asymptomatic patients are not aware of the source of infection and contamination;Progression in chronic hepatitis B: 85% of the patients after the acute phase will develop chronic hepatitis C, which can occur at first hidden (latent phase), and then start to progress (reactivation phase), when already identified clinical and laboratory signs of exacerbation.Transformation in cirrhosis - a serious illness, against which may develop complications and liver cancer, leading to death.They may not appear ever to transition to cirrhosis. However, non-specific, that is typical for other diseases and symptoms may occur in hepatitis C: chronic fatigue, weakness, fatigue,In cirrhosis may appear jaundice, spider veins on the skin, ascites (fluid in the abdominal cavity).possible extrahepatic manifestations of viral hepatitis C., for example skin diseases, kidney, joints.Hidden (incubation) period for hepatitis C is about 50 days (20 to 140).Symptoms of hepatitis C may not appear ever. Any evidence of infection at all can be detected only when the switch hepatitis to cirrhosis.In general, hepatitis C - is an asymptomatic disease, is diagnosed more often by accident when people are surveyed about other diseases. Therefore, early diagnosis is important analyzes.Often fatigue, weakness, fatigue. But these symptoms are non-specific (one of their presence can not talk about hepatitis C).cirrhotic liver may appear jaundice, increases in volume abdomen (ascites), spider veins appear, growing weakness.Any chronic infection and intoxication can be accompanied by asthenic syndrome, weakness, fatigue.

How can hepatitis C diagnosis be done ?

Hepatitis C symptoms and diagnosis , Hepatitis treatment

The diagnosis of acute hepatitis C infection based on clinical (increased hepatic manifestations, liver palm size of the liver and spleen), virological (presence of viral RNA in the blood and / or anti-virus), biochemical (elevated levels of transaminases, ALT and AST) data having clear link with parenteral manipulations in the first months to its development: surgical operations, blood transfusion, the first injection of narcotics, etc. Unfortunately, most patients show no signs of acute hepatitis and viral RNA detection can not distinguish acute hepatitis from chronic hepatitis. In this case, the diagnosis of hepatitis C should be based on the availability of relevant data epidemic history for 1-4 months before the first detected signs of hepatitis C, which are antibodies to hepatitis C virus and levels of enzyme. The criteria for the diagnosis of chronic hepatitis C are enlarged liver and spleen, as well as the presence of antibodies to hepatitis C virus in the blood within 6 months. The exact nature of liver - fibrosis and degree of necrosis and inflammatory changes - allows you to define a liver biopsy, which is by far the most accurate and informative method of diagnosis of chronic hepatitis C. In addition, the procedure is carried out for a few seconds and is completely safe for the patient. Note that the presence or absence of HCV RNA is not diagnostic of chronic hepatitis C, but only determines the phase of the process (active, inactive).Acute hepatitis C is rarely diagnosed and often by chance. Characterized by a rather high activity of transaminase liver (often an increase in ALT 10 times or more) in the absence of clinical manifestations (patient complaints, no outward signs of illness). The symptoms of acute hepatitis C include intoxication, lack of appetite, weakness, nausea, and sometimes - joint pain. Then may develop jaundice, which with the advent of transaminase activity is reduced. Possible enlargement of the liver and spleen (hepatosplenomegaly). Overall, intoxication and elevated transaminases are less pronounced than in hepatitis A and B.For the diagnosis of hepatitis C, the following laboratory and instrumental methods of examination:

•     Biochemical analysis of blood alanine aminotransferase (ALT), alaninaminotranspeptidazu (AST), bilirubin;
•     Blood for antibodies to hepatitis C virus (anti-HCV);
•     PCR (polymerase chain reaction hepatitis C) to determine an RNA virus;
•     Ultrasound examination of the abdominal cavity (US);
•     Liver biopsy.

Positive test results for antibodies to hepatitis C virus (anti-HCV) can mean the following:

•     Do you suffer from chronic hepatitis.
•     Moved past infection. Previously you were faced with this virus, but the natural protective reaction helped you overcome the infection. Why some people can cope with the virus, while others do not is still unknown. Probably play a role in this, and kind of virus, and the condition of the body's defenses.
•     False positive result. At first blood in some patients may be determined positive, which is not confirmed by a deeper examination. Such reactions may be related to other causes, and not with the hepatitis C virus

The greatest danger is a chronic form of the disease, which often turns into cirrhosis and liver cancer. Hepatitis C combination with other forms of viral hepatitis, dramatically aggravates the disease and threatens death.

 Examination must also addicts, children born to mothers with hepatitis, people leading promiscuous. However, there still prevails "accidental" discovery of hepatitis C in the survey about other diseases before surgery or childbirth. The analysis determines the presence of antibodies to hepatitis C virus (anti-HCV), operate in most medical institutions. This analysis establishes only the fact of infection in the present or the past. Furthermore, this analysis can give false-positive (infections are actually not) and false-negative results (infection actually is), for different reasons. Therefore, accurate diagnosis of hepatitis C is more complex examination: blood biochemical analysis, PCR for HCV-RNA (qualitative, quantitative genotyping), complete blood count, coagulation (blood clotting). Need to do ultrasound of the abdomen can be shown hepatic biopsy. With all the results, the doctor will be able to deliver the full diagnosis, determine the level of virus in the body, to assess the condition of the liver and the degree of damage, pick up an effective and safe treatment.

Laboratory and instrumental diagnosis of chronic hepatitis C according to the standards of diagnosis

The list of approved research include:

•     Ultrasonography of the abdomen;
•     a blood test for hepatitis;
•     coagulation;
•     study level of bilirubin in the blood fractions (AFP);
•     Study Blood urea;
•     study in serum creatinine level;
•     study aminotransferase levels in the blood (ACT);
•     study aminotransferase levels in the blood (ALT);
•     study the level of gamma-glyutamiltranspeptidozy (GGT);
•     study of alkaline phosphatase in the blood;
•     study the level of potassium in the blood;
•     study of sodium levels in the blood;
•     study level of lipids in the blood;
•     Study AFP level in serum;
•     Study level cryoglobulins in serum;
•     study of antibodies to antigens of mitochondria;
•     study of antibodies to antigens of the muscle tissue;
•     study of antibodies to antigens of the cell nucleus and DNA;
•     fecal occult blood;
•     laparoscopy inspection of the liver and gallbladder;
•     clinical analysis of urine;
•     electrocardiography;
•     definition HBsAg Hepatitis C virus;
•     determination of antibody class M, G (IgM, IgG) to the Hepatitis C virus;
•     determination of antibody class M, G (IgM, IgG) to the Hepatitis D virus;
•     detection of antigen HBeAg Hepatitis C virus;
•     determination of antibody class M, G (IgM, IgG) to HbeAg Hepatitis B virus;
•     determination of antibody class M, G (IgM, IgG) to HVsAg Hepatitis B virus;
•     RNA PCR qualitative, quantitative, genotype blood Hepatitis C virus;
•     PCR DNA qualitative, quantitative, genotype blood Hepatitis B virus;
•     RNA PCR qualitative, quantitative, genotype blood Hepatitis D virus;
•     RNA PCR qualitative blood Hepatitis G virus;
•     liver biopsy;
•     morphological study of liver tissue;
•     esophagogastroduodenoscopy.