History from life - Interview with a real person who became infected with hepatitis C and joined the fight against the disease. Perhaps the example of Victoria will help many patients to accept their illness and defeat it.
Content
Scary diagnosis
— How you showed hepatitis?
— I did not have any symptoms associated with the liver. There were heart problems. I went to the cardiologist who said that I am healthy. Gynecologist, endocrinologist, other doctors talked the same. And at the same time I had such a fortune that I could no longer work, quit, lying all the time, I had a strong weakness, several times a week I was called an ambulance. Hepatitis was discovered by chance. At that time, I handed a lot of tests, and once again, the ambulance doctor recommended me to make blood test for biochemistry. It turned out that the spectrum of biochemical analyzes is very large, including the liver, kidney and so on. The attending physician decided to check the liver. Analysis showed that the liver is sick. It was clear that it was hepatitis, and now it followed what.
— What was your reaction?
— I immediately climbed the Internet to find out what kind of illness. I became clear that it was not, because he is not chronic, and I have for quite a long time. When, standing in the laboratory, I read the booth dedicated to hepatitis, I read about all his forms, except for viral hepatitis with. Because it seemed to me that this is something terrible, distant and unreal, that it does not even need to read that it is not about me. «According to the first results, – Told me a doctor, – This is not hepatitis in, all is well with that, we will very much hope that it is not hepatitis C, because it is deadly and is not treated». And when it all turned out that I had hepatitis C, it became clear that you need to change the doctors. That is, it is either really mortally and is not treated, or there is another doctor who can work with it. Then I appealed to Igor Anatolyevich.
Hepatitis S – Recreation is possible?
— What turned out to be the most difficult in the process of treatment?
— It was most difficult to hear how much treatment is. It was almost larger shock than to know that I have hepatitis with. That is, there are methods, treatment is, but it is not available to everyone.
Vika found the opportunity to undergo a course of treatment. Today she is completely healthy. Until the end of the course there are still several injections, and the tests show that the virus in the body is no longer.
About what hepatitis is from a medical point of view, and how to deal with him correctly, we talked to the viki doctor, Associate Professor of the Department of Infectious Diseases of the National Medical University them. BUT. BUT. Bogomolets, Candidate of Medical Sciences Igor Anatolyevich Anastasim.
Information for reflection
— What are the symptoms of viral hepatitis with? That man can alert?
— First of all it should be noted that viral hepatitis C is the leading problem of modern health care. Today 400—700 million. The world's population is infected with hepatitis C virus. This virus is the cause of 20% of cases of acute hepatitis, 80% of cases of chronic hepatitis, 40% — Terminal liver cirrhosis, 60% — hepatocellular carcinoma, 30% of liver transplant cases. If urgent measures are not taken, then after 10—20 years mortality from viral hepatitis C and its consequences will increase 3 times and significantly exceeds this indicator in HIV infection. During this time, according to the forecasts of the World Health Organization, chronic viral hepatitis C will become the main problem of national health authorities. As for your questions… Characteristic of viral hepatitis with symptoms does not exist. A person may notice a decrease in working capacity, general weakness, deterioration of appetite. But these symptoms may not manifest. Viral hepatitis with even in medical literature is called «affectionate silent killer». Among all types of hepatitis, viral hepatitis C has the highest percentage of chronic — 70—85%. That is, if a person fell ill, then it is very high likely to get the chronic form of hepatitis. The natural course of viral hepatitis C (from infection to the development of the liver cirrhosis) takes from 10 to 15 years, and sometimes up to 25 years — Depending on the lifestyle of a person. Therefore, it often happens that when a person appeals to the doctor, then with an extremely launched form of chronic hepatitis, often already at the liver cirrhosis stage.
— What problems people are addressed if they have not diagnosed viral hepatitis from previously?
— A person can prepare for a planned operation, to be treated in the therapeutic, gastroenterological department in connection with heart disease, stomach and t. NS. During the examination, the viral hepatitis with. Typically, chronic hepatitis goes into liver cirrhosis in 20% of cases. Among all patients with cirrhosis in 20% there will be a decompensation of the disease, slow progression of cirrhosis — 75%, primary liver cancer — one—4% per year. In order to understand the problem: one of the first places in the world in the liver transplant occupies US. So, among the reasons leading to the liver transplant, the first place is taken by viral hepatitis with. And this is in the country where the diagnosis is well developed.
— What frequency you recommend doing an analysis for viral hepatitis with?
— I recommend to be examined for the presence of a virus once a year, or at least once every two years. Persons belonging to risk groups — more often. Then the chance to stop the disease will be more.
— What are the ways of infection with a virus?
— Viral hepatitis C refers to a group of infections with a parenteral transmission method. That is, the infection occurs through blood and sexually. Danger represent all blood manipulations: tattoo, piercing, manicure, pedicure, medical procedures. If a person had surgical operations or blood transfusions until 1989, it is obliged to be examined for the presence of hepatitis C virus, since it was opened this year. The risk groups include the same persons as for HIV infection or hepatitis B: these are people who have been transfused blood, parenteral interventions, taking drugs and so on.
— In what cases shows the specific therapy of viral hepatitis with?
— Until recently, on international protocols of patients, treatment was necessary to carry out treatment, resorting to specific antiviral therapy if the virus replication is diagnosed (PCR positive), and the level of Alt (Alanine-Aminotransferase) above the norm. Alt level is the main criterion of cytolysis (inflammation) of hepatic cells. To date, these criteria for the appointment of therapy revised. Since it turned out that only 44% of patients with a normal level of Alt, with many years of observation, morphological changes in the liver. Therefore, today, the European Liver Study Association adopted such a decision: indications for viral hepatitis therapy with — This is a positive analysis on a polymerase chain reaction (PCR), that is, for the presence of a virus in the blood. Alt criterion is no longer.
— Where you can make an analysis for hepatitis with?
— In order to say, there is a problem or not, to begin with, it is necessary to be examined for the presence of antibodies to the hepatitis C virus, to make PCR and biochemical blood test. This can be done in any commercial laboratory of the city, or in the district polyclinic. If this analysis gives a negative result and biochemical indicators of blood, primarily Alt will be normal — So today everything is fine. If the result of PCR is positive — should contact a specialist.
Hepatitis pregnant women
— If hepatitis C is found in a pregnant woman what to do?
— This is a separate and very serious topic. If a woman was preparing for pregnancy, she was obliged to be examined for hepatitis with.
— And yet, if it happened?
— Full statistics on intrauterine transmission of the virus no. Risk exists. But a woman with viral hepatitis C can give birth to a healthy child.
— Can infection occurs during childbirth?
— I will try to explain on the example of hepatitis B and HIV, which are characterized by the same transmission methods. It is necessary to take into account the difference between them — The risk of infection with a checker-infected needle for hepatitis B virus is 30%, for hepatitis from 3%, and for HIV 0.3%. The minimum infamination dose for HIV is 0.1 ml (this is quite a lot) and for viral hepatitis in this 0.00004 ml. (literally at the tip of the needle). To date, in the order of the Ministry of Health to maintain pregnant women, with viral hepatitis B, there are no direct indications of akin to the help of cesarean section, because the statistical difference, according to these evidence-based medicine, for the infection of the child with a cesarean section and natural labor does not exist. To date, it is difficult to say when and how the fruit is infected, this is, I repeat, a complex separate topic.
— Can a man with viral hepatitis with become a father of a healthy child?
— A man with hepatitis C, going to become a father, must pass therapy and six months after her successful completion, if he does not detect the virus, plan the conception of a child. Can an infected man conceive a healthy child — I can't tell you because there is no statistical data on this issue. And no doctor I think will not recommend a patient with a diagnosis of viral hepatitis with planning the conception of a child before conducting specific therapy.
Treatment of hepatitis C
— Then we turn to the issue of therapy. What is still treating hepatitis with how long the treatment lasts how much it costs?
— Hepatitis therapy with has undergone a number of modifications since the opening of the virus. Initially therapy was carried out simply by interferon, then — Interferons in combination with Ribaverin, to date, the gold standard of therapy is the appointment of pegylated interferons, that is, those interferons that apply 1 time per week (than achieving greater efficiency of therapy and the frequency of side effects is reduced) and Ribaverin daily. The duration of therapy is recorded by the European Liver Study Association (ESL) in 2002. Depending on the virus genotype, the virus is genetically extremely heterogeneous, and this is one of the reasons why there is no vaccination from hepatitis C) therapy lasts 24 or 48 weeks. A significant moment is that treatment is quite expensive. Pegylated interferons, produce only two pharmaceutical companies in Switzerland and in the US. The average cost of one injection with such a drug is 374 dollars. Good news today is that the patient who passes this therapy receives a subsidized ribavmerin, that is, he does not pay for him.
— And what about the domestic alpha-2-recombinant interferon?
— This is a short interferon, and the effectiveness of therapy with such interferons is within thirty percent.
— What is the effectiveness of therapy with pegylated interferons?
— The effectiveness of such therapy, depending on the virus genotype ranges from 40 to 80 percent.
— I saw advertising the so-called «Efferent therapy», which private clinics offer patients with hepatitis with.
— This has nothing to do with the international protocol of patients with viral hepatitis C has no. Methods of efferent therapy can prepare a patient for treatment, remove intoxication, improve biochemical indicators. The hepatitis with the immune system produces antibodies, why immunity in the end can not destroy this virus, as in the case of hepatitis A and in. Due to the genetic heterogeneity of the virus and due to its minimum antigenic irritation of the immune system, simply put the hepatitis virus with constantly manages to escape from an immune response. Hence such a difference in chronic diseases. When hepatitis in chronization is 20%, that is, the remaining 80% is recovering, even if you do not conduct active therapy. When hepatitis with 80% chronic, so it is very important to identify the disease in the earliest stage. The earlier the patient has a viral hepatitis C, the greater the chance of recovery.
