Hepatitis C: drugs, symptoms, causes, etc. & bull; hello healthy

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Definition

What is hepatitis C?

Hepatitis C is a contagious liver disease caused by the hepatitis C virus (HCV). This viral infection causes inflammation so that it interferes with the working function of the liver.

This disease is generally transmitted through blood transfusions, hemodialysis or dialysis, and use of needles. Meanwhile, transmission through sexual contact is rare.

Hepatitis C has the potential to cause complications in the form of serious liver disease, such as liver cirrhosis, liver cancer, and permanent liver damage.

HCV infection that lasts for a short period of time is called acute hepatitis C. Meanwhile, hepatitis HCV that occurs for a long time can develop into chronic hepatitis infection.

Generally, patients with this disease do not always experience symptoms. When symptoms appear, sufferers may feel tired, nauseous and vomiting, and jaundice.

To diagnose this disease, you need to do blood tests. Unlike other hepatitis diseases, there is currently no vaccine to prevent hepatitis C.

Even so, this viral infection can be treated through hepatitis treatment, such as interferon injection and antiviral drugs.

How common is this disease?

The virus that causes this disease can infect anyone and is transmitted from one person to another. This disease is also spread in various parts of the world and is one of the main causes of liver cancer.

In 2016, the World Health Organization estimated that 399,000 million hepatitis C patients died from cirrhosis and liver cancer. Meanwhile, the number of hepatitis cases in Indonesia is also quite large.

Basic Health Research Data (Riskesdas) in 2014 reported that around 28 million Indonesians were infected with hepatitis B and C. This was proven through blood tests conducted by PMI.

14 million of these patients are at risk of developing chronic hepatitis and 1.4 million of those with chronic hepatitis have the potential to develop liver cancer.

Cause

What causes hepatitis C?

The cause of hepatitis C is infection with the HCV virus. HCV is an RNA virus that has at least 6 different genotypes. This viral infection actually does not directly cause inflammation of the liver.

The presence of this virus triggers a reaction from the immune system or immune system. In the process of fighting hepatitis infection, the immune system destroys the infected liver cells.

Resistance of the immune system to the development of the virus that lasts for years, over time it can cause damage to the liver to failure of liver function.

Acute HCV infection vs chronic HCV infection

When it enters the host cell in the liver, this virus does not reproduce immediately. HCV will have an incubation period of 2 - 24 weeks.

Acute HCV infection lasts 6 months, whereas chronic HCV infection lasts more than 6 months to years.

The most likely progression of viral infection from acute to chronic (80%) in people with hepatitis C.

How is hepatitis C transmitted?

Generally, hepatitis transmission to this type of HCV occurs through contact with blood infected with a virus, such as:

• use of the same syringe as a person with hepatitis,
• through blood transfusions or organ transplants,
• having sex with hepatitis patients, especially without a condom,
• use of non-sterile needles for tattoos or piercing, as well
• transmission vertically, namely from mother to baby during delivery.

Signs and symptoms

What are the signs and symptoms of hepatitis C?

Most people who are infected with HCV show no signs and symptoms, making it difficult to detect the disease. If they appear, the symptoms will last after the virus's incubation period ends, which is about 2 weeks - 6 months.

In addition, the progression of HCV infection also affects the severity of symptoms. That is why, there is a difference between the symptoms of acute hepatitis C and chronic hepatitis infection.

Symptoms of acute hepatitis C

The acute HCV period usually lasts when an infected person first comes into contact with the virus until the virus replicates itself.

Symptoms also do not necessarily appear, but about 25 - 35% of people who are infected will experience disorders, such as:

• mild fever,
• fatigue,
• loss of appetite,
• pain in the abdomen or upper abdomen,
• yellowing of the skin and lining of the eyes (jaundice), and
• nausea and vomiting

Symptoms of chronic hepatitis C

The appearance of chronic hepatitis C symptoms is more likely than acute hepatitis infection. However, the infection that develops also sometimes shows no symptoms. As a result, you may not even notice.

When symptoms appear, the signs and health problems that occur will also vary. The reason is, chronic HCV is closely related to other liver diseases or is caused by complications, such as:

• difficulty concentrating,
• pain in the upper abdomen,
• pain in muscles and joints,
• pain when passing urine,
• the color of the stool turns pale,
• dark and concentrated urine,
• itching of the skin,
• bleeds easily, as well
• bruising easily.

When to see a doctor?

HCV does not have distinctive symptoms and is sometimes similar to symptoms from hepatitis to other liver diseases. Therefore, it is highly recommended not to make a self-diagnosis that you are infected with hepatitis C.

If you experience any worrisome symptoms, whether they are mentioned or not, consult your doctor. This aims to get the right treatment according to your condition.

Risk factors

What factors increase the risk of developing this disease?

There are a number of conditions that can increase your risk of developing hepatitis C, including the following.

• Born in the year the hepatitis C outbreak occurred.
• Received a blood transfusion in the year the epidemic occurred.
• History of chronic liver disease due to HIV.
• Having liver function disorders.
• Routinely undergo dialysis (dialysis).
• Abuse of illegal drugs through needles.
• Babies born to infected mothers.
• Having sex with an infected person.
• Getting tattoos or body parts piercing.
• Use the same toothbrush and razor with hepatitis patients.

If you experience the risk factors above, consult a doctor immediately for a hepatitis diagnosis test.

Complications

The liver is one of the largest organs in the body that plays an important role in the digestive system. Its function is quite a lot, starting from digesting nutrients from food, to maintaining the immune system.

If hepatitis infection lasts for years, of course there are complications of hepatitis C in the form of damage to the liver below.

Cirrhosis

Cirrhosis of the liver is liver damage caused by chronic HCV infection. The liver experiences swelling and hardening, so that a number of liver functions are disturbed.

Heart cancer

Chronic HCV infection also causes wild cells to thrive and harms liver cells. Nearly 5% of chronic hepatitis C patients have cancer cells in their liver.

Liver failure

HCV can also cause permanent liver failure, aka liver failure.

Diagnosis

In addition to a physical exam, your doctor will also ask you to undergo a number of other examinations. The tests below are done to see if HCV is actively infecting the body or not. Here are some screening procedures to detect HCV.

Antibody test

An antibody test is done to check for the presence of HCV antibodies in the body. If the result is positive, it means that you are infected with hepatitis C. After an antibody test, the doctor will also confirm whether the infection is still active or not through an RNA test.

RNA test

An RNA test is performed to detect whether HCV is still actively replicating itself in the body. In addition, the RNA test also shows the amount of virus present in the blood.

HCV genotype test

HCV consists of several different types of genotypes (genotypes). Therefore, you will need to undergo an HCV genotype test to see what type of genotype is infecting your liver.

This is also done to determine the type of hepatitis C treatment to be carried out.

Liver biopsy

A liver biopsy is done especially if you are at risk for other liver diseases. The doctor will perform a biopsy procedure that aims to take samples of liver cells to analyze the level of liver damage that has occurred.

Knowing how badly damaged your liver is can help your doctor determine which treatment method is appropriate.

Treatment

Not everyone who is infected with hepatitis C needs to undergo treatment, especially for those who do not experience symptoms. However, for people who are chronically infected while experiencing a number of troublesome symptoms, treatment is important.

The hepatitis C virus cannot be completely eliminated from the body, but the infection can be stopped.

Hepatitis treatment aims to cure or stop continuing HCV infection, especially for 6 months after treatment is started. The following treatments can be done for hepatitis C.

Combination of pegylated interferon and ribavirin

Previously, interferon was used to treat hepatitis C. However, now interferon is no longer used alone. The reason is, this drug needs to be combined with ribavirin to stop viral infections.

Antiviral drugs

Apart from interferon and ribavirin, antiviral drugs ordirect acting antivirals (DAAs) are also claimed to be the newest hepatitis C drugs.

This is because antiviral drugs are said to have a cure rate of up to 90 percent.

This treatment is very effective because it specifically stops one of the virus's life cycles and prevents HCV from replicating.

However, the antivirals used must be adjusted to the genotype of the infectious HCV virus. The dosage must also follow the amount of virus in the liver, how much damage to the liver is caused.

Antivirus also usually needs to be consumed for one day for 8-12 weeks. Unfortunately, the price of antivirals for hepatitis treatment is still relatively expensive.

Liver transplant

If there are complications that cause liver damage so that it fails to function, treatment through drugs is no longer effective.

Liver transplant is the only solution to restore liver function. A liver transplant is performed by replacing your damaged liver with a donated healthy liver.

In many cases, liver transplantation does not actually cure hepatitis C. HCV infection can recur after the transplant is performed. To overcome this, treatment needs to be accompanied by antiviral drugs.

Can hepatitis C be cured?

The chance of healing from this disease actually depends on how severe the infection is.

In people who are acutely infected with HCV there is still a possibility that it will recover on its own or through treatment.

So far there is no specific drug to eradicate chronic HCV. However, treatment as recommended by a doctor has a high chance of recovery.

Prevention

How can you prevent hepatitis C?

Until now, there is no vaccine to prevent hepatitis C. However, that does not mean that nothing can be done as a form of prevention.

You can prevent hepatitis by avoiding risk factors and living a healthy lifestyle. If you are still infected, HCV transmission can also be prevented in the following ways.

• Cover open wounds with tape or a bandage.
• Clean the blood-soaked tissues, sanitary napkins, and cloths before throwing them away.
• Always clean items exposed to blood with antiseptic solutions.
• Avoid using tools that allow blood to be exposed to other people.
• Do not breastfeed if there is an open sore on the nipple.
• Do not donate blood.

If you have further questions, please consult your doctor to get the right treatment.