It is an infectious disease of the liver due to infection with hepatitis C virus (HCV). Hepatitis C virus is transmitted by contact with blood of an infected person.
For infection with hepatitis C virus it is necessary that the material containing the virus (the blood of an infected person), gets into the bloodstream of another person. According to WHO statistics: About 150 million people are chronically infected with hepatitis C virus, and each year more than 350,000 people die of liver disease associated with hepatitis C. Approximately 70-80% of patients with hepatitis C develop a chronic form of the disease, which is the most dangerous because it can lead to cirrhosis or liver cancer occurrence. Hepatitis C can be cured with the help of antiviral drugs. At the moment there is no effective, proven over the years vaccine for hepatitis C, but scientists are continuing their research in this area.
Causes of the disease
Infection with the hepatitis C virus is possible in the following situations:
- Using a syringe by drug addicts;
- Tattooing or piercing instruments contaminated with infectious blood;
- In sharing toothbrushes, razors, nail accessories;
- Hemodialysis (artificial kidney);
- Health care workers during any medical procedures related to blood;
- Blood transfusion (this mode of transmission is gradually becoming less and less relevant, as in developed countries, blood products are required to be tested for the presence of hepatitis C virus);
- Sexual transmission of hepatitis C (with unprotected sexual contact with the virus, transmission probability is 3-5%);
- Transmission from an infected mother to her child (which happens less than 5% of cases);
- The risk of infection with hepatitis C virus during medical procedures can be quite large in developing countries.
Common symptoms of hepatitis C
In general, hepatitis C – is an asymptomatic disease, usually diagnosed by chance when people are screened for other diseases. Therefore, early diagnosis is important with laboratory tests.
The incubation period of hepatitis C lasts from 2 weeks to 6 months. After the initial infection, approximately 80% of individuals do not experience symptoms. People with acute clinical manifestations may have fever, loss of appetite, nausea, vomiting, fatigue, abdominal pain, stool gray, dark urine, joint pain and yellowing of the skin and whites of the eyes.
Approximately 75-85% of newly infected people develop chronic disease, and 60-70% of chronically infected people develop chronic liver disease; 5-20% develop cirrhosis and 1-5% die from cirrhosis or liver cancer. 25% of patients with liver cancer are caused by hepatitis C.
Diagnosis
Diagnosis includes a number of different blood tests. Typically, the first is a screening test which indicates the presence of HCV antibodies (proteins contained in blood produced by the body in response to a virus). The presence of a positive antibody test for determination, indicates that the organism was exposed to the virus. If there is a positive antibody test, the physician is likely to designate a test for the presence of the virus itself.
Another test, called RNA HCV (determination of HCV RNA) reveals the presence of hepatitis C virus in the blood and measures the degree of damage made to the body by the virus.
Genotyping (genotyping of hepatitis C virus) is one of the most important tests. It will allow to predict the chances of successful treatment of the patient and the doctor will establish the necessary dosage of drugs and duration of therapy. It is important to know that the presence of the virus in a patient of a particular genotype does not mean that he is more or less sick.
There are 11 genotypes of HCV.
Why do I need to determine the genotype?
This analysis is very important. Different genotypes have different resistance to treatment. Thus, for example, genotypes 2 and 3 are treated in the standard therapy for 6 months with an efficiency of 80%, and genotype 1 and 4 – 12 months with an efficiency of 60%.
FibroTest
This biochemical analysis of blood, that would reveal the presence of liver fibrosis and its stages.
Fibrosis occurs with lesions of the liver due to hepatitis, fat or alcohol. Fibrosis appears as scars developed on the liver. The severity of fibrotic liver disease is calculated on a scale from F0, which corresponds to no fibrosis to F4, corresponding to a heavy fibrosis.
Fibroscan
The procedure is based scanning device Fibroscan put elastometry liver – method of determining the degree of liver fibrosis using elastic waves. Ultrasonic signals are used to measure the velocity of propagation of elastic waves in the liver. This result is expressed in kilopascals (kPa), and allows us to estimate the stage of disease from F0 to F4 in METAVIR. The procedure is painless, it takes just a few minutes. The results are displayed on a monitor and recorded in the database of patients.
Treatment in 2016
In years past interferon-based treatment of hepatitis C was giving response rates of 40 -70% depending on genotype, however with substantial serious side effects and poor tolerance which made the long course of therapy of 6 to 12 months quite an uphill battle. With the advent in 2014 of interferon-free treatments, a new era of hepatitis C therapy has begun. The response rates are now of 95 – 100% with practically no side effects and excellent tolerance with one or a few pills a day for 3 to 4 months depending on genotype and previous history. Evaluation and staging of liver disease remains most important to decide which treatment would be most appropriate in a particular case. Several new drugs have been marketed such as Sovaldi, Harvoni, Viekirax, Exviera, Daklinza, and several more to come shortly. The price of these new and very effective treatments is ranging from CHF 35’000 to 40’000. However what is at stake is to prevent cirrhosis and liver cancer and to avoid even more expensive liver transplantation.
Our check-up program includes:
- Blood test for antibodies to hepatitis C
- Consultation with a gastroenterologist, hepatologist
Price: 990 CHF
If the result of the test to determine antibodies is positive:
- HCV RNA (test for presence of the virus and the degree of distribution in the body)
- Genotyping (genotyping of hepatitis C virus)
- FibroTest (blood chemistry, gives an indication of the presence of liver fibrosis and its stages)
- Consultation with a gastroenterologist, hepatologist
Price: 1’900 CHF
- It is also possible to perform a fibroscan to determine the degree of liver fibrosis.
Price: 850 CHF