What is the percentage of sexual transmission of hepatitis. How is hepatitis C transmitted from person to person? Frequent questions to the doctor about the transmission of hepatitis C to a person in everyday life

Hepatitis C is more common in young people. However, the "age" of infection is gradually increasing.

More than 170 million of the world's population is affected by chronic hepatitis C. Every year, 3-4 million people become infected. The disease is common in all countries, but unevenly.

Where can you get hepatitis C virus?

You can get infected when performing piercings, tattoos - in the respective salons. However, according to statistics, they are more likely to become infected in those places where there is a joint use of injecting drugs. High risk of infection in prisons.
Medical staff can become infected at work (in a hospital, clinic) when injured while working with infected blood.
Hemotransfusions (blood transfusion) are currently rarely the cause of infection in patients, their contribution is no more than 4%.
Previously, hepatitis C was characterized as "post-transfusion". The risk of infection during medical procedures may persist in developing countries. If sanitary standards are grossly violated, then any office where medical manipulations are performed can become the site of infection.

Often with hepatitis C, it is not possible to establish the exact source of infection.

How is infection transmitted?

The main mechanism of infection is hematogenous, parenteral (through the blood). Most often, infection with the hepatitis C virus occurs when a sufficient amount of infected blood is injected with a shared needle.

Infection is possible when performing piercings and tattoos with instruments contaminated with the blood of a patient or carrier of an infection, possibly when sharing razors, manicure accessories, and even toothbrushes (infected blood that gets on them can cause infection), with a bite.

Infection with hepatitis C through the introduction of blood products during operations and injuries, the introduction of medical drugs and mass vaccination, in dental offices is less likely in developed countries.

sexually transmitted infection

Sexual transmission of hepatitis C is of little relevance. With unprotected sexual contact with a carrier of the virus, the probability of transmission is 3-5%.
In a monogamous marriage, the risk of infection transmission is minimal, but it increases with a large number of partners, casual relationships.
It is not known how much oral sex contributes to transmission.

Persons who have sexual contact with patients with hepatitis C or carriers of the virus are advised to use condoms.
At the same time, as a rule, you cannot tell by the appearance of a person whether he has hepatitis C, and even more so - whether he is a carrier of the virus.

Transmission of hepatitis C from mother to child

Hepatitis C virus is rarely transmitted from an infected mother to a fetus, in no more than 5% of cases. Infection is possible only in childbirth, during the passage of the birth canal. Preventing infection today is not possible.

In most cases, children are born healthy. Data on the course of infection in the long term is still insufficient, and treatment protocols for newborns have not been developed either.

There are no data indicating the possible transmission of the virus with mother's milk. Breastfeeding in the presence of hepatitis C in the mother is recommended to be canceled if there are violations of the integrity of the skin of the mammary glands, bleeding.

Is hepatitis C transmitted through normal household contact?

Hepatitis C is not transmitted by airborne droplets (when talking, sneezing, with saliva, etc.), shaking hands, hugging, sharing utensils, food or drinks.
If an infection has been transmitted in everyday life, then a particle of blood from a patient or a carrier of the hepatitis C virus must enter the blood of an infected person (in case of injury, cut, through abrasions, etc.).

Patients and carriers of the hepatitis C virus should not be isolated from family members and society, they should not be limited or create special conditions in work, study, care for them (children, the elderly) only on the basis of the presence of infection.
However, persons infected with viral hepatitis C in Russia are exempt from military conscription.

How do I know if I'm at risk for hepatitis C?

There are groups of people who are at higher risk of contracting hepatitis C. CDC epidemiologists distinguish three degrees of increased risk.
The highest risk of infection are:

• People who inject drugs
• Persons transfused with clotting factors prior to 1987

Intermediate (medium-increased) risk of contracting hepatitis C have:

• Patients on hemodialysis (artificial kidney machine)
• Persons who received an organ transplant (transplant) or who received a blood transfusion prior to 1992, and anyone who received blood from a donor who subsequently tested positive for hepatitis C
• Persons with unidentified liver diseases (problems)
• Babies born to infected mothers

• Medical workers and employees of the sanitary and epidemiological service
• Persons who have sex with multiple partners
• Persons who have sex with one infected partner

People in high- and intermediate-risk groups should be screened for hepatitis C.
At the same time, tests should be taken even if (for example) injecting drug use occurred only once or several times many years ago. All persons infected with HIV are also tested for hepatitis C.
In children born to infected mothers, the analysis is performed at the age of 12-18 months.
Health care workers should be screened in all cases of suspected contact with infected blood (for example, if they were pricked with a needle or blood got into the eye).

People in certain risk groups for hepatitis C should be vaccinated against hepatitis B because they are at risk of contracting this infection as well.

What tests establish the fact of infection?

The first test that is usually recommended is antibodies to hepatitis C virus (anti-HCV). It is performed in most medical institutions. This analysis establishes only the fact of infection in the present or past.
In addition, this test can give false positives (the test is positive, but there really is no infection) and false negative results (the test is negative, but there is actually an infection), for various reasons.
Therefore, a more complex examination is performed to accurately diagnose hepatitis C.

Is it possible to catch the hepatitis C virus and not get sick?

You can get infected and recover from hepatitis C, i.e. get well. The probability of this is about 10-20%.
You can become infected and become a carrier of the hepatitis C virus. Viruses multiply in the body of the carrier, but they do not cause much harm to him. These people do not show changes in liver tests and signs of hepatitis on liver biopsy. However, latent progression is also possible.

But still, once infected with the hepatitis C virus, the majority of those infected acquire chronic hepatitis C. The probability of this is about 70%. All infected people need constant medical supervision because they remain at risk of activating the disease.

Is it possible to get infected and get sick with hepatitis C again?

Yes, you can get infected and get sick again. Even if the treatment was successful, immunity to the hepatitis C virus is not developed, so re-infection (including another type of HCV) causes the disease.

What to do if there is a patient with hepatitis C in the family?

A sick or infected family member must follow all measures to prevent transmission of the virus to other family members, including:

• Do not donate blood or organs for transplant
• Do not use common household items that can serve as transmission factors (razors and appliances, epilators, toothbrushes and floss, manicure sets)
• For cuts and abrasions, cover them with a bandage or plaster so that the blood does not get out (if he needs to make a bandage or put a plaster, you need to wear medical gloves)

It has been established that the hepatitis C virus survives in the external environment (for example, in dried blood drops) at room temperature for at least 16 hours, and even up to 4 days.

All places where drops of blood of an infected family member accidentally fall should be treated with a disinfectant solution - for example, chlorine-containing detergents, or a solution of bleach at a dilution of 1:100. Washing at 60 degrees inactivates the virus in 30 minutes, boiling in 2 minutes.

A healthy liver is a guarantee of well-being, but not all inhabitants of the planet can boast of a healthy liver, since according to medical indicators, about 30% of the population suffers from one or another liver disease. The danger and insidiousness of such pathologies is that almost all liver diseases in the early stages of their disease do not have pronounced symptoms, but appear only when the disease acquires more serious stages of development.

The first place among all liver pathologies is occupied by hepatitis, which combines several types of acute and chronic diffuse liver lesions, in most cases of viral origin. In the practice of doctors, viral hepatitis of groups A, B, C, D is most often encountered, which are quite dangerous for human health and can lead to death.

Hepatitis viruses of these groups are well studied by medicine, but despite its capabilities, for many, the diagnosis of hepatitis sounds like a sentence, since it cannot be cured. Any of the hepatitis viruses is hepatotropic, that is, it infects liver cells, with subsequent damage to internal organs and systems. Given the complexity and danger of this disease, many are interested in the question of how hepatitis is transmitted from person to person and what are its consequences?

How is hepatitis C transmitted?

Hepatitis C is the most insidious type of virus, which is also called the “gentle killer”, since it can live in the human body for several years and not manifest itself in any way, but significantly harm the internal organs and slowly destroy the whole organism. Patients or carriers of the hepatitis C virus cannot be distinguished from healthy people. The disease has a sluggish course and does not cause any suspicion in a person. Hepatitis C is most commonly transmitted through the following routes:

• Hematogenous or parenteral route (through the blood) - blood transfusion or the use of a common needle from a syringe by several people.
• Contact. You can become infected with hepatitis C in beauty salons, making piercings, tattoos, through nail scissors and other tools that have not undergone the necessary sterilization and contain infected blood of a sick person on their surface.
• medical manipulation. During surgery, the introduction of drugs, dental procedures, there is also a risk of infection with this disease.

• Sexual infection. It occurs quite rarely and only in 3% of cases with unprotected intercourse. Hepatitis C is transmitted sexually only through unprotected intercourse. The transmission of the virus through oral sex is little known to medicine.
• Intrauterine infection of the fetus. This route of infection is also quite rare, less than 5% of cases. But the risk of infection of the child during childbirth is quite high. There is no exact information about whether the disease can be transmitted to the child through breastfeeding, but in the case when a woman in labor has hepatitis C, breastfeeding is recommended to be canceled.

In any of the above cases, hepatitis C is transmitted only through the blood.

How hepatitis B is transmitted

Infection of the liver with the hepatitis B virus in almost all cases is quite severe and entails a number of complications, including cirrhosis of the liver or stenosis of the bile ducts. The danger of infection is the same as with hepatitis C, that is, transmission to a person from a person mainly occurs through the blood. The virus is not transmitted by household or airborne droplets. The risk of infection increases with the use of non-sterile medical material. Also, this disease often affects drug addicts who do not follow the rules of sterility of syringes.

One of the main signs of hepatitis B is yellowness of the skin and sclera of the eyes, which speaks of inflammatory processes in the liver tissue.

Ways of transmission of hepatitis B can be natural or artificial, but in any case, infection occurs through infected blood. Artificial infection includes infection associated with medical manipulations: blood transfusion, lack of sterility of a medical instrument. There is some risk during dental procedures, but only when clinic staff do not use the Anti-Hepatitis and Anti-AIDS instrument reprocessing system. Only the processing of medical instruments with this system will protect against the virus.

It is not uncommon to become infected with this disease with invasive diagnostic methods: conducting EGD, examination by a gynecologist and any other doctor who uses non-sterile instruments that contain particles of the virus. Natural transmission of hepatitis B includes sexual or oral transmission. Promiscuous sex, lack of contraception, frequent change of sexual partners at times increases the risk of infection with the hepatitis B virus.

How does hepatitis A get transmitted?

Hepatitis A, or Botkin's disease, also has a viral origin. On the this moment This is a fairly common form of viral hepatitis. Unlike other types of the disease, hepatitis A does not have serious consequences, but infection can occur in several ways. The source of infection of viral hepatitis of group A is a sick person. After the penetration of the infection into the body, the cells of the liver parenchyma are damaged.

The main route of infection is enteral, that is, infection occurs through the stomach and intestines. You can get infected with this virus through dirty water, shaking hands with a sick person. A person with hepatitis A, along with feces, releases the virus into the environment. Transmission of the virus can also occur after drinking dirty water, food that has not been properly processed, or household items. Sometimes outbreaks of the disease can occur in the whole family.

The main prevention of the virus is personal hygiene, the use of products that have undergone the necessary processing. Hepatitis A most often affects children and adults who do not follow the rules of personal hygiene. It is almost impossible to control the sterility of food and water, so the risks of infection are quite high.

How does hepatitis D occur?

Group D hepatitis virus, unlike other types, is the most contagious. It has a tendency to mutate, capable of infecting both humans and animals. Basically, hepatitis D is diagnosed in people with a chronic form of hepatitis B. After the virus enters the human body, it begins to actively multiply, but its first symptoms will appear no earlier than 4 weeks to 6 months. It is important to know how Hepatitis D is transmitted and how it can enter the human body.

• Blood transfusion. Donors for blood transfusions can often be people who carry the virus but show no signs of illness. In this case, if the blood has not been properly examined, the risk of infection increases several times.
• Reusable syringes that may contain blood particles with the virus.
• Carrying out manipulations in which there may be damage to the skin: acupuncture, piercing, manicure, pedicure.
• Sexual contact. Unprotected intercourse increases the risk of infection by several times, since this virus can be found not only in the blood, but also in the semen of a man.

• Infection during childbirth. It is not uncommon for the type D virus to be passed from mother to child during childbirth. The risk of infection also increases with breastfeeding. It is important to note that breast milk itself does not contain the virus, but cracked nipples can cause infection.
• The contact of the blood of a sick person with the skin of a healthy person. In this case, we can talk about medical workers who treat the wounds of patients or take blood for analysis. Hepatitis D is not transmitted through food, water or household items.

According to the Hepatitis C Virus (HCV) study, it is now believed that sexual transmission is possible, but this occurs much less frequently than with sexual transmission of hepatitis B virus (HBV) or human immunodeficiency virus (HIV). If you suspect that you have contracted HCV from your sexual partner, then first of all, you need to carefully consider whether this could have happened in another way: whether someone uses your toothbrush, scissors, razor; did you get tattoos (where and how); whether you shared needles if you used drugs. It is necessary to remember whether you had surgery, blood transfusion, etc. Scientific studies of the frequency and, accordingly, the relevance of the sexual transmission of HCV are also accompanied by certain difficulties. They are: 1) the need to exclude another way of infection of the sexual partner; 2) the need to prove that sexual partners are infected with the same subtype of the virus. Sexual transmission of the virus has been studied in various groups of people infected with HCV. This made it possible to identify a group at high risk of sexual transmission of HCV and a group at the lowest risk of sexual transmission of HCV. The high-risk group includes those who frequently change sexual partners, including prostitutes and homosexuals. They also have an increased risk of contracting HIV and other sexually transmitted diseases. The group at the lowest risk of sexual transmission of HCV includes people with regular sexual partners and stable sexual relationships over many years. The frequency with which HCV markers are detected varies greatly among the above groups. According to studies in the United States, antibodies to HCV, on average, are determined in prostitutes in 6%, in homosexuals - in 4%; among patients attending venereal clinics and HIV-infected - in 4%. These studies noted that HBV and HIV were more likely to be detected in these individuals than HCV. %), then in North America (2.0-4.8%), South America - 11.8%, Africa (5.6-20.7%), and the largest - in Southeast Asia (8.8-27%). How does hepatitis C virus infection occur through sexual transmission? Sexual transmission of the virus occurs when an infected secret (any substance that is secreted by the human body) or infected blood enters a healthy partner's body through the mucous membrane. However, the infected secretion alone is not enough for infection to occur. The so-called predisposing factors must be present: a large amount of the virus in the secretion secreted by the body, impaired integrity of the mucosa with which it comes into contact, the presence of other sexual infections (viral or bacterial). Studies on the content of HCV in male semen, vaginal secretions, saliva indicate that the virus is rarely found in them and is contained in a low titer, which probably underlies the low incidence of HCV infection through sexual contact. What factors increase the risk of sexually transmitted HCV infection? Risk factors in individuals with sexual behavior associated with increased traumatism are: - HIV co-infection; - homosexuality; - sexually transmitted diseases (herpes simplex virus, trichomoniasis, gonorrhea); - sex with the risk of damage to the mucous membrane (for example, anal). Thus, it can be noted that although the risk of sexual transmission of HCV exists, it is not high. Practical recommendations. 1. In order to reduce the already very low risk of HCV infection in regular sexual partners, barrier methods of contraception (condoms) can be used. It is advisable to periodically (once a year) examine HCV markers. 2. For persons infected with HCV and having several sexual partners or various short-term sexual relations, it is recommended to use condoms. 3. It is advisable to use condoms if there are other sexual infections, when having sex during menstruation, as well as when having sex with an increased risk of mucosal injury (anal sex, etc.). 4. It is not recommended to use the personal belongings of an infected sexual partner that may contain traces of blood (toothbrush, razor, manicure accessories, etc.). Once again, we draw your attention to the fact that the sexual route of transmission of the hepatitis C virus is not the main one for this infection. The virus enters the body mainly with infected blood.

Hepatitis is any inflammatory process in the liver that leads to the destruction of liver cells and impaired liver function. It is generally accepted that hepatitis is only of a viral nature. In fact, inflammation in the liver and the destruction of its cells can be caused by a variety of factors: alcohol, drugs, poisons, a person's own antibodies.

Hepatitis C is one of the types of a fairly large group of viral hepatitis. Recently, world statistics have shown rather disappointing performance. Approximately 170 million people in the world are infected with the hepatitis C virus, and their number is steadily increasing every year. Among them are a large number of children, pregnant women, young able-bodied people.

Features of hepatitis C

"Affectionate killer" - such a poetic name is hepatitis C among infectious disease specialists. A distinctive feature of this type of viral hepatitis is a very slow and latent course. The disease has a fairly long incubation period, a gradual onset without severe symptoms, and fairly rapid liver damage. Hepatitis C attacks a person gradually, without manifesting itself for many years. The patient until a certain time does not show any serious complaints, lives a normal life and can infect other people.

The hepatitis C virus is quite stable in the external environment, survives for many hours on the surface, and remains viable in the dried state. These qualities distinguish hepatitis C from the AIDS virus, which dies instantly in the absence of a moist environment. Once in the human body, the virus travels through the blood stream to the liver and inserts its genome into the liver cell.

The peculiarity of the hepatitis C virus is that it itself does not have a destructive effect on the cell. The genetic material of the virus embedded in the cell “wakes up” the human immune system. Antibodies and other protective factors attack the virus, but along with it, they also infect their own liver cells.

Consequences of infection

The liver performs many important tasks in the body: digestive, protective, hematopoietic, immune, storage. With massive destruction of liver cells, each of these functions begins to suffer. Let us name only the main manifestations and consequences of hepatitis C.

1. Cirrhosis, fibrosis or fatty degeneration of the liver. The dead liver tissue is not restored, but is replaced by connective and adipose tissue. The liver increases in size to compensate for the loss.
2. Jaundice. Having lost the function of exchanging bile pigments, the liver cannot cope with the conversion and excretion of bilirubin, the substance of destroyed erythrocytes. Bilirubin accumulates in tissues, has a toxic effect on them and stains the skin and mucous membranes yellow.
3. Syndrome of intoxication. The liver is the main filter of the body, removing all toxins and poisons from the blood. In the case of impaired liver function, all harmful substances accumulate in the body.
4. asthenia syndrome. The body cannot adequately produce bile digestive enzymes. Food is poorly digested, vitamins and microelements are not absorbed. The patient loses weight, anemia appears, manifestations of a lack of vitamins.
5. Hemorrhagic syndrome or excessive bleeding. The liver normally produces a number of blood clotting factors. With their lack, hematomas and hemorrhages occur even from minimal injuries.
6. Ascites or dropsy are very characteristic of severe liver damage. A critical lack of proteins in the body leads to the release of blood plasma into tissues and cavities. Severe edema occurs both in the subcutaneous fatty tissue and in the natural cavities of the body: abdominal, pleural, cardiac.

Ways of transmission of hepatitis C

Hepatitis C refers to the so-called parenteral hepatitis. "Parenteral" means transmission through the blood and other body fluids. The virus is contained in one amount or another in every liquid medium of the body: blood, saliva, sweat, semen, vaginal secretions, and so on. It is very important to understand the two main points of transmission of any parenteral hepatitis:

1. The source of infection is a person with hepatitis in acute and chronic forms of hepatitis, as well as the most dangerous contingent of infected persons - asymptomatic carriers. The degree of "contagiousness" of each individual patient depends on the amount of virus in the blood and, accordingly, other biological fluids. This amount of virus is called the viral load and is measured by quantitative PCR. The fewer copies of the virus in the blood, the less contagious the patient is.
2. For infection, it is not so much contact with a biological fluid that is important, but the conditions of this contact. For example, it is believed that hepatitis C is not transmitted through kissing. In fact, this is true, because in a patient with an average viral load, the amount of virus in saliva is very small. However, imagine a patient with hepatitis with a huge viral load and, for example, inflammation in the oral cavity. Any damage to the mucous membranes opens up additional gates for infection. Such a kiss for another person with a weakened immune system and impaired oral mucosa (tooth extraction, bitten cheek, stomatitis, etc.) can be potentially dangerous.

This leads to possible ways of infection. Let's talk about each of them in more detail.

• Sexual way. A certain amount of the virus is found in seminal fluid and vaginal secretions. In couples where one partner has hepatitis C but is being treated, has viral load under control, and is taking precautionary measures, it is extremely rare for the other spouse to become infected. However, in persons with inflammatory diseases of the genital organs (vaginitis, urethritis, balanoposthitis), microcracks of the mucous membranes (atrophic vaginitis, anal sex), latent sexually transmitted diseases (chlamydia, trichomoniasis, and others), as well as frequently changing sexual partners, the likelihood of infection increases exponentially .
• Directly parenteral route, that is, "blood to blood." This includes transfusions of untested blood, transplantation of donor organs and tissues, medical operations, piercings, tattoos, cosmetic procedures using non-sterile instruments. It is important to understand that the toolkit can be disposable and reusable. Reusable instruments are subject to a thorough multi-stage disinfection and sterilization procedure. In medical institutions, special indicators in the form of pieces of paper or test tubes are used to control the quality of sterilization. These indicators, together with the instrument, are sterilized and, subject to the required exposure time, temperature and pressure, change color. At the slightest doubt, do not hesitate to ask for a control indicator from the batch of instruments to be sterilized. .
• vertical path. This term characterizes the possible transmission of hepatitis from mother to fetus during pregnancy, because the hepatitis C virus is able to cross the placenta to the fetus and be in the amniotic fluid. For hepatitis C, according to various sources, the probability of infection of the fetus during pregnancy ranges from 5 to 20%. Such a large difference was due to the fact that various studies did not always take into account the viral load of the mother and, accordingly, the degree of her infectiousness. Recent studies show that adequate pregnancy management and controlled viral load in women with hepatitis C reduce the risk of intrauterine infection by up to 5%. In women with hepatitis C, they try to limit as much as possible invasive intrauterine manipulations such as chorionic villus biopsy, amniocentesis, exchange transfusion of blood to the fetus, and so on.
• Transmission of hepatitis C during childbirth is a major risk to the fetus. Until now, researchers have argued about the methods of delivery in women with hepatitis C. It is too early to draw unequivocal conclusions about the advisability of caesarean section, but in women with high viral loads at the time of delivery, operative delivery is significantly safer. Also, children born to mothers with hepatitis C must be vaccinated against hepatitis B and the introduction of immunoglobulin.
• Is hepatitis C transmitted through breastfeeding? The question is ambiguous and controversial. It is important to be aware of the conditions of infection. In breast milk, the content of the virus is extremely low, in addition, the milk itself contains a number of immunoglobulins and protective factors. Cracked nipples in the mother, combined with a high viral load, stomatitis or candidiasis in the baby's mouth can increase the risk of infection. However, with normal attachment of the child, especially with the use of silicone pads on the nipples, and monitoring the condition of the baby's oral cavity, breastfeeding is definitely possible.

Hepatitis C (C) is an inflammation of the liver that occurs due to infection of the human body with a virus (hepatitis C virus). In the process of its reproduction, liver tissue is damaged, cirrhosis and oncological pathologies develop.

What is hepatitis C?

Hepatitis C is a viral disease of the liver. It is also called the "gentle killer". This disease creeps up on the sly, proceeds without clear signs and leads to severe consequences: cancer or cirrhosis of the liver.

Sometimes infection with this virus can occur without any symptoms for several years. But after 15-20 years of inflammatory liver damage, hepatitis C can provoke a destructive change in the liver by a cancerous tumor or.

The virus has an interesting feature. He is constantly changing. To date, there are 11 variants of it - genotypes. But after being infected by one of them, the virus continues to mutate. As a result, up to 40 varieties of one genotype can be identified in a patient.

Virus resistance

The hepatitis C virus does not multiply in cell cultures, which makes it impossible to study in detail its resistance in the external environment, but it is known that it is slightly more resistant than HIV, dies when exposed to ultraviolet rays and can withstand heating up to 50 ° C. Sick people are the reservoir and source of infection. The virus is contained in the blood plasma of patients.

Both those suffering from acute or chronic hepatitis C and those with asymptomatic infection are contagious.

You can inactivate the infection (HCV) by:

• disinfectant solution (detergents containing chlorine, bleach in a ratio of 1:100);
• washing at 60°C for 30-40 minutes;
• boil the item for 2-3 minutes.

Forms

Hepatitis C can occur as an acute or chronic infectious disease. The acute form can turn into a chronic one (more often it happens), and the chronic one, in turn, can have episodes of exacerbation.

Acute viral hepatitis C

Acute hepatitis C is a viral disease caused by HCV infection that enters the bloodstream and leads to damage and subsequent destruction of the liver. Infection with this virus occurs not only by the parenteral route, since the causative agent of this disease can be found not only in the blood of a sick person, but also in other body fluids (sperm, urine, etc.).

Chronic form

Chronic hepatitis C is a viral inflammatory liver disease caused by a blood-borne virus. According to statistics, newly emerging hepatitis C becomes chronic in 75-85% of cases, and it is infection with the C virus that occupies a leading position in terms of the number of severe complications.

This disease is especially dangerous because for six months or several years it can be completely asymptomatic, and its presence can only be detected by performing complex clinical blood tests.

How is hepatitis C transmitted from person to person?

The main route of infection with hepatitis C is through the blood, so donors are always tested for the presence of the virus. A small amount of it can be found in lymph, saliva, menstrual blood in women and seminal fluid in men. The virus can live from 12 to 96 hours. The degree of probability of infection depends on the intensity of the lesion and the state of the body's immunity.

Due to difficulties in accumulating a sufficient amount of test material and the lack of surviving patients, the pathogen has not been fully identified.

After the virus enters the bloodstream, it enters the liver with the blood stream and, thereby, infects its cells, then the process of reproduction of infected cells occurs. This virus easily mutates and changes its genetic structure.

It is this ability that makes him difficult to detect early.

There are three main routes of transmission of the virus:

1. blood contact (through the blood),
2. sexual,
3. vertical (from mother to child)

The virus is unstable in the external environment, therefore it is not transmitted by household means when using common household items, clothes and utensils. The pathogen is contained in blood, semen, vaginal secretions and mother's milk, but does not multiply on the skin and in saliva, is not released into the external environment, so it is impossible to get hepatitis C by airborne droplets or through touch.

Transmission of hepatitis C through the blood

Hepatitis C is mainly transmitted through the blood. The serum and blood plasma of carriers of the infection is dangerous even a week before the onset of symptoms of the disease and retains the ability to become infected for a long time.

In order for transmission to occur, a sufficient amount of infected blood must enter the bloodstream, so the most common route of transmission of the pathogen is through a needle during an injection.

The first risk group is drug addicts. Also, transmission in this way can be with:

• tattoo,
• piercing,
• during acupuncture,
• in hospitals for blood transfusion or other manipulations,
• during manicure and pedicure,
• using common manicure devices,
• visiting the dental office, with improper observance of the measures of disinfection of instruments.

sexual transmission

Factors contributing to infection with hepatitis C during sexual contact:

• violation of the integrity of the inner surface of the genital tract and oral cavity, their bleeding;
• inflammatory diseases of the genital organs;
• sexual intercourse during menstruation;
• concomitant diseases of the urinary and genital areas, HIV infection;
• promiscuity;
• the practice of anal sex;
• traumatic sex in an aggressive form.

Risk factors

There is a risk of infection during various medical procedures if sterility requirements are not met. You can become infected in the following situations:

• various surgical interventions;
• injection procedures;
• gynecological manipulations, including abortions;
• transfusion of blood and its components;
• diagnostic manipulations with blood sampling;
• dental procedures;
• manicure, pedicure;
• stuffing tattoos;
• unprotected sex with a person with hepatitis;
• during childbirth and lactation (vertical route of infection from mother to child).

It is also possible to single out separate groups of people for whom the transfer of this disease is more difficult:

• people who abuse alcohol;
• faces with ;
• with chronic liver diseases, as well as with another kind;
• older persons, as well as children - in these cases, among other things, full-fledged antiviral treatment measures may often be contraindicated for them.

Hepatitis C cannot be transmitted:

1. airborne droplets when sneezing, talking;
2. with hugs, touches and handshakes;
3. with mother's breast milk;
4. through food and drink;
5. while using household items, common dishes, towels.

In extremely rare cases, a household route of transmission is fixed, but the condition for the development of the disease is the ingress of the patient's blood into wounds, abrasions or cuts of a healthy person.

The first signs in men and women

Once infected, hepatitis is very secretive. Viruses multiply in the liver, gradually destroying its cells. At the same time, in most cases, a person does not feel any signs of the disease. And since there are no complaints and visits to the doctor, there is no treatment.

As a result, in 75% of cases, the disease becomes chronic, and there are serious consequences. Often, a person feels the first signs of the disease only when cirrhosis of the liver has developed, which cannot be cured.

There is a small list of signs that may indicate the presence of the hepatitis virus:

• growing weakness;
• fast fatiguability;
• asthenia (general weakness of all organs and systems of the body).

Such manifestations are characteristic of any colds, chronic diseases or poisoning (intoxication). Later may appear:

• jaundice;
• the abdomen may increase in volume (ascites);
• spider veins may appear;
• lack of appetite;
• nausea;
• joint pain (rare symptom);
• possible enlargement of the spleen and liver.

In general, we can say that the first signs are symptoms of intoxication and impaired liver function.

Hepatitis C Symptoms

The incubation period of viral hepatitis C ranges from 2 to 23 weeks, sometimes dragging on to 26 weeks (due to one or another mode of transmission). The acute phase of infection in the vast majority of cases (95%) is not manifested by severe symptoms, proceeding in an anicteric subclinical variant.

Late serological diagnosis of hepatitis C may be associated with the likelihood of an "immunological window" - a period when, despite an existing infection, antibodies to the pathogen are absent, or their titer is immeasurably low.

In 61% of cases, viral hepatitis diagnosed by laboratory 6 months or more after the first clinical symptoms.

Signs of acute hepatitis C

Most of those infected do not notice any symptoms of the disease at all, so the acute phase is often not diagnosed. The patient may note:

• exanthema - skin rashes (by type);
• flu-like syndrome (fever, short-term fever, muscle and joint pain);
• general malaise (fatigue, loss of appetite);
• dyspeptic syndrome (nausea, vomiting, heaviness in the stomach, pain in the right hypochondrium);
• jaundice syndrome (yellow color of the skin or sclera of the eyes, lightening of feces, darkening of urine);
• on palpation, there is a moderate increase in the size of the liver, sometimes the spleen.

Symptoms of chronic hepatitis C

Unfortunately, in 80% of cases hepatitis C has a primary chronic course. For many years, the disease flows hidden, practically without manifesting itself. A person is unaware of his illness, leads a normal life, consumes alcohol, aggravating his condition, has unprotected sex and infects others. Liver function in hepatitis C remains compensated for a long time, but often such imaginary well-being ends in acute liver failure.

The following symptoms (clinical manifestations) are characteristic of the chronic stage of the disease:

• general malaise, in which the sleep pattern is disturbed;
• feces become light;
• you can feel heaviness and mild pain in the right hypochondrium;
• a rash appears on the body, which looks like an allergy;
• an increase in body temperature that occurs periodically throughout the day;
• appetite is disturbed, there is an aversion to food;
• Dryness and pallor of the skin, hair loss, brittleness and foliation of nails are the consequences of a lack of vitamins and iron metabolism disorders, for which the liver is responsible. Often in patients with hepatitis there is a pronounced lack of B vitamins and iron, leading to (anemia).

The hepatitis C virus affects not only the liver, but also other organs. If a person has been sick for a long time (10 years or more), then he may have so-called extrahepatic symptoms of hepatitis C. More than half of these symptoms are associated with cryoglobulinemia, a disease sometimes caused by the hepatitis C virus, in which special proteins are found in the patient's blood - cryoglobulins.

Complications

Complications of hepatitis C:

• liver fibrosis;
• steatohepatitis - fatty degeneration of the liver;
• cirrhosis of the liver;
• liver cancer (hepatocellular carcinoma);
• portal hypertension;
• ascites (an increase in the volume of the abdomen);
• varicose veins (mainly in the internal organs);
• hidden bleeding;
• hepatic encephalopathy;
• accession of a secondary infection - hepatitis B virus (HBV).

With the use of alcoholic beverages, the symptoms intensify, and pathological liver damage accelerates up to 100 times.

Complications can be recognized by the following signs:

• a severe exacerbation begins, which is characterized by bloating with a general weight loss, as water begins to accumulate in the abdominal cavity;
• the liver is covered with scars (connective tissue);
• so-called asterisks, venous streaks appear on the body.

The appearance of the above signs and changes in the body is a signal to a person that he needs to check himself and start timely treatment.

Diagnostics

The diagnosis is established on the basis of:

• the availability of data on the possible method of infection - the so-called starting point (it is typical that in approximately half of the infected the cause of the disease cannot be identified);
• the presence of specific clinical manifestations (with icteric form);
• determination of IgM and IgG to HCV;
• detection of HCV RNA (HCV-RNA) by polymerase chain reaction;
• changes in the biochemical blood test [increased levels of liver enzymes (ALT, AST), hyperbilirubinemia];
• positive thymol test.

Treatment of hepatitis C (C) in adults

Successful therapy includes an integrated approach: medicines are combined with alternative methods, diet, regular examinations are carried out, patients monitor physical activity, rest regimen.

Treatment is aimed at:

• eliminate the virus from the blood;
• reduce, remove the inflammatory process in the liver;
• prevent the formation of a tumor, transformation into cirrhosis.

How to treat hepatitis C should be decided by a specialist. He prescribes medications taking into account the individual characteristics of the organism, the genotype of the virus, the severity of the disease.

Why is it necessary to treat hepatitis C under medical supervision?

1. The observation of a specialist is necessary because there is a risk of activation of the disease with active damage to the liver tissue and extrahepatic lesions - this threat persists throughout the entire period of the virus carriage.
2. The observation of a specialist includes the determination of liver tests and blood serology (PCR study of the activity of the infectious process).
3. If an unfavorable picture of liver tests is detected, or a high viral load (a high level of the genetic material of the virus detected in the blood), then antiviral and hepatoprotective therapy is required because the risk of developing liver cirrhosis is high.

Medicines for treatment

The specificity of hcv therapy depends on a number of factors that can influence a positive or negative result:

• gender of the patient;
• Age;
• duration of the disease;
• Virus genotype;
• degree of fibrosis.

The goal of antiviral therapy is the complete recovery of the patient and the prevention of inflammatory and degenerative lesions: fibrosis, cirrhosis and cancer. Most specialists for the treatment of hepatitis C use dual therapy with interferon, aimed at combating HVA, and ribavirin, which accelerates the work of the first.

The patient should receive interferon daily. Another treatment regimen involves the administration of short-acting interferon once every three days and pegelated interferon once a week.

Specific drugs that fight the causative agent of the disease are Ribavirin, Zeffix. The first acts as a means of antiviral therapy, which helps to reduce the concentration of the pathogen in the body by influencing its reproduction.

Pros and cons:

• The advantage is to note the high efficiency in combination with interferon preparations;
• the downside is that one of the side effects is dose-dependent.

The choice of the scheme and duration of the course of treatment is determined by the type of virus, the stage of the disease and the course of the infectious process. The course of combined treatment with interferon + ribavirin lasts an average of 12 months.

No need to self-medicate and use suspicious drugs and remedies. Before using any medicine, be sure to consult your doctor, because. self-treatment can harm your body. Please take this disease seriously.

Diet

The general principles of nutrition of patients are:

• Providing complete protein (1.0–1.2 g per kg of body weight).
• An increase in its content at . It was noted that with viral hepatitis C there is a pronounced fatty degeneration of hepatocytes.
• Protein restriction in liver failure in the stage of decompensation and threatening coma.
• Adequate fat content up to 80 g/day.
• Providing complex carbohydrates (they should be 50% of the energy value) through the use of cereals, cereals, vegetables and fruits.
• Enrichment of the diet with vitamins (groups B, C, folates).
• Control of salt content (limit to 8 g, and with edema and ascites - up to 2 g).
• Inclusion in the diet of specialized products (protein composite mixtures for protein correction of the diet).

To unload the liver, a patient with hepatitis C needs to compose his menu so that it does not contain foods that are prohibited for consumption. People with hepatitis are completely prohibited from drinking alcoholic beverages, spicy foods. You also need to abandon the consumption of fats of unnatural origin (combi fat, margarine) and those that are poorly digested (lard, palm oil, lard).

Patients must follow Diet No. 5 during remission, and during exacerbation - No. 5A. The range of products of this option corresponds to Diet No. 5, but it contains more thorough cooking - boiling and obligatory rubbing or pureeing. The diet is applied for 2-4 weeks, and then the patient is transferred to the main table.

Human prognosis

Hepatitis C, of ​​course, can threaten with serious complications, however, favorable prognosis with this diagnosis is not excluded, moreover, for many years the disease may not manifest itself at all. During this period, it does not require special treatment - the main thing is to ensure appropriate medical control. It implies a regular check of liver functions, as a result of which, in case of activation of hepatitis, appropriate antiviral therapy is provided.

How long do people live with hepatitis C?

According to the general course of hepatitis C, statistics have the following possible outcomes per 100 patients considered:

1. from 55 to 85 patients will face the transition of hepatitis into a chronic form;
2. for 70 patients, liver disease in a chronic form may become relevant;
3. from 5 to 20 patients in the next 20-30 years will face the development of cirrhosis of the liver against the background of hepatitis;
4. from 1 to 5 patients will die as a result of the consequences provoked by chronic hepatitis C (again, this is cirrhosis or liver cancer).

Prevention

The main preventive measures:

• compliance with personal hygiene measures;
• hand washing and use of gloves when working with blood;
• refusal of casual unprotected sexual relations;
• refusal to take drugs;
• receiving medical, cosmetology services in official licensed institutions;
• conducting regular preventive examinations in case of possible professional contact with blood.

If an HCV-infected person lives in the household:

1. Avoid contact of open cuts, abrasions of an infected person with household items in the house so that his blood does not have the opportunity to remain on those things that other family members use;
2. Do not share common personal hygiene items;
3. Do not use this person as a donor.

Hepatitis C - is a very dangerous disease, because. may not show up for a long time. It is important to undergo diagnostics in time, and if a virus is detected in the blood, it is imperative to start treatment under the supervision of a specialist. Take care of yourself and your health!