Hepatitis C is the most severe form of liver disease caused by the hepatitis C virus (HCV) or HCV. The infection is transmitted through blood during visits to medical institutions, beauty salons, collective use of drugs, etc. In 80% of cases, the disease acquires chronic course and is complicated by cirrhosis. Hepatitis C often has a hidden course, so patients seek medical care with a delay, when it is almost impossible to restore the structure of the gland.
Therefore, many patients are interested in the question of at what temperature the hepatitis C virus dies and how susceptible it is to environmental conditions. It is important for healthy people to know what measures to take after suspected exposure to HCV and how to prevent infection.
Stability of HCV in the external environment
In recent years, I have increasingly been diagnosed with hepatitis C, which provokes HCV of various genotypes, and this cannot but alarm doctors. For this reason, studies have been conducted that indicate good resistance of the hepatitis C virus during external environment. The pathogenic agent retains its properties in dried blood for about 6 weeks.
HCV is stable in the external environment
Doctors studied various methods spread of infection in laboratory conditions. How long the hepatitis C virus lives in the air depends on temperature indicators. It is known that after entering the human body, HCV feels great. But periodically it is released out along with biological fluids (blood, saliva, etc.), so the pathogenic microorganism is able to adapt to other conditions.
Hepatitis C in the external environment remains infectious for 7 days if the temperature ranges from +2 to +22°. When it decreases or increases, the activity of the infectious agent decreases.
According to the results of laboratory studies, the virus can remain infectious at sub-zero temperatures for a long time; when boiled, it is inactivated in 1-2 minutes. When exposed to ultraviolet light, the hepatitis C virus dies.
Employees of the research center conducted studies during which they determined how long hepatitis lives at room temperature. For this purpose, the blood of infected monkeys was used (105 doses). All samples were dried in vacuum for 16 hours. Some of them were soaked (a sterile liquid was used for this) and frozen at -70°, and the remaining doses of blood were kept at a temperature of 25° and humidity above 40%. Some of the samples were stored under such conditions for 4 days, and the rest for 7 days. Then they were also soaked and frozen.
After the first stage of research, the blood doses were restored, injected into the body of healthy monkeys, or studied by laboratory staff. Samples were tested for viral load, the presence of antibodies to HCV, and the concentration of alanine aminotransphenase (ALT - an enzyme that helps identify liver pathologies).
First, we studied blood doses that were kept under normal conditions for 1 week. A small viral load was detected in the blood plasma. After approximately 4 months, the animals had no HCV markers, and the ALT concentration returned to normal.
Then the scientists moved on to studying the samples, which were stored for 4 days. A larger number of viral particles were found in the blood than in the first experiment. But after 130 days, there were no symptoms of hepatitis C or dysfunction of the gland.
And finally, samples that were frozen after drying were examined. The concentration of viral particles in them was high, and the animals were diagnosed with acute hepatitis C. The viral load increased rapidly, liver cells with antigens to the infection were detected, and the ALT concentration increased.
Based on the results of the study, we can conclude that the hepatitis C virus outside the body at room temperature can exist from 16 hours to 4 days. Dry drops of blood, which can be found on a syringe, razor, medical or cosmetic instruments, are especially dangerous for healthy people. Infection occurs when blood, saliva, or semen enter wounds on the skin or internal membranes.
HCV is killed immediately when dried by ultraviolet radiation.
The infectious agent retains its properties in donor blood for a long time. To prevent infection, it is recommended to carefully examine biological material donors.
Disinfecting agents and antiseptics quickly destroy HCV.
HCV lives in water bodies for 10 months, on land – about 7 days. At a temperature of 60°, the virus persists for about 60 minutes, and when boiling it dies after 5 minutes.
Now you know in what conditions the virus can live and which are destructive for it.
Means for destroying the hepatitis C virus
Researchers have found that the pathogenic microorganism is not resistant to disinfectants with a certain concentration of antiseptic components. It is these solutions that inactivate the hepatitis C virus.
Antiseptics can destroy the virus
To quickly destroy HCV, you need to treat the contaminated surface with antiseptic agents. Hydrochloric, phosphoric, boric acid will kill the pathogenic microorganism. Chloramine, Miramistin, and hydrogen peroxide are also used for this purpose.
An iodized solution is often used during surgical intervention, with its help the surgical field is treated. Thus, the antiseptic prevents the penetration of pathogenic microorganisms. The virus remains viable in the solution, but it is recommended to use it for emergency treatment of wound surfaces. For this purpose, iodine 5% is used.
Many people are interested in the question of whether alcohol kills the hepatitis C virus. Ethanol (70%) and alcohol-containing liquids help eliminate the infection. Ethyl alcohol (96%) is powerful antiseptic, killing HCV within 2 minutes. According to doctors, 96 percent alcohol destroys the protein shell of the virus by coagulating it. When processing a contaminated item, it is important not to allow the alcohol to evaporate.
According to doctors, HCV can exist in an alcohol solution for about 2 minutes, but during this period the liquid will simply evaporate. For this reason, it cannot be guaranteed that the infectious agent will be destroyed.
As mentioned earlier, in order to definitely get rid of the hepatitis C pathogen, you need to disinfect the room using ultraviolet light.
Boiling is also reliable way destruction of HCV. If there are dried drops of the patient’s blood on things, they must be boiled. The infectious agent dies in water at a temperature of 100° in a few minutes, at 50° in 30 minutes. Therefore, it is recommended to process items in a washing machine at a temperature of +60° or more for half an hour or boil the laundry for 5 minutes.
Actions in case of contact with infected blood
If the blood of an infected person comes into contact with your skin, the following measures must be taken:
- To destroy the causative agent of hepatitis C, use bleach. Before processing, the powder is mixed with water (1:100). This substance helps against various infections: hepatitis, immunodeficiency, tuberculosis, etc. Also, special antiseptics are used to inactivate the virus, which are sold in pharmacies.
- If a healthy person has damaged the integrity of the skin with a sharp object that may contain the hepatitis virus, he should immediately squeeze the blood out of the wound. Then the damaged area is washed with soapy water and wiped with ethyl alcohol (70%). The last antiseptic can be replaced with iodine.
- If the blood of an infected person gets on the mucous membrane of the eyes, they are washed with a solution boric acid (1%).
- If the virus enters the oral cavity, blood or other biological fluid, you need to spit it out and rinse your mouth. For disinfection, use a solution of potassium permanganate or alcohol (70%).
- It happens that the patient's blood enters the nasal passages. Then the mucous membrane is treated with Protargol 1% (colloidal silver solution).
After HCV penetrates into the wound, the skin is washed with soapy water and treated with an antiseptic.
After completing the above steps, HCV should die. But to make sure of this, you need to immediately go to a doctor who will prescribe laboratory blood tests. As a rule, diagnosis is carried out immediately after contact with the patient’s biological fluids, then after 4 weeks, and finally after 12 weeks.
How to avoid hepatitis C?
Everyone needs to know the rules for preventing hepatitis C: healthy people to prevent infection, and sick people to avoid infecting others.
Hepatitis C virus may be present on manicure tools
Preventive actions:
- Avoid injecting drugs, but if you still use them, use a new syringe each time.
- During sexual intercourse, use barrier contraceptives. This is especially true for men who practice homosexual relations.
- When visiting a dentist, gynecologist and other specialists, ask how the doctor sterilizes instruments. If possible, persuade your doctor to use a disposable instrument.
- The previous rule applies to cosmetology salon employees. If you go for a manicure, get piercings or tattoos, then before the procedure, ask for the instrument to be sterilized or ask the specialist to use a new one.
- Before blood transfusion or organ transplantation, ask your doctor to check the donor's status. If doctors cannot provide you with such information, then refuse the procedure.
- If there are wounds or scratches on the skin, be sure to cover them with a band-aid and treat the area with an antiseptic.
A newborn can become infected with hepatitis C if his mother has HCV in her body. To avoid this, a woman should notify her gynecologist about her condition. Then the doctor will raise the question of performing a caesarean section.
Based on all of the above, we can conclude that the hepatitis C virus is a very stable form of life that can live in the environment for a long time. To destroy the infection, boiling, ultraviolet radiation, and alcohol solutions are used. But the most the best way out- This is the prevention of infection. Only by following the rules described above can the patient live for a long time without encountering this terrible disease.
Video on the topic
Viral hepatitis- this is a group of common and dangerous infectious diseases for humans, which differ quite significantly from each other, are caused by different viruses, but still have common feature is a disease that primarily affects the human liver and causes its inflammation. Therefore, viral hepatitis of different types is often combined under the name “jaundice” - one of the most common symptoms of hepatitis.
Epidemics of jaundice were described as early as the 5th century BC. Hippocrates, but the causative agents of hepatitis were discovered only in the middle of the last century. In addition, it should be noted that the concept of hepatitis in modern medicine can mean not only independent diseases, but also one of the components of a generalized, that is, affecting the body as a whole, pathological process.
Hepatitis (a, b, c, d), that is inflammatory liver disease, possible as a symptom yellow fever, rubella, herpes, AIDS and some other diseases. There is also toxic hepatitis, which includes, for example, liver damage due to alcoholism.
We will talk about independent infections - viral hepatitis. They differ in origin (etiology) and course, but some symptoms various types of this disease somewhat similar to each other.
Classification of viral hepatitis
Classification of viral hepatitis is possible according to many criteria:
The danger of viral hepatitis
Particularly dangerous for human health hepatitis viruses B and C. Ability for a long time exist in the body without noticeable manifestations leads to severe complications due to the gradual destruction of liver cells.
Another characteristic feature of viral hepatitis is that Anyone can become infected with them. Of course, in the presence of factors such as blood transfusion or working with blood, drug addiction, promiscuity, the risk of contracting not only hepatitis, but also HIV increases. Therefore, for example, medical workers You should regularly donate blood for markers of hepatitis.
But you can also become infected after a blood transfusion, an injection with a non-sterile syringe, after surgery, a visit to the dentist, a beauty salon or a manicure. Therefore, a blood test for viral hepatitis is recommended for anyone who is exposed to any of these risk factors.
Hepatitis C can also cause extrahepatic manifestations, such as autoimmune diseases . The constant fight against the virus can lead to a perverted immune response to the body’s own tissues, resulting in glomerulonephritis, skin lesions, etc.
Important: In no case should the disease be left untreated, since in this case there is a higher risk of it becoming chronic or rapidly damaging the liver.
Therefore, the only available way to protect yourself from the consequences of hepatitis infection is to rely on early diagnosis through tests and subsequent consultation with a doctor.
Forms of hepatitis
Acute hepatitis
The acute form of the disease is the most typical for all viral hepatitis. Patients experience:
- deterioration of health;
- severe intoxication of the body;
- liver dysfunction;
- development of jaundice;
- an increase in the amount of bilirubin and transaminase in the blood.
With adequate and timely treatment, acute hepatitis ends complete recovery of the patient.
Chronic hepatitis
If the disease lasts more than 6 months, the patient is diagnosed with chronic hepatitis. This form is accompanied by severe symptoms (asthenovegetative disorders, enlarged liver and spleen, disorders metabolic processes) and often leads to liver cirrhosis and the development of malignant tumors.
Human life is at risk when chronic hepatitis, the symptoms of which indicate damage to vital organs, worsens improper treatment, reduced immunity, alcohol addiction.
General symptoms of hepatitis
Jaundice appears in hepatitis as a result of the release of bilirubin enzyme, which is not processed in the liver, into the blood. But cases of absence of this symptom in hepatitis are not uncommon.
Typically, hepatitis in the initial period of the disease manifests itself flu symptoms. The following are noted:
- temperature increase;
- body aches;
- headache;
- general malaise.
As a result of the inflammatory process, the patient’s liver enlarges and its membrane stretches; at the same time, pathological process V gallbladder and pancreas. All this is accompanied pain in the right hypochondrium. The pain often lasts for a long time, aching or dull in nature. But they can be sharp, intense, paroxysmal and radiate to the right shoulder blade or shoulder.
Descriptions of symptoms of viral hepatitis
Hepatitis A
Hepatitis A or Botkin's disease is the most common form of viral hepatitis. Its incubation period (from the moment of infection to the appearance of the first signs of the disease) ranges from 7 to 50 days.
Causes of hepatitis A
Hepatitis A is most widespread in third world countries with their low sanitary and hygienic standards of living, but isolated cases or outbreaks of hepatitis A are possible even in the most developed countries of Europe and America.
The most common route of transmission of the virus is through close household contact between people and the consumption of food or water contaminated with fecal material. Hepatitis A is also transmitted through dirty hands, so children most often get it.
Symptoms of Hepatitis A
The duration of hepatitis A disease can vary from 1 week to 1.5-2 months, and the recovery period following the disease sometimes stretches to six months.
The diagnosis of viral hepatitis A is made taking into account the symptoms of the disease, medical history (that is, the possibility of the disease occurring due to contact with patients with hepatitis A is taken into account), as well as diagnostic data.
Treatment of hepatitis A
Of all forms, viral hepatitis A is considered the most favorable in terms of prognosis; it does not cause severe consequences and often ends spontaneously, without requiring active treatment.
If necessary, hepatitis A treatment is carried out successfully, usually in a hospital setting. During illness, patients are recommended bed rest, prescribed a special diet and hepatoprotectors - drugs that protect the liver.
Prevention of hepatitis A
The main measure to prevent hepatitis A is compliance with hygiene standards. In addition, children are recommended to be vaccinated against this type of viral hepatitis.
Hepatitis B
Hepatitis B or serum hepatitis - this is much more dangerous disease, characterized by severe liver damage. The causative agent of hepatitis B is a virus containing DNA. The outer shell of the virus contains a surface antigen - HbsAg, which causes the formation of antibodies to it in the body. Diagnosis of viral hepatitis B is based on the detection of specific antibodies in the blood serum.
Viral hepatitis b remains infectious in blood serum at 30–32 degrees Celsius for 6 months, at minus 20 degrees Celsius for 15 years, after warming up to plus 60 degrees Celsius for an hour, and only with 20 minutes of boiling it completely disappears. This is why viral hepatitis B is so common in nature.
How is hepatitis B transmitted?
Infection with hepatitis B can occur through blood, as well as through sexual contact and vertically - from mother to fetus.
Symptoms of hepatitis B
In typical cases, hepatitis B, like Botkin's disease, begins with the following symptoms:
- temperature rise;
- weaknesses;
- joint pain;
- nausea and vomiting.
Symptoms such as dark urine and discolored stool are also possible.
Other symptoms of viral hepatitis B may also appear:
- rashes;
- enlarged liver and spleen.
Jaundice is uncommon for hepatitis B. Liver damage can be extremely severe and in severe cases lead to cirrhosis and liver cancer.
Treatment of hepatitis B
Treatment of hepatitis B requires a comprehensive approach and depends on the stage and severity of the disease. Immune drugs, hormones, hepatoprotectors, and antibiotics are used in treatment.
To prevent the disease, vaccination is used, which is usually carried out in the first year of life. It is believed that the duration of post-vaccination immunity to hepatitis B is at least 7 years.
Hepatitis C
The most severe form of viral hepatitis is considered hepatitis C or post-transfusion hepatitis. Hepatitis C virus infection can develop in anyone and is more common in young people. The incidence is growing.
This disease is called post-transfusion hepatitis because infection with viral hepatitis C most often occurs through blood - through blood transfusion or through unsterile syringes. Currently, all donated blood must be tested for the hepatitis C virus. Less commonly, sexual transmission of the virus or vertical transmission from mother to fetus is possible.
How is hepatitis C transmitted?
There are two ways of transmitting the virus (as with viral hepatitis B): hematogenous (i.e. through blood) and sexual. The most common route is hematogenous.
How does infection occur?
| At blood transfusion and its components. Previously, this was the main method of infection. However, with the advent of the method laboratory diagnostics viral hepatitis C and with its introduction into the mandatory list of donor screenings, this path faded into the background. |
| The most common method currently is infection by tattooing and piercing. The use of poorly sterilized and sometimes not sanitized instruments has led to a sharp surge in morbidity. |
| Infection often occurs when visiting dentist, manicure salons. |
| Using shared needles For intravenous administration drugs. Hepatitis C is extremely common among drug addicts. |
| Using general with a sick man holding toothbrushes, razors, nail scissors. |
| The virus can be transmitted from mother to child at the time of birth. |
| At sexual contact: This route is not as relevant for hepatitis C. Only 3-5% of cases of unprotected sex can cause infection. |
| Injections from infected needles: this method of infection is not uncommon among medical workers. |
In approximately 10% of patients with hepatitis C, the source remains unclear.
Symptoms of hepatitis C
There are two forms of viral hepatitis C: acute (relatively short period, severe course) and chronic (protracted course of the disease). Most people, even in the acute phase, do not notice any symptoms, but in 25-35% of cases, signs similar to other acute hepatitis appear.
Symptoms of hepatitis usually appear in 4-12 weeks after infection (however, this period can be within 2-24 weeks).
Symptoms of acute hepatitis C
- Loss of appetite.
- Abdominal pain.
- Dark urine.
- Light chair.
Symptoms of chronic hepatitis C
As with the acute form, people with chronic hepatitis C often experience no symptoms in the early or even late stages of the disease. Therefore, it is not uncommon for a person to be surprised to learn that he is sick after a random blood test, for example, when going to the doctor for a common cold.
Important: You can be infected for years and not know it, which is why hepatitis C is sometimes called the “silent killer.”
If symptoms do appear, they will most likely be as follows:
- Pain, bloating, discomfort in the liver area (on the right side).
- Fever.
- Muscle pain, joint pain.
- Decreased appetite.
- Weight loss.
- Depression.
- Jaundice (yellow discoloration of the skin and sclera of the eyes).
- Chronic fatigue, fatigue.
- Spider veins on the skin.
In some cases, as a result of the body's immune response, damage may develop not only to the liver, but also to other organs. For example, kidney damage called cryoglobulinemia may develop.
In this condition, there are abnormal proteins in the blood that become solid when the temperature drops. Cryoglobulinemia can lead to various consequences from skin rashes to severe renal failure.
Diagnosis of viral hepatitis C
Differential diagnosis is similar to that for hepatitis A and B. It should be borne in mind that icteric form Hepatitis C infection usually occurs with mild intoxication. The only reliable confirmation of hepatitis C is the results of marker diagnostics.
Considering the large number of anicteric forms of hepatitis C, it is necessary to carry out marker diagnostics of people who systematically receive a large number of injections (primarily people who use drugs intravenously).
Laboratory diagnosis of the acute phase of hepatitis C is based on the detection of viral RNA in PCR and specific IgM by various serological methods. If hepatitis C virus RNA is detected, genotyping is advisable.
The detection of serum IgG to viral hepatitis C antigens indicates either a previous illness or the ongoing persistence of the virus.
Treatment of viral hepatitis C
Despite all the dangerous complications that hepatitis C can lead to, in most cases the course of hepatitis C is favorable - for many years the hepatitis C virus may not manifest itself.
At this time, hepatitis C does not require special treatment - only careful medical monitoring. It is necessary to regularly check liver function; at the first sign of activation of the disease, it should be carried out antiviral therapy.
Currently, 2 antiviral drugs are used, which are most often combined:
- interferon-alpha;
- ribavirin.
Interferon-alpha is a protein that the body synthesizes independently in response to a viral infection, i.e. it is actually a component of natural antiviral defense. In addition, interferon-alpha has antitumor activity.
Interferon-alpha has many side effects, especially when administered parenterally, i.e. in the form of injections, as it is usually used in the treatment of hepatitis C. Therefore, treatment should be carried out under mandatory medical supervision with regular determination of a number of laboratory parameters and appropriate adjustment of the dosage of the drug.
Ribavirin as a stand-alone treatment is low in effectiveness, but when combined with interferon it significantly increases its effectiveness.
Traditional treatment quite often leads to complete recovery from chronic and acute forms of hepatitis C, or to a significant slowdown in the progression of the disease.
Approximately 70–80% of people with hepatitis C develop the chronic form of the disease, which is the most dangerous because the disease can lead to the formation of a malignant liver tumor (that is, cancer) or cirrhosis of the liver.
When hepatitis C is combined with other forms of viral hepatitis, the patient's condition can deteriorate sharply, the course of the disease can become more complicated and lead to death.
The danger of viral hepatitis C is also that effective vaccine, capable of protecting a healthy person from infection, does not currently exist, although scientists are making a lot of efforts in this direction to prevent viral hepatitis.
How long do people live with hepatitis C?
Based on medical experience and research conducted in this area, life with hepatitis C is possible and even quite long. A common disease, like many others, has two stages of development: remission and exacerbation. Often, hepatitis C does not progress, that is, it does not lead to cirrhosis of the liver.
It must be said right away that fatal cases, as a rule, are associated not with the manifestation of the virus, but with the consequences of its impact on the body and general disruptions in the functioning of various organs. It is difficult to indicate a specific period during which pathological changes incompatible with life occur in the patient’s body.
The rate of progression of hepatitis C is influenced by various factors:
According to statistics from the World Health Organization, there are more than 500 million people in whose blood a virus or pathogen antibodies are detected. These data will only go up every year. The number of cases of liver cirrhosis has increased by 12 percent worldwide over the past decade. The average age category is 50 years.
It should be noted that in 30% of cases The progression of the disease is very slow and lasts about 50 years. In some cases, fibrotic changes in the liver are quite minor or absent even if the infection lasts several decades, so you can live with hepatitis C for quite a long time. Yes, when complex treatment patients live 65-70 years.
Important: If appropriate therapy is not carried out, life expectancy is reduced to an average of 15 years after infection.
Hepatitis D
Hepatitis D or delta hepatitis differs from all other forms of viral hepatitis in that its virus cannot multiply in the human body separately. To do this, he needs a “helper virus,” which is the hepatitis B virus.
Therefore, delta hepatitis can be considered not as an independent disease, but as a companion disease complicating the course of hepatitis B. When these two viruses coexist in a patient's body, a severe form of the disease occurs, which doctors call superinfection. The course of this disease resembles that of hepatitis B, but complications characteristic of viral hepatitis B are more common and more severe.
Hepatitis E
Hepatitis E its symptoms are similar to hepatitis A. However, unlike other types of viral hepatitis, with severe form Hepatitis E causes severe damage not only to the liver, but also to the kidneys.
Hepatitis E, like hepatitis A, has a fecal-oral mechanism of infection, is common in countries with a hot climate and poor water supply, and the prognosis for recovery in most cases is favorable.
Important: the only group of patients for whom infection with hepatitis E can be fatal are women in the last trimester of pregnancy. In such cases, mortality can reach 9–40% of cases, and the fetus dies in almost all cases of hepatitis E in a pregnant woman.
Prevention of viral hepatitis of this group is similar to prevention of hepatitis A.
Hepatitis G
Hepatitis G- the last representative of the family of viral hepatitis - in its symptoms and signs it resembles viral hepatitis C. However, it is less dangerous, since the progression of the infectious process inherent in hepatitis C with the development of cirrhosis and liver cancer is not typical for hepatitis G. However, the combination of hepatitis C and G can lead to cirrhosis.
Medicines for hepatitis
Which doctors should I contact if I have hepatitis?
Tests for hepatitis
To confirm the diagnosis of hepatitis A, a biochemical blood test is sufficient to determine the concentration of liver enzymes, protein and bilirubin in the plasma. The concentration of all these fractions will be increased due to the destruction of liver cells.
Biochemical blood tests also help determine the activity of hepatitis. It is by biochemical indicators that one can get an impression of how aggressive the virus behaves towards liver cells and how its activity changes over time and after treatment.
To determine infection with two other types of virus, a blood test is performed for antigens and antibodies to hepatitis C and B. You can take blood tests for hepatitis quickly, without spending a lot of time, but their results will allow the doctor to obtain detailed information.
By assessing the number and ratio of antigens and antibodies to the hepatitis virus, you can find out about the presence of infection, exacerbation or remission, as well as how the disease responds to treatment.
Based on dynamic blood test data, the doctor can adjust his prescriptions and make a prognosis for further development diseases.
Diet for hepatitis
The diet for hepatitis is as gentle as possible, since the liver, which is directly involved in digestion, is damaged. For hepatitis it is necessary frequent split meals.
Of course, diet alone is not enough to treat hepatitis; drug therapy is also necessary, but proper nutrition plays a very important role and has a beneficial effect on the well-being of patients.
Thanks to the diet, pain decreases and general condition improves. During an exacerbation of the disease, the diet becomes more strict, during periods of remission - more free.
In any case, you cannot neglect your diet, because it is precisely reducing the load on the liver that allows you to slow down and alleviate the course of the disease.
What can you eat if you have hepatitis?
Products that can be included in the diet with this diet:
- lean meats and fish;
- low-fat dairy products;
- inconvenient flour products, lingering cookies, yesterday’s bread;
- eggs (whites only);
- cereals;
- boiled vegetables.
What not to eat if you have hepatitis
You should exclude the following foods from your diet:
- fatty meats, duck, goose, liver, smoked meats, sausages, canned food;
- cream, fermented baked milk, salty and fatty cheeses;
- fresh bread, puff pastry and pastry, fried pies;
- fried and hard-boiled eggs;
- pickled vegetables;
- fresh onions, garlic, radishes, sorrel, tomatoes, cauliflower;
- butter, lard, cooking fats;
- strong tea and coffee, chocolate;
- alcoholic and carbonated drinks.
Prevention of hepatitis
Hepatitis A and hepatitis E, transmitted by the fecal-oral route, are quite easy to prevent if you follow basic hygiene rules:
- wash your hands before eating and after using the toilet;
- do not eat unwashed vegetables and fruits;
- Do not drink raw water from unknown sources.
For children and adults at risk, there is vaccination against hepatitis A, but it is not included in the compulsory vaccination calendar. Vaccination is carried out in the event of an epidemic situation regarding the prevalence of hepatitis A, before traveling to areas unfavorable for hepatitis. It is recommended that preschool workers and healthcare workers be vaccinated against hepatitis A.
As for hepatitis B, D, C and G, transmitted through the infected blood of a patient, their prevention is somewhat different from the prevention of hepatitis A. First of all, it is necessary to avoid contact with the blood of an infected person, and since it is enough to transmit the hepatitis virus minimum amount of blood, then infection can occur when using one razor, nail scissors, etc. All these devices must be individual.
As for the sexual route of transmission of the virus, it is less likely, but still possible, therefore sexual contacts with untested partners should be only using a condom. Intercourse during menstruation, defloration, or other situations in which sexual contact involves the release of blood increases the risk of contracting hepatitis.
The most effective protection against hepatitis B infection today is considered vaccination. In 1997, vaccination against hepatitis B was included in the compulsory vaccination schedule. Three vaccinations against hepatitis B are carried out in the first year of a child’s life, and the first vaccination is done in the maternity hospital, a few hours after the baby is born.
Teenagers and adults are vaccinated against hepatitis B on a voluntary basis, and experts strongly recommend that representatives of the risk group receive such a vaccination.
Let us remind you that the risk group includes the following categories of citizens:
- workers of medical institutions;
- patients who received blood transfusions;
- drug addicts.
In addition, persons living or traveling in areas with widespread hepatitis B virus transmission, or having family contact with hepatitis B patients or carriers of hepatitis B virus.
Unfortunately, vaccines to prevent hepatitis C are currently does not exist. Therefore, its prevention comes down to the prevention of drug addiction, mandatory testing of donor blood, educational work among adolescents and young people, etc.
Questions and answers on the topic "Viral hepatitis"
Question:Hello, what is a healthy carrier of hepatitis C?
Answer: A carrier of hepatitis C is a person who has the virus in his blood and painful symptoms not visible. This condition can last for years while the immune system controls the disease. Carriers, being a source of infection, must constantly take care of the safety of their loved ones and, if they wish to become parents, carefully approach the issue of family planning.
Question:How do I know if I have hepatitis?
Answer: Do a blood test for hepatitis.
Question:Hello! I am 18 years old, hepatitis B and C negative, what does this mean?
Answer: The analysis showed the absence of hepatitis B and C.
Question:Hello! My husband has hepatitis B. I recently had last vaccination from hepatitis B. A week ago my husband’s lip was cracked; now it’s not bleeding, but the crack hasn’t healed yet. Is it better to stop kissing until it heals completely?
Answer: Hello! It’s better to cancel and give you anti-hbs, hbcorab total, PCR test for him.
Question:Hello! I had a trimmed manicure done at the salon, my skin was injured, now I’m worried, how long will it take to get tested for all infections?
Answer: Hello! Contact an infectious disease specialist to decide on emergency vaccination. After 14 days, you can take a blood test for RNA and DNA of hepatitis C and B viruses.
Question:Hello, please help: I was recently diagnosed with chronic hepatitis B with low activity (hbsag +; DNA PCR +; DNA 1.8*10 in 3 st. IU/ml; alt and ast are normal, other indicators are normal biochemical analysis fine; hbeag - ; anti-hbeag+). The doctor said that no treatment is required, no diet is needed, however, I have repeatedly come across information on various sites that all chronic hepatitis can be treated, and there is even a small percentage full recovery. So maybe it’s worth starting treatment? And yet, I’ve been using it for several years now. hormonal drug which was prescribed by the doctor. This drug has a negative effect on the liver. But it is impossible to cancel it, what should you do in this case?
Answer: Hello! Observe regularly, follow a diet, eliminate alcohol, and possibly prescribe hepatoprotectors. HTP in this moment not required.
Question:Hello, I'm 23 years old. Recently I had to take tests for a medical examination and this is what was discovered: the test for hepatitis B deviates from the norm. Do I have a chance to pass a medical examination for contract service with such results? I was vaccinated against hepatitis B in 2007. I have never observed any symptoms related to the liver. I didn't have jaundice. Nothing bothered me. Last year, I took SOTRET 20 mg per day for six months (I had problems with my facial skin), nothing special.
Answer: Hello! Possibly a history of viral hepatitis B with recovery. The chance depends on the diagnosis made by the hepatology commission.
Question:Maybe the question is in the wrong place, tell me who to contact. The child is 1 year and 3 months old. We want to vaccinate him against infectious hepatitis. How can this be done and are there any contraindications?
Answer:
Question:What should other family members do if the father has hepatitis C?
Answer: Viral hepatitis C refers to “blood infections” of a person with a parenteral mechanism of infection - during medical procedures, blood transfusions, during sexual contacts. Therefore, at the household level in family settings, there is no danger of infection for other family members.
Question:Maybe the question is in the wrong place, tell me who to contact. The child is 1 year and 3 months old. We want to vaccinate him against infectious hepatitis. How can this be done and are there any contraindications?
Answer: Today you can vaccinate a child (as well as an adult) against viral hepatitis A (infectious), against viral hepatitis B (parenteral or “blood”) or with a combined vaccination (hepatitis A + hepatitis B). Vaccination against hepatitis A is one-time, against hepatitis B - three times at intervals of 1 and 5 months. Contraindications are standard.
Question:My son (25 years old) and daughter-in-law (22 years old) are sick with hepatitis G and they live with me. In addition to my eldest son, I have two more sons, 16 years old. Is hepatitis G contagious to others? Can they have children and how will this infection affect the child’s health?
Answer: Viral hepatitis G is not transmitted through household contact and is not dangerous for your younger sons. A woman infected with hepatitis G can give birth in 70-75% of cases healthy child. Since this is generally a fairly rare type of hepatitis, and even more so in two spouses at the same time, to exclude a laboratory error, I recommend repeating this analysis again, but in a different laboratory.
Question:How effective is the hepatitis B vaccine? What side effects does this vaccine have? What should be the vaccination plan if a woman plans to become pregnant in a year? What are the contraindications?
Answer: Vaccination against viral hepatitis B (carried out three times - 0, 1 and 6 months) is highly effective, cannot in itself lead to jaundice and has no side effects. It has practically no contraindications. Women planning pregnancy and who have not had rubella or chickenpox should mandatory In addition to hepatitis B, you should also get vaccinated against rubella and chickenpox, but no later than 3 months before pregnancy.
Question:What to do about hepatitis C? To treat or not to treat?
Answer: Viral hepatitis C should be treated in the presence of three main indicators: 1) the presence of cytolysis syndrome - elevated ALT levels in whole and 1:10 diluted blood serum; 2) positive result testing for immunoglobulin M class antibodies to the nuclear antigen of the hepatitis C virus (anti-HCVcor-Ig M) and 3) detection of hepatitis C virus RNA in the blood by polymerase chain reaction (PCR). Although final decision Still, it must be taken by the attending physician.
Question:In our office, an employee was diagnosed with hepatitis A (jaundice). What should we do? 1. Should the office be disinfected? 2. When does it make sense for us to test for jaundice? 3. Should we limit contact with families now?
Answer: The office should be disinfected. Tests can be taken immediately (blood for AlT, antibodies to HAV - hepatitis A virus of immunoglobulin classes M and G). It is advisable to limit contact with children (before testing or up to 45 days after identifying a case of the disease). After clarification of the situation of healthy non-immune employees (negative test results for IgG antibodies to HAV) it is advisable to vaccinate against viral hepatitis A, as well as hepatitis B - to prevent similar crises in the future.
Question:How is the hepatitis virus transmitted? And how to avoid getting sick.
Answer: Hepatitis A and E viruses are transmitted through food and drink (the so-called fecal-oral transmission). Hepatitis B, C, D, G, TTV are transmitted through medical procedures, injections (for example, among injecting drug addicts using one syringe, one needle and a common “Shirka”), blood transfusions, during surgical operations with reusable instruments, as well as during sexual contact (so-called parenteral, blood transfusion and sexual transmission). Knowing the routes of transmission of viral hepatitis, a person can to a certain extent control the situation and reduce the risk of disease. There have been vaccines against hepatitis A and B in Ukraine for a long time, vaccinations with which provide a 100% guarantee against the occurrence of the disease.
Question:I have hepatitis C, genotype 1B. I was treated with Reaferon + Ursosan - without results. What medications to take to prevent liver cirrhosis.
Answer: For hepatitis C, the most effective combination antiviral therapy is: recombinant alpha 2-interferon (3 million per day) + ribavirin (or in combination with other drugs - nucleoside analogues). The treatment process is long, sometimes more than 12 months, under the control of ELISA, PCR and cytolysis syndrome indicators (AlT in whole and 1:10 diluted blood serum), as well as at the final stage - liver puncture biopsy. Therefore, it is advisable to be observed and undergo laboratory examination by one attending physician - it is necessary to understand the definition of “without result” (dosage, duration of the first course, laboratory results in the dynamics of drug use, etc.).
Question:Hepatitis C! A 9-year-old child has had a fever for 9 years. How to treat? What's new in this area? Will they soon find the right treatment? Thank you in advance.
Answer: Temperature is not the main symptom of chronic hepatitis C. Therefore: 1) it is necessary to exclude other causes of elevated temperature; 2) determine the activity of viral hepatitis C according to three main criteria: a) ALT activity in whole and 1:10 diluted blood serum; b) serological profile - Ig G antibodies to HCV proteins of classes NS4, NS5 and Ig M to the HCV nuclear antigen; 3) test the presence or absence of HCV RNA in the blood using the polymerase chain reaction (PCR), and also determine the genotype of the detected virus. Only after this will it be possible to talk about the need to treat hepatitis C. Today there are quite progressive drugs in this area.
Question:Is it possible to breastfeed a child if the mother has hepatitis C?
Answer: It is necessary to test the mother's milk and blood for hepatitis C virus RNA. If the result is negative, you can breastfeed the baby.
Question:My brother is 20 years old. Hepatitis B was discovered in 1999. Now he has been diagnosed with hepatitis C. I have a question. Does one virus change to another? Can it be cured? Is it possible to have sex and have children? He also has 2 lymph nodes on the back of his head, maybe he should be tested for HIV? Didn't take drugs. Please, please answer me. Thank you. Tanya
Answer: You know, Tanya, with a high degree of probability, infection with two viruses (HBV and HCV) occurs precisely through injecting drug use. Therefore, first of all, it is necessary to clarify this situation with your brother and, if necessary, recover from drug addiction. Drugs are a cofactor that accelerates the unfavorable course of hepatitis. It is advisable to get tested for HIV. One virus does not pass into another. Chronic viral hepatitis B and C are treated today and sometimes quite successfully. Sexual life - with a condom. After treatment you can have children.
Question:How is the hepatitis A virus transmitted?
Answer: The hepatitis A virus is transmitted from person to person through the fecal-oral route. This means that a person with hepatitis A sheds viruses in their stool, which, when insufficient compliance hygiene, can get into food or water and lead to infection of another person. Hepatitis A is often called the “disease of dirty hands.”
Question:What are the symptoms of viral hepatitis A?
Answer: Often, viral hepatitis A is asymptomatic, or under the guise of another illness (for example, gastroenteritis, flu, colds), but, as a rule, some of the following symptoms may indicate the presence of hepatitis: weakness, increased fatigue, drowsiness, in children, tearfulness and irritability; decreased or lack of appetite, nausea, vomiting, bitter belching; discolored stool; fever up to 39°C, chills, sweating; pain, feeling of heaviness, discomfort in the right hypochondrium; darkening of urine - occurs a few days after the first signs of hepatitis appear; jaundice (the appearance of a yellow coloration of the sclera of the eyes, body skin, and oral mucosa), as a rule, appears a week after the onset of the disease, bringing some relief to the patient’s condition. Often there are no signs of jaundice with hepatitis A at all.
Hepatitis C is an inflammatory infection liver, caused by a hepatotropic virus from the Flaviviridae group, capable of multiplying exclusively in the tissues of this organ. The size of the microorganism is about 80 nm.
For your own safety, you need to know the ways of infection by the virus and some of the features of its life activity, especially in the external environment. So how long does hepatitis live outside the body? Let's try to figure this out.
Lifespan
Many interested people are concerned about how long the hepatitis C virus can live outside the human body.
For a long time there was an opinion that the hepatitis C virus dies very quickly outside the body. For the research, blood taken from chimpanzee monkeys was used. The drying process lasted sixteen hours. The samples were then dissolved with sterile water and half were frozen. The other part of the material was left for storage at a temperature of + 25.
As a result, it became known that the virus does not die when it dries out. At a temperature of about +25, he can live and retain his abilities for up to four days. After additional research It was found that in some cases the virus can exist in the external environment for up to six weeks. A decrease or increase in air temperature reduces or increases its activity. It can survive in blood used for transfusion for several years.
The greatest danger comes from dried blood particles (on syringes, gynecological or dental instruments, blades). If these devices are reused without disinfection, the likelihood of contracting hepatitis C is quite high.
How long does the hepatitis C virus live when frozen? It tolerates negative temperatures well, so life cycle its more than one year old. There is no exact data on how long it can actually live when frozen.
In the external environment, the virus lives at a temperature of about 25 degrees for up to 4 days, when frozen - about one year.
Viruses quickly die when treated with chlorine-containing substances or ethyl alcohol. They also die when boiled for two minutes.
In semen, leucorrhoea or saliva, the virus is concentrated in very small quantities. In most cases, this is not enough to infect another person (with normal immunity) with it.
Routes of infection
You can become infected with hepatitis C in the following situations.
- If during the medical manipulations sanitary standards are violated, then the risk of contracting the disease is 4%. Basically, infection occurs through injections with unsterile syringes. The likelihood of contracting the disease depends on the amount of blood entering the body and the concentration of the virus. The diameter of the needle plays a special role in this, so people receiving injections with a syringe with a volume of 2 ml are at less risk than those who were administered the medicine intravenously using infusion systems. The disease can be acquired during surgical procedures if the instruments are not properly disinfected.
- If you had sexual intercourse without a condom with a carrier of the disease, the risk of contracting hepatitis C reaches 5%. It increases when the mucous membranes are damaged as a result of inflammatory processes or sexually transmitted diseases. Also, the likelihood of becoming infected increases in couples who practice anal sex or are sexually active during menstruation.
- The disease can be contracted through an organ transplant or blood transfusion. The material is examined for the presence of the virus, but infection cannot be completely excluded in this way. There is a period of serological sleep when a person has recently become infected and markers of the disease have not yet been detected.
- In 5% of cases, the disease can be transmitted to the fetus from a mother infected with hepatitis.
- About 3% of patients get the disease while getting a tattoo or while visiting a nail salon.
- If contaminated blood enters open wound In a healthy person, infection will occur in almost 85% of cases.
- A large percentage of patients are people who use injection drugs. According to statistics, about 75% of people who take drugs are infected with hepatitis C.
- Cases of infection have been observed in individuals who inhale cocaine. The reason for this is damage to the nasal mucosa, which allows the virus to quickly enter the body.
Hepatitis C cannot be contracted through utensils and things (toothbrushes and cutting objects are an exception). The virus does not enter the body through kissing, hugging or shaking hands. It is also impossible to get this infection when visiting a bathhouse, sauna, public toilet or swimming in an open body of water.
Hundreds of suppliers bring hepatitis C medications from India to Russia, but only M-PHARMA will help you buy sofosbuvir and daclatasvir, and professional consultants will answer any of your questions throughout the entire treatment.
Hepatitis is the name given to acute and chronic inflammatory diseases of the liver that are not focal, but widespread. Different hepatitises have different methods of infection; they also differ in the rate of disease progression, clinical manifestations, methods and prognosis of therapy. Even the symptoms of different types of hepatitis are different. Moreover, some symptoms are stronger than others, which is determined by the type of hepatitis.Main symptoms
- Jaundice. The symptom occurs frequently and is due to the fact that bilirubin enters the patient’s blood when the liver is damaged. Blood, circulating throughout the body, carries it to organs and tissues, coloring them yellow.
- The appearance of pain in the area of the right hypochondrium. It occurs due to an increase in the size of the liver, leading to pain that can be dull and prolonged or of a paroxysmal nature.
- Deterioration of health, accompanied by fever, headaches, dizziness, indigestion, drowsiness and lethargy. All this is a consequence of the effect of bilirubin on the body.
Hepatitis acute and chronic
Hepatitis in patients has acute and chronic forms. In acute form they appear in the case of viral infection liver, as well as if there has been poisoning by various types of poisons. In acute forms of the disease, the condition of patients quickly deteriorates, which contributes to the accelerated development of symptoms.
With this form of the disease, favorable prognosis is quite possible. Except for its transformation into chronic. In its acute form, the disease is easily diagnosed and easier to treat. Untreated acute hepatitis easily develops into a chronic form. Sometimes, with severe poisoning (for example, alcohol), the chronic form occurs independently. In the chronic form of hepatitis, the process of replacement of liver cells with connective tissue occurs. It is weakly expressed, progresses slowly, and therefore sometimes remains undiagnosed until cirrhosis of the liver occurs. Chronic hepatitis is less treatable, and the prognosis for its cure is less favorable. In the acute course of the disease, health deteriorates significantly, jaundice develops, intoxication appears, the functional functioning of the liver decreases, and the bilirubin content in the blood increases. With timely detection and effective treatment of acute hepatitis, the patient most often recovers. When the disease lasts more than six months, hepatitis becomes chronic. The chronic form of the disease leads to serious disorders in the body - the spleen and liver enlarge, metabolism is disrupted, complications arise in the form of cirrhosis of the liver and cancer. If the patient reduced immunity, the treatment regimen is chosen incorrectly or there is alcohol dependence, then the transition of hepatitis to a chronic form threatens the patient’s life.
Types of hepatitis
Hepatitis has several types: A, B, C, D, E, F, G, they are also called viral hepatitis, since they are caused by a virus.Hepatitis A
This type of hepatitis is also called Botkin's disease. It has an incubation period lasting from 7 days to 2 months. Its causative agent, an RNA virus, can be transmitted from a sick person to a healthy person through poor-quality food and water, or contact with household items used by the sick person. Hepatitis A is possible in three forms, they are divided according to the severity of the disease:- in the acute form with jaundice, the liver is seriously damaged;
- with subacute without jaundice, we can talk about a milder version of the disease;
- in the subclinical form, you may not even notice symptoms, although the infected person is the source of the virus and is capable of infecting others.
Hepatitis B
This disease is also called serum hepatitis. Accompanied by an enlarged liver and spleen, joint pain, vomiting, fever, and liver damage. It occurs either in acute or chronic forms, which is determined by the state of the patient’s immunity. Routes of infection: during injections in violation of sanitary rules, sexual contact, during blood transfusions, and the use of poorly disinfected medical instruments. The duration of the incubation period is 50 ÷ 180 days. The incidence of hepatitis B decreases with vaccination.Hepatitis C
This type diseases are among the most serious illnesses, as it is often accompanied by cirrhosis or liver cancer, which subsequently leads to death. The disease is difficult to treat, and moreover, having had hepatitis C once, a person can be infected with the same disease again. It is not easy to cure HCV: after contracting hepatitis C in an acute form, 20% of patients recover, but in 70% of patients the body is not able to recover from the virus on its own, and the disease becomes chronic. It has not yet been possible to establish the reason why some heal on their own and others do not. The chronic form of hepatitis C will not disappear on its own and therefore requires therapy. Diagnosis and treatment acute form HCV is carried out by an infectious disease specialist, chronic forms of the disease are carried out by a hepatologist or gastroenterologist. You can become infected during a plasma or blood transfusion from an infected donor, through the use of poorly processed medical instruments, through sexual contact, and a sick mother transmits the infection to her child. The hepatitis C virus (HCV) is rapidly spreading throughout the world; the number of patients has long exceeded one and a half hundred million people. Previously, HCV was difficult to treat, but now the disease can be cured using modern direct-acting antivirals. But this therapy is quite expensive, and therefore not everyone can afford it.Hepatitis D
This type of hepatitis D is possible only with coinfection with the hepatitis B virus (coinfection is the case of infection of one cell with viruses of different types). It is accompanied by massive liver damage and an acute course of the disease. The route of infection is the entry of the disease virus into the blood of a healthy person from a virus carrier or a sick person. The incubation period lasts 20 ÷ 50 days. Externally, the course of the disease resembles hepatitis B, but its form is more severe. It can become chronic, later turning into cirrhosis. It is possible to carry out vaccination similar to that used for hepatitis B.Hepatitis E
It is slightly reminiscent of hepatitis A in its course and transmission mechanism, since it is also transmitted through the blood. Its peculiarity is the occurrence of lightning-fast forms that cause death in a period not exceeding 10 days. In other cases, it can be effectively cured, and the prognosis for recovery is most often favorable. An exception may be pregnancy, since the risk of losing a child is close to 100%.Hepatitis F
This type of hepatitis has not yet been studied enough. It is only known that the disease is caused by two different viruses: one was isolated from the blood of donors, the second was found in the feces of a patient who received hepatitis after a blood transfusion. Signs: the appearance of jaundice, fever, ascites (accumulation of fluid in abdominal cavity), an increase in the size of the liver and spleen, an increase in the levels of bilirubin and liver enzymes, the occurrence of changes in urine and feces, as well as general intoxication of the body. Effective methods of treating hepatitis F have not yet been developed.Hepatitis G
This type of hepatitis is similar to hepatitis C, but is not as dangerous because it does not contribute to the development of cirrhosis and liver cancer. Cirrhosis can only appear in cases of co-infection with hepatitis G and C.Diagnostics
Viral hepatitis is similar in its symptoms to one another, just like some other viral infections. For this reason, it can be difficult to accurately diagnose a sick person. Accordingly, to clarify the type of hepatitis and the correct prescription of therapy, laboratory blood tests are required to identify markers - indicators individual for each type of virus. By identifying the presence of such markers and their ratio, it is possible to determine the stage of the disease, its activity and possible outcome. In order to track the dynamics of the process, the examinations are repeated after a period of time.How is hepatitis C treated?
Modern treatment regimens for chronic forms of HCV are reduced to combination antiviral therapy, including direct-acting antivirals such as sofosbuvir, velpatasvir, daclatasvir, ledipasvir in various combinations. Sometimes ribavirin and interferons are added to enhance effectiveness. This combination of active ingredients stops the replication of viruses, saving the liver from their destructive effects. This type of therapy has a number of disadvantages:- The cost of drugs to combat the hepatitis virus is high; not everyone can buy them.
- Taking certain medications is accompanied by unpleasant side effects, including fever, nausea, and diarrhea.
Features of HCV genotypes
Hepatitis C is one of the most dangerous viral hepatitis. The disease is caused by an RNA virus called Flaviviridae. The hepatitis C virus is also called the “gentle killer.” He received such an unflattering epithet due to the fact that at the initial stage the disease is not accompanied by any symptoms at all. There are no signs of classic jaundice, and there is no pain in the area of the right hypochondrium. The presence of the virus can be detected no earlier than a couple of months after infection. Before this, the reaction of the immune system is completely absent and markers cannot be detected in the blood, and therefore genotyping is not possible. Another feature of HCV is that after entering the bloodstream during the process of reproduction, the virus begins to rapidly mutate. Such mutations prevent the infected person’s immune system from adapting and fighting the disease. As a result, the disease can proceed for several years without any symptoms, after which cirrhosis or a malignant tumor appears almost immediately. Moreover, in 85% of cases, the disease goes from an acute form to a chronic one. The hepatitis C virus has important feature– diversity of genetic structure. In fact, hepatitis C is a collection of viruses, classified depending on their structural variants and divided into genotypes and subtypes. The genotype is the sum of genes encoding hereditary traits. So far, medicine knows 11 genotypes of the hepatitis C virus, which have their own subtypes. The genotype is designated by numbers from 1 to 11 (although genotypes 1 ÷ 6 are mainly used in clinical studies), and subtypes are designated by letters Latin alphabet:- 1a, 1b and 1c;
- 2a, 2b, 2c and 2d;
- 3a, 3b, 3c, 3d, 3e and 3f;
- 4a, 4b, 4c, 4d, 4e, 4f, 4h, 4i and 4j;
How are HCV strains distributed across the planet?
Hepatitis C genotypes are distributed heterogeneously across the globe, and genotypes 1, 2, 3 can most often be found, and in certain areas it looks like this:
- V Western Europe and in its eastern regions genotypes 1 and 2 are most common;
- in the USA - subtypes 1a and 1b;
- in northern Africa, genotype 4 is the most common.
- genotype 1b accounts for ~50% of cases;
- for genotype 3a ~20%,
- ~10% of patients are infected with hepatitis 1a;
- hepatitis with genotype 2 was found in ~5% of infected people.
- age of patients. The chance of cure is much higher in young people;
- It is easier for women to recover than for men;
- the degree of liver damage is important - the favorable outcome is higher with less damage;
- the magnitude of the viral load - the fewer viruses in the body at the time of treatment, the more effective the therapy;
- the patient’s weight: the higher it is, the more complicated the treatment becomes.
Who is at risk for HCV infection?
As you know, the hepatitis C virus is transmitted through blood, and therefore the following are most likely to become infected:- patients receiving blood transfusions;
- patients and clients in dental offices and medical institutions where medical instruments are improperly sterilized;
- visiting nail and beauty salons can be dangerous due to unsterile instruments;
- piercing and tattoo enthusiasts can also suffer from poorly processed tools,
- there is a high risk of infection for those who use drugs due to repeated use of unsterile needles;
- the fetus can become infected from a mother infected with hepatitis C;
- During sexual intercourse, the infection can also enter the body of a healthy person.
How is hepatitis C treated?
It was not for nothing that the hepatitis C virus was considered a “gentle” killer virus. It can remain silent for years, and then suddenly appear in the form of complications accompanied by cirrhosis or liver cancer. But more than 177 million people in the world have been diagnosed with HCV. The treatment that was used until 2013, combining injections of interferon and ribavirin, gave patients a chance of healing that did not exceed 40-50%. Moreover, it was accompanied by serious and painful side effects. The situation changed in the summer of 2013 after the US pharmaceutical giant Gilead Sciences patented the substance sofosbuvir, produced in the form of a drug under the Sovaldi brand, which included 400 mg of the drug. It was the first direct-acting antiviral drug (DAA) to combat HCV. The results of clinical trials of sofosbuvir pleased doctors with the effectiveness, which reached 85 ÷ 95% depending on the genotype, while the duration of the course of therapy was more than halved compared to treatment with interferons and ribavirin. And, although the pharmaceutical company Gilead patented sofosbuvir, it was synthesized in 2007 by Michael Sophia, an employee of Pharmasett, which was later acquired by Gilead Sciences. From Michael’s last name, the substance he synthesized was named sofosbuvir. Michael Sofia himself, together with a group of scientists who made a number of discoveries that revealed the nature of HCV, which made it possible to create effective drug for his treatment, received the Lasker-DeBakey Award for Clinical Medical Research. Well, almost all of the profit from the sale of the new effective product went to Gilead, which set monopoly high prices for Sovaldi. Moreover, the company protected its development with a special patent, according to which Gilead and some of its partner companies became the owners of the exclusive right to manufacture the original DPP. As a result, Gilead's profits in just the first two years of sales of the drug many times covered all the costs that the company incurred to acquire Pharmasett, obtain a patent and subsequent clinical trials.What is Sofosbuvir?
The effectiveness of this drug in the fight against HCV has proven to be so high that now almost no treatment regimen can do without its use. Sofosbuvir is not recommended for use as monotherapy, but when used in combination it shows exceptionally good results. Initially, the drug was used in combination with ribavirin and interferon, which made it possible to achieve a cure in just 12 weeks in uncomplicated cases. And this despite the fact that therapy with interferon and ribavirin alone was half as effective, and its duration sometimes exceeded 40 weeks. After 2013, each subsequent year brought news of the emergence of more and more new drugs that successfully fight the hepatitis C virus:
- daclatasvir appeared in 2014;
- 2015 was the year of birth of ledipasvir;
- 2016 pleased with the creation of velpatasvir.
- Harvoni, combining sofosbuvir 400 mg and ledipasvir 90 mg;
- Epclusa, which included sofosbuvir 400 mg and velpatasvir 100 mg.
The emergence of generics
Clinical trials confirmed the effectiveness of the treatment, but all these highly effective drugs had one significant drawback - too high prices, which prevented the majority of patients from purchasing them. Monopoly high prices for products set by Gilead caused outrage and scandals, which forced patent holders to make certain concessions, granting some companies from India, Egypt and Pakistan licenses to produce analogues (generics) of such effective and popular drugs. Moreover, the fight against patent holders offering drugs for treatment at biasedly inflated prices was led by India, as a country where millions of chronic hepatitis C patients live. As a result of this struggle, Gilead issued licenses and patent developments to 11 Indian companies to independently produce first sofosbuvir, and then its other new drugs. Having received licenses, Indian manufacturers quickly began producing generics, assigning their own trade names to the drugs they produced. This is how generics Sovaldi first appeared, then Daklinza, Harvoni, Epclusa, and India became the world leader in their production. Indian manufacturers, under a licensing agreement, pay 7% of earnings to patent holders. But even with these payments, the cost of generics produced in India turned out to be tens of times less than the originals.Mechanisms of action
As already reported above, the new HCV therapy products that have emerged are classified as DAAs and act directly on the virus. Whereas interferon with ribavirin, previously used for treatment, strengthened the human immune system, helping the body resist the disease. Each substance acts on the virus in its own way:- Sofosbuvir blocks RNA polymerase, thereby inhibiting viral replication.
- Daclatasvir, ledipasvir and velpatasvir are NS5A inhibitors that interfere with the spread of viruses and their entry into healthy cells.
Manufacturers of generics from India
Pharmaceutical companies in the country have taken advantage of the licenses granted to them, and now India produces the following generic Sovaldi:- Hepcvir - manufactured by Cipla Ltd.;
- Hepcinat - Natco Pharma Ltd.;
- Cimivir - Biocon ltd. & Hetero Drugs Ltd.;
- MyHep is manufactured by Mylan Pharmaceuticals Private Ltd.;
- SoviHep - Zydus Heptiza Ltd.;
- Sofovir - manufactured by Hetero Drugs Ltd.;
- Resof - produced by Dr Reddy's Laboratories;
- Virso - produced by Strides Arcolab.
- Natdac from Natco Pharma;
- Dacihep by Zydus Heptiza;
- Daclahep from Hetero Drugs;
- Dactovin by Strides Arcolab;
- Daclawin from Biocon ltd. & Hetero Drugs Ltd.;
- Mydacla from Mylan Pharmaceuticals.
- Ledifos - released by Hetero;
- Hepcinat LP - Natco;
- Myhep LVIR - Mylan;
- Hepcvir L - Cipla Ltd.;
- Cimivir L - Biocon ltd. & Hetero Drugs Ltd.;
- LadyHep - Zydus.
- Velpanat was released by the pharmaceutical company Natco Pharma;
- the release of Velasof was mastered by Hetero Drugs;
- SoviHep V was launched by Zydus Heptiza.
Requirements for generics
A generic is a drug that is capable of pharmacological properties replace treatment with expensive original medicines with a patent. They can be produced either with or without a license; only its presence makes the produced analogue licensed. In the case of issuing a license to Indian pharmaceutical companies, Gilead also provided the production technology for them, giving the license holders the right to an independent pricing policy. In order for a drug analogue to be considered a generic, it must meet a number of parameters:- It is necessary to observe the ratio of the most important pharmaceutical components in the drug according to qualitative as well as quantitative standards.
- Compliance with relevant international standards should be adhered to.
- Proper production conditions are required.
- The preparations should maintain the appropriate equivalent absorption parameters.
Egyptian generics of sofosbuvir
Unlike India, Egyptian pharmaceutical companies have not become world leaders in the production of generic drugs for hepatitis C, although they have also mastered the production of sofosbuvir analogues. True, the bulk of the analogues they produce are unlicensed:- MPI Viropack, produces the drug Marcyrl Pharmaceutical Industries - one of the very first Egyptian generics;
- Heterosofir, produced by Pharmed Healthcare. Is the only licensed generic in Egypt. There is a code hidden on the packaging under the hologram that allows you to check the originality of the drug on the manufacturer’s website, thereby eliminating its counterfeit;
- Grateziano, manufactured by Pharco Pharmaceuticals;
- Sofolanork produced by Vimeo;
- Sofocivir, manufactured by ZetaPhar.
Generics to fight hepatitis from Bangladesh
Another country producing large volumes of generic anti-HCV drugs is Bangladesh. Moreover, this country does not even require licenses for the production of analogues of branded medicines, since by 2030 its pharmaceutical companies It is allowed to produce such medications without the appropriate licensing documents. The most famous and equipped with the latest technology is the pharmaceutical company Beacon Pharmaceuticals Ltd. The design of its production capacity was created by European specialists and meets international standards. Beacon produces the following generics for the treatment of hepatitis C virus:- Soforal is a generic version of sofosbuvir, containing 400 mg of active substance. Unlike traditional packaging in bottles of 28 pieces, Soforal is produced in the form of blisters of 8 tablets in one plate;
- Daclavir is a generic version of daclatasvir, one tablet of the drug contains 60 mg of the active substance. It is also produced in the form of blisters, but each plate contains 10 tablets;
- Sofosvel is a generic version of Epclusa, containing sofosbuvir 400 mg and velpatasvir 100 mg. A pangenotypic (universal) drug, effective in the treatment of HCV genotypes 1 ÷ 6. And in this case, there is no usual packaging in bottles, the tablets are packaged in blisters of 6 pieces in each plate.
- Darvoni is a complex drug that combines sofosbuvir 400 mg and daclatasvir 60 mg. If it is necessary to combine sofosbuvir therapy with daklatasvir, using drugs from other manufacturers, you must take a tablet of each type. And Beacon combined them into one pill. Darvoni is packaged in blisters of 6 tablets in one plate and sent for export only.
Natco Pharma Ltd.
The most popular pharmaceutical company is Natco Pharma Ltd., whose drugs have saved the lives of several tens of thousands of people with chronic hepatitis C. It has mastered the production of almost the entire line of direct-acting antiviral drugs, including sofosbuvir with daclatasvir and ledipasvir with velpatasvir. Natco Pharma appeared in 1981 in Hyderabad with an initial capital of 3.3 million rupees, then the number of employees was 20 people. Now in India, 3.5 thousand people work at five Natco enterprises, and there are also branches in other countries. In addition to production units, the company has well-equipped laboratories that allow it to develop modern medications. Among her own developments, it is worth noting drugs to combat cancer. One of the most well-known drugs in this area is Veenat, produced since 2003 and used for leukemia. And the production of generics for the treatment of hepatitis C virus is a priority area of activity for Natco.Hetero Drugs Ltd.
This company has set its goal to produce generics, subordinating its own network of production facilities, including factories with branches and offices with laboratories. Hetero's production network is designed to produce medicines under licenses received by the company. One of its areas of activity is medications that help fight serious viral diseases, the treatment of which has become impossible for many patients due to the high cost of original drugs. The acquired license allows Hetero to quickly begin producing generics, which are then sold at a price affordable for patients. The creation of Hetero Drugs dates back to 1993. Over the past 24 years, a dozen factories and several dozen production units have appeared in India. The presence of its own laboratories allows the company to carry out experimental work on the synthesis of substances, which contributed to the expansion of the production base and the active export of drugs to foreign countries.Zydus Heptiza
Zydus is an Indian company that has set as its goal the creation of a healthy society, which, according to its owners, will be followed by a positive change in the quality of life of people. The goal is noble, and therefore, to achieve it, the company conducts active educational activities that affect the poorest segments of the country's population. Including through free vaccination of the population against hepatitis B. Zidus is in fourth place in terms of production volumes on the Indian pharmaceutical market. In addition, 16 of its drugs were included in the list of 300 most important drugs of the Indian pharmaceutical industry. Zydus products are in demand not only on the domestic market; they can be found in pharmacies in 43 countries on our planet. And the range of drugs produced at 7 enterprises exceeds 850 drugs. One of its most powerful production facilities is located in the state of Gujarat and is one of the largest not only in India, but also in Asia.HCV therapy 2017
Hepatitis C treatment regimens for each patient are selected by the doctor individually. To correctly, effectively and safely select a regimen, the doctor needs to know:- virus genotype;
- duration of illness;
- degree of liver damage;
- presence/absence of cirrhosis, concomitant infection (for example, HIV or other hepatitis), negative experience of previous treatment.
- Possible schemes Treatments proposed by EASL for hepatitis C monoinfection or HIV+HCV co-infection in patients without cirrhosis and who have not previously been treated:
- for treatment genotypes 1a and 1b can be used:
- during therapy genotype 2 used without ribavirin for 12 weeks:
- during treatment genotype 3 without the use of ribavirin for a period of therapy of 12 weeks, use:
- during therapy genotype 4 You can use without ribavirin for 12 weeks:
- EASL recommended treatment regimens for hepatitis C monoinfection or concomitant HIV/HCV infection in patients with compensated cirrhosis who have not previously been treated:
- for treatment genotypes 1a and 1b can be used:
- during therapy genotype 2 apply:
- during treatment genotype 3 use:
- during therapy genotype 4 apply the same schemes as for genotypes 1a and 1b.
Treatment with modern drugs for HCV
Take tablets of direct antiviral drugs as prescribed by a doctor orally once a day. They are not divided into parts, not chewed, but washed down with plain water. It is best to do this at the same time, this way a constant concentration in the body is maintained. active substances. There is no need to be tied to the timing of meals, the main thing is not to do it on an empty stomach. When you start taking medications, pay attention to how you feel, since during this period it is easiest to notice possible side effects. DAAs themselves do not have very many of them, but drugs prescribed in combination have much less. Most often, side effects appear as:- headaches;
- vomiting and dizziness;
- general weakness;
- loss of appetite;
- joint pain;
- changes in biochemical blood parameters, expressed in low hemoglobin levels, a decrease in platelets and lymphocytes.
Contraindications
In some cases, taking DAAs is excluded, this applies to:- individual hypersensitivity of patients to certain drug ingredients;
- patients under 18 years of age, since there is no accurate data on their effect on the body;
- women carrying a fetus and breastfeeding babies;
- Women should use reliable methods of contraception to avoid conception during therapy. Moreover, this requirement also applies to women whose partners are also undergoing DAA therapy.
Storage
Store direct-acting antiviral drugs in places inaccessible to children and out of direct sunlight. Storage temperature should be in the range of 15 ÷ 30ºС. When starting to take medications, check their production and storage dates indicated on the packaging. Expired medications should not be taken. How to purchase DAAs for residents of Russia Unfortunately, you can find it in Russian pharmacies Indian generics will not succeed. The pharmaceutical company Gilead, having granted licenses to produce drugs, prudently banned their export to many countries. Including all European countries. Those wishing to purchase budget Indian generics to combat hepatitis C can use several options:- order them through Russian online pharmacies and receive the goods in a few hours (or days) depending on the delivery location. Moreover, in most cases, even an advance payment is not required;
- order them through Indian online stores with home delivery. Here you will need an advance payment in foreign currency, and the waiting time will last from three weeks to a month. Plus there will be the need to communicate with the seller on English language;
- go to India and bring the drug yourself. This will also take time, plus the language barrier, plus the difficulty of checking the originality of the product purchased at the pharmacy. Added to this is the problem of self-export, which requires a thermal container, a doctor’s report and a prescription in English, as well as a copy of the receipt.
The life of the hepatitis C virus in the external environment is long; it dies only when boiled. It reacts to external factors earlier than other hepatitis pathogens. It is necessary to understand under what circumstances the hepatitis C virus is dangerous in order to reduce the risk of infection. This is especially true for families in which there is a sick person.
Lifespan of the virus in the external environment
The causative agents of hepatitis are highly resistant in the external environment and are able to survive for a long time. There are many myths regarding their endurance, most of which have been refuted through research.
Scientists have been able to establish that the activity of the hepatitis C virus is little affected by an increase in temperature. Its reduction, even to minus levels, does not at all affect the life activity of the pathogen. However, it is impossible to contract the disease through the respiratory route.
Of all the known subtypes, the hepatitis C virus in clinical trials turned out to be the least resistant to external factors. When located in temperature conditions of about 25 degrees, it is able to live for 4 days outside the host’s body. Heat reduces the activity of this pathogen. Ultraviolet light kills it in 30 minutes.
When the rate drops to 4 degrees, the virus can survive for 6 months. Freezing even to -70 degrees also does not kill the pathogen; its activity at subzero temperatures is observed in samples throughout the year.
The highest life expectancy was recorded for viral particles contained in blood plasma. If it is frozen, the pathogen will not die and will remain dangerous for several years. Frozen plasma is always checked for the presence of the virus when six months have passed since the moment of freezing, because during this time it is able to become more active. For this reason, patients with hepatitis cannot donate blood and organs.
Given the survivability of the virus, there is a risk of infection when coming into contact with objects that contain biomaterial from an infected person.
What affects the life of the hepatitis C virus
The infection dies quite quickly when exposed to certain factors. The survival of the hepatitis C agent under various conditions was studied in the blood of chimpanzees. The infected blood was first dried and then divided into 3 parts, which were stored under different conditions. One of the parts was frozen to -70 degrees. Under these conditions, the virus remained active. After administering this test to a healthy chimpanzee, the animal was diagnosed with hepatitis C.
The second part was stored at room temperature 25 degrees for 3 days. During this period, the virus remained in the blood. The third part was kept under similar conditions, but the study of the samples began 7 days after the start of the experiment. No pathogen was found in this biomaterial. When these samples were introduced into the blood of the chimpanzee, the animal remained healthy, which confirmed the assumption that the pathogen had died.
The experiment confirmed the following facts:
- Freezing is ineffective against this pathogen. In this state it becomes highly active.
- The virus dies only in room conditions after 4 days.
- The higher the ambient temperature, the less active the pathogen becomes.
- Hepatitis C is resistant to most disinfectants.
When infected material is exposed to chlorine compounds, the pathogen dies almost instantly. It needs to be kept in alcohol for several minutes, and the effectiveness of the solution of iodine and brilliant green is questioned by researchers, since there is no evidence of the destruction of the virus by these drugs.
The virus is affected by boiling temperature if it affects it for at least 2 minutes. If this time is reduced, the pathogen will not die. Ultraviolet radiation has virtually no effect on the hepatitis C agent. Ultraviolet treatment is effective only when exposed for 30 minutes.
The causative agent of hepatitis C is difficult to grow in laboratory conditions, so the information known about it cannot be considered exhaustive. Scientists do not rule out that in conditions of different humidity and with a high viral load, those caught in environment biomaterial, infection survival may be different.
At what temperature can the virus die?
Hepatitis pathogens are extremely hardy and often require temperatures exceeding 100 degrees to kill them. The virus showed the least resistance to increasing degrees. Many studies have been conducted regarding the survival of the pathogen under different temperature conditions. During the experiments, the following data were obtained:
- When the temperature rises to 60 degrees, the virus can survive for 30 minutes.
- The infection dies when boiled, but even in such conditions it can survive for 2 minutes.
- Most quick way to get rid of the virus - steam treatment, which is used to sterilize instruments.
Thus, the researchers concluded that only temperatures exceeding 100 degrees are effective against the hepatitis C virus. In other conditions, he is able to live for several hours. To completely destroy the infectious agent, it is advisable to use an autoclave. Processing should take several minutes.
What to do if you come into contact with a contaminated object
If the biological fluid of a person infected with hepatitis gets on interior items, they should be thoroughly treated. All manipulations are carried out using rubber gloves. It is recommended to clean carpets with a soda solution and treat them with steam, since at this temperature the virus dies very quickly.
Disinfection of surfaces when biomaterial from a hepatitis patient comes into contact with it can be carried out with the following substances:
- soda solution;
- chloramine;
- formaldehyde;
- potassium permanganate;
- bleach.
The hepatitis C virus is killed when exposed to alcohol, but even in such circumstances it survives for 2 minutes. Doctors emphasize that treatments alcohol solutions is not enough to disinfect tools and objects, since its vapors quickly evaporate. Acids and fat-soluble agents (freon, chloroform, ether) do not destroy the pathogen. Treatment with hydrogen peroxide is effective only at high concentrations of the drug, which should not be used on the skin.
Clothes and underwear containing blood from someone infected with hepatitis should be washed at 60 degrees. If a person is sick with hepatitis C, it is enough to wait half an hour. Light-colored items are soaked for 30 minutes in chlorine-containing preparations. The virus is killed by boiling in a soda solution. It requires 20 g per 1 liter of water.
If biological material from a patient with hepatitis C gets on clothing or objects, they are covered with bleach and then left for 1 hour to allow the pathogen to die.
If an injury occurs due to contact with an infected object, the damaged area is washed several times with soap and water to prevent the spread of infection. There is no need to stop the bleeding. The effectiveness of iodine and other alcoholic tinctures against the hepatitis C agent has not been confirmed clinical trials. It is recommended to treat the mucous membranes with a 0.9% solution of NaCl or soda, and rinse the oral cavity with Miramistin.
Conclusion
For hepatitis C virus Better conditions negative temperatures are created for life outside the human body. An increase in this indicator has an unfavorable effect on the pathogen. You can get rid of the infection using boiling and an autoclave, as well as after treatment with chlorine compounds. Knowing the survivability of the virus helps prevent infection.
