Hepatitis C : symptoms, causes and treatment
Hepatitis C is an inflammation of the liver caused by a virus. In two-thirds of patients, it becomes chronic. Fortunately, its treatment has made great progress in recent years.
Hepatitis C is an inflammation of the liver caused by a virus. It can become chronic (not cured after six months) or cause serious complications such as liver cancer (hepatocellular carcinoma).
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There are severe forms of Hepatitis C and the so-called fulminant forms. They can lead to death, but they are still exceptional.
Hepatitis C is caused by the hepatitis C virus (HCV).
The virus is transmitted through blood (directly or by contact with dirty equipment, for example when drug users exchange contaminated syringes).
Therefore, the populations at risk are people who were transfused before 1992 and drug users who share syringes.
Contamination can be exceptionally sexual or mother-to-child (less than 5% of cases).
Acute Hepatitis C is a silent disease that progresses without symptoms for several years. When there are signs, they begin after an incubation period of 15 to 90 days during which the germ spreads in the body.
The symptoms are nonspecific and of varying importance:
- ...severe fatigue;
- nausea, even vomiting;
- loss of appetite;
- alteration of the general state ;
- abdominal pain on the right side;
- joint pain...
A few days later, the urine may become dark, the stools may become discolored, and jaundice may appear. Sometimes there is itching.
The most serious hepatitis
When severe hepatitis occurs, there are signs of liver failure (malfunctioning of the liver) such as clotting abnormalities, altered consciousness.
If a coma occurs, it is fulminant hepatitis and it is an emergency.
When certain signs persist (fatigue, altered general condition, etc.) for at least six months, it may be chronic hepatitis. However, it can be asymptomatic and discovered during a biological check-up. It may also be detected at the stage of cirrhosis and its complications.
Hepatitis C requires prompt medical management and hospitalization for severe or fulminant hepatitis and cirrhosis.
There is no vaccine for Hepatitis C, however, some recommendations for use may need to be followed:
- use condoms during sex;
- respect the necessary precautions for the handling of blood products (nursing staff...) ;
- avoid needle exchanges (drug addicts) ;
- control the hygiene conditions during the piercing and tattooing process;
- Avoid lending or exchanging sharp or pointed toiletries that may come in contact with blood (toothbrush, nail clippers, razor...).
Hepatitis C virus (HCV) testing is done through a blood test (Hepatitis C antibody test). These antibodies are usually detectable one month after contamination.
They mean that the person has been in contact with HCV. When this test is positive, the virus is tested for the presence of the virus in the body (virus RNA).
Rapid diagnostic (Trod) counselling tests for hepatitis C, modelled on those already available for the AIDS virus, are available from May 2016.
The challenge: increase control of people at risk to limit contamination.
These tests give a result within 15 minutes from a drop of blood or a saliva sample. They can only be performed by health professionals or patient associations.
When chronic hepatitis C is detected, a liver sample is required.
Other tests (ultrasound) may also be necessary. It is essential to detect possible associated sexually transmitted diseases (HIV...).
There is no specific treatment for acute hepatitis C. However, it is useful to consider some recommendations:
- Avoid alcohol and drugs metabolized in the liver, as they can aggravate liver damage;
- stop working if the fatigue is too great
- Consider hospitalizing people with severe hepatitis to be monitored in a specialized unit.
The evolution of acute hepatitis C can be favorable: the subject recovers in a few weeks.
In the case of fulminant hepatitis, treatment is carried out in an intensive care unit. Sometimes a liver transplant is necessary.
Will chronic hepatitis C be eradicated soon?
Treatment of chronic hepatitis C has progressed considerably in recent years.
Initially it was a dual therapy combining the basic medication, interferon (weekly injection) and ribavirin (daily tablets), for patients of genotype 2, 3, 4, 5 or 6.
For carriers of the more resistant genotype 1 virus, a triple therapy was proposed: an anti-protease agent (telaprevir or boceprevir) was added to the other two drugs. However, the side effects, particularly those due to interferon, were significant.