Viral hepatitis C
Viral hepatitis C is caused by hepatitis C virus (HCV), which is transmitted through blood or blood products transfusion, hemodialysis, single-collection plasma also transfusion of blood cells, kidney transplantation, intravenous drug use, sexual transmission, and mother-to-child transmission.
Contents
Clinical manifestations
Treatment measures Luo Mingzhou, Department of Infectious Diseases, Gucheng County People’s Hospital
A small number of people with good living habits can be cured by themselves
Symptoms
Transmission routes
Reasons for high mortality rate of hepatitis C
Etiology and pathology
Pathogenesis
Pathological changes
Pathologic features
Tests
Diagnosis
Prognosis
Treatment
Treatment
Diet precautions
General knowledge of medication
Chinese Medicine Treatment
Prevention
Health Care
Safety Tips
Other
Misconceptions about asymptomatic hepatitis C patients
Pathogenesis
Epidemiology
Extrahepatic manifestations of chronic hepatitis C
Differences between Hepatitis C and Hepatitis B
Introduction
Diagram of the virus
Hepatitis C is more widely distributed and more likely to evolve into chronicity, cirrhosis and liver cancer. Screening of blood donors is an important part of the preventive measures against hepatitis C. Any blood positive for anti-HCV or positive for HCV RNA cannot be used as a blood donor.
Clinical manifestations
Clinical manifestations
Acute hepatitis C has mild gastrointestinal symptoms, a low proportion of jaundiced type occurs, and ALT and serum bilirubin levels are significantly lower than those of acute hepatitis B.
Examination: Hepatitis C virus indicators include anti-HCV and HCV RNA.
Treatment measures
Although some patients with acute hepatitis C can recover spontaneously, all patients with acute hepatitis C should be treated aggressively because of the efficacy of the acute phase. Its treatment can be appropriate rest, enzyme lowering, hepatoprotection, antiviral and other symptomatic treatment according to the patient’s specific situation, of which the most important treatment is the antiviral treatment.
For the treatment of chronic hepatitis C, only interferon is recognized as effective both at home and abroad, and it should also be treated early. The clinical tendency is to use a combination of drugs. For example, interferon plus thymidine or interferon plus virazole tablets.
A small number of people with good lifestyle habits can be cured on their own
Symptoms
(i) Incubation period: Hepatitis C 2 weeks – 6 months, average 40 days.
(B) Clinical course
1. Acute hepatitis can be caused by all types of viruses. More than 50% of hepatitis C turns chronic. (1) Acute jaundiced hepatitis: the clinical course of the stages is more obvious, can be divided into three stages, the total duration of 2-4 months. Pre-jaundice: Hepatitis C has a relatively slow onset, with only a few having fever. A small number of patients have headache, fever, aching limbs and other symptoms, similar to the flu. The main symptoms of this period include general malaise, loss of appetite, nausea, vomiting, aversion to oil, abdominal distension, pain in the liver area, and deepening of urine color, etc. Liver function changes are mainly ALT elevation. This period lasts for 1-21 days, with an average of 5-7 days. Jaundice phase: Self-perceived symptoms improve, fever subsides, urine yellow deepens, jaundice appears on the sclera and skin, and jaundice reaches its peak within 1-3 weeks. Some patients may show obstructive jaundice such as transient lightening of fecal color, itching of the skin, and bradycardia. The liver is large, soft and sharply margined, with pressure and percussion pain. Some cases had mild splenomegaly. Liver function tests are elevated for ALT and bilirubin and positive for urinary bilirubin. This period lasts for 2-6 weeks. Recovery period: symptoms gradually disappear, jaundice subsides, liver and spleen retract, and liver function gradually returns to normal. This period lasts from 2 weeks to 4 months, with an average of 1 month. (2) Acute non-jaundiced hepatitis: Except for the absence of jaundice, other clinical manifestations are similar to those of the jaundiced type. In contrast, the jaundice type has a slower onset and milder symptoms, mainly general malaise, decreased appetite, nausea, abdominal distension, pain in the liver area, liver enlargement with light pressure pain and percussion pain. Recovery is rapid and the duration of the disease is mostly within 3 months. Some cases have no obvious symptoms and are easily overlooked. In fact, the incidence of the non-jaundiced type is much higher than that of the jaundiced type. The clinical manifestations of acute hepatitis C are generally mild, mostly without obvious symptoms or with very mild symptoms, and the jaundice-free type accounts for more than 2/3 of cases. Most cases do not have fever, and serum ALT is mildly to moderately elevated even in acute jaundice cases, serum total bilirubin generally does not exceed 52umol/L.
2, chronic hepatitis Acute hepatitis for more than six months, or the original hepatitis B, C, D or HBsAg carrier history of the same pathogen reappeared hepatitis symptoms, signs and liver function abnormalities. The onset of hepatitis is not clear or there is no history of hepatitis, but it is consistent with the manifestation of chronic hepatitis based on liver histopathology or comprehensive analysis based on symptoms, signs, laboratory tests and ultrasound examination. Chronic hepatitis is only seen in hepatitis B, C and D 3. Mild: The disease is mild and may be recurrent with weakness, dizziness, some loss of appetite, aversion to oil, yellow urine, discomfort in the liver area, poor sleep, light tenderness with less liver, and may have mild splenomegaly. Some cases have symptoms and body as. Only 1 or 2 liver function indicators are mildly abnormal. Moderate: Symptoms, signs, and laboratory tests reside between mild and severe. Severe: Significant or persistent hepatitis symptoms, such as weakness, poor appetite, abdominal distension, yellow urine, loose stools, etc., with liver disease face, liver palm, obsession, splenomegaly, repeated or persistent elevation of ALT and/or aspartate aminase (AST), reduced albumin or abnormal A/G ratio, significantly elevated gammaglobulin. Anti-A ≤ 32g/L, Bil > 5 times upper limit of normal, PAT 60%-40%, CHE 35μmol/L, PAT 35g/L, A/G > 1.0, Bi > 35μmol/L, PAT