Hepatitis C prevention and treatment starts with you and me

  Viral hepatitis is a common infectious disease caused by hepatitis virus, which is highly contagious, widely prevalent and has a high incidence, among which hepatitis B and C are the main causes of liver cirrhosis and liver cancer. At present, the damage to liver function caused by hepatitis B has attracted great attention, while hepatitis C is often neglected because of its insidious onset and lack of obvious symptoms. When many patients with hepatitis C are discovered due to symptoms, the best time for treatment is often missed, and the damage of hepatitis C is more serious than that of hepatitis B.  In October 2008, the Ministry of Health released information on the national epidemic of legally reported infectious diseases, and hepatitis C is now “among” the fifth leading cause of death from infectious diseases A and B in China. According to the WHO, there are 170 million people infected with HCV worldwide, with 3 to 4 million new HCV infections each year. Globally, there are 10 million HCV infections in North and South America, 9 million in Europe, 40 million in China, 32 million in Southeast Asia, and 32 million in Africa. From these data, China has the largest number of HCV-infected people.  Every year, there are about 2 million new cases of hepatitis C in China, of which about 1.2 million are able to go to the hospital, about 1 million are clearly diagnosed, and only about 700,000 patients receive treatment, accounting for only 37% of the number of new cases in the same year. This means that most patients with hepatitis C do not receive proper and timely treatment, which is the result of a chronic lack of awareness.  Since hepatitis C has an insidious onset and the initial symptoms are not obvious, when people are infected with hepatitis C virus (HCV), most of them have no obvious clinical symptoms for a long time or only have non-specific symptoms such as malaise, but the destruction of liver cells by the virus continues all the time, and if left untreated, it will eventually turn into cirrhosis and liver cancer. In contrast, antiviral treatment for hepatitis C is far more effective than that for hepatitis B, and most patients can be cured by antiviral treatment. Therefore, understanding the natural history of hepatitis C and grasping the timing of treatment can enable more patients to recover and avoid the development of cirrhosis and liver cancer, thus greatly reducing the social medical burden.  The lack of awareness and health education about viral hepatitis has led to misconceptions about viral hepatitis. At the same time, hepatitis patients are often discriminated against from all aspects of society, even affecting employment, marriage and family life as a result. These conditions and the fear of the disease prevent people from being screened, treated, and ultimately cured.  In recent years, with the emphasis on nosocomial infections and occupational protection, many hospitals have placed emphasis on testing for HCV infection before blood transfusion, before surgery and before certain invasive tests to prevent nosocomial infections and medical disputes. However, not all medical staff are aware of the importance of prevention and treatment of HCV infection, and the level of awareness and attention to the treatment of hepatitis C is much lower among non-infectious medical staff than in specialized departments.  Understanding the transmission routes of hepatitis C and cutting off these routes is something that every health care worker must know and do. Routes of blood-borne transmission of HCV include needlesticks, needle sharing, hemodialysis, transplants, transfusions of blood and blood products, acupuncture, tattoos, and punctures. Both sexual and perinatal transmission are rare, but HCV medical transmission is more common in developing countries (including China).  The prevention and control of hepatitis C should start with all medical personnel, strengthen the awareness of hepatitis C prevention and control, and further increase the efforts of health promotion and education in the whole society to make people understand hepatitis C correctly. Firstly, we should pay attention to the prevention of hepatitis C and avoid the transmission of HCV; secondly, we should pay attention to the screening of hepatitis C to achieve early detection and early treatment so that we can seize the best time for complete cure and avoid the development of the disease to the point of incurability; we should realize that like hepatitis B, antiviral treatment is also the principle of treatment for hepatitis C and other therapies and simple liver-protective treatment are inappropriate. Unlike hepatitis B patients with normal transaminases who may not need treatment for the time being, hepatitis C patients with low transaminase levels and normal transaminases also need treatment, and the previous view that hepatitis C patients with normal transaminases do not need treatment should be changed.  All medical professionals should pay attention to the prevention and treatment of not only hepatitis B, but also hepatitis C. Especially non-infectious doctors, pay attention to every anti-HCV positive person around you, don’t let hepatitis C patients “slip” from your side, prevention and treatment of hepatitis C, starting from you and me.