Patient: Description of condition (onset, main symptoms, hospital visited, etc.): The patient was 20 years old and was found to be positive for hepatitis C antibodies during physical examination, with hepatitis C virus RNA 1.15×10E6 IU/L; liver function: total bilirubin 15.6μmol/L, direct bilirubin 3.30μmol/L, ghrelin 22U/L, glutamic aminotransferase 29U/L, albumin 41.2g/L, without any symptoms. Special consultation: ① What is the most effective treatment method? How long does it take to treat? Is there any significant reaction during treatment? Do I need to be hospitalized? What is the total medical cost of treatment? Thank you! Jianhua Yi, Department of Infectious Diseases, Wuhan Union Medical College Hospital
Wuhan Union Medical College Hospital, Department of Infection Yi Jianhua.
1. First, three points should be clear: first, chronic hepatitis C is a curable disease; second, as long as HCV RNA is positive, timely antiviral treatment should be given; third, the efficacy of chronic hepatitis C is predictable.
2. The standard treatment for chronic hepatitis C should be pegylated interferon combined with ribavirin antiviral therapy, and the course of treatment should be one year after HCV RNA has turned negative. There are three time points in the treatment process that can predict the efficacy and course of treatment: first, if the HCV RNA is negative at 1 month of treatment (rapid virological response), then the course of treatment is one year; second, if the HCV RNA is negative at 3 months of treatment (complete early response), then the course of treatment should be one year after conversion; third, if the HCV RNA is negative at 6 months of treatment for slow responders, then the course of treatment should undoubtedly be one and a half years. Of course, the course of treatment may be different for different HCV genotypes.
All drugs have adverse effects, but as long as there are no contraindications and the treatment is monitored by a doctor, it should be possible to complete the treatment safely. Of course, the patient must be seen in person before treatment to allow the doctor to fully assess the condition and any contraindications to treatment, and to fully communicate with the doctor and patient about the issues to be noted during treatment and the monitoring of adverse reactions.
4. No hospitalization is required, and the total cost of standard treatment is approximately $50,000-$80,000.
Yi Jianhua