Hepatitis C is caused by infection with the hepatitis C virus (HCV), which has no symptoms in the early stages but poses a serious threat to human health and is known as the “invisible killer”. Currently, most people, including many physicians, are seriously unaware of hepatitis C. A survey by the Liver Foundation showed that the public awareness rate of hepatitis C is only 38%, much lower than that of hepatitis A (91%) and hepatitis B (95%). Hepatitis C is a common viral hepatitis that is widely prevalent worldwide and is the leading cause of cirrhosis and liver cancer in Europe, the United States, Japan and other countries, as well as the leading cause of post-transfusion hepatitis in China.
The lack of awareness of hepatitis C has resulted in several misconceptions about it.
1. Few patients with hepatitis C
Because hepatitis C screening is not part of the routine physical examination, it is easy to miss the diagnosis. In addition, one third of hepatitis C patients do not have high transaminases, but this does not mean that there are few hepatitis C patients, just that they are not found. There are about 40 million people infected with the hepatitis C virus in China.
2, hepatitis C is not as harmful as hepatitis B
Wrongly thought that hepatitis C is not as harmful as hepatitis B, do not need to take more precautions. In fact, it is not. Compared to hepatitis B, hepatitis C is more insidious and more likely to be chronic. The proportion of hepatitis C developing into cirrhosis and liver cancer is also above that of hepatitis B.
3. Hepatitis C is only transmitted through blood transfusions
This is a misconception about transmission, but some people with hepatitis C do not have a history of blood transfusions. In addition to blood transfusions or the use of blood products, hepatitis C is also transmitted through broken skin, mucus, sexual intercourse and mother-to-child transmission.
It is important to note that kissing, hugging, sneezing, coughing, food, drinking, sharing utensils and water glasses, no skin breaks and other non-blood-exposed contacts generally do not transmit HCV.
The dangers of hepatitis C are often overlooked because of the lack of awareness that exists. Moreover, in the current routine medical examination, there is no hepatitis C test, and people tend to think that everything is fine if the liver function test is normal. In fact, the damage of HCV to the liver is particularly insidious, and many HCV-infected patients often show normal liver function tests, so they are easily missed. However, once a person is infected with HCV, the chances of developing chronic hepatitis and cirrhosis are higher than with hepatitis B. About 50-85% of adults infected with HCV will develop chronic hepatitis and cirrhosis, and even more so, liver cancer.
Early symptoms of hepatitis C are mild and the course of the disease is slow. Patients infected with hepatitis C virus (HCV) often have no symptoms, and chronic hepatitis C patients can even go 20 years without any noticeable symptoms. A few patients may feel weakness, nausea and discomfort in the right quadrant of the rib cage. Some patients may have a liver disease face, liver palms, spider nevi and mild hepatomegaly and splenomegaly. In short, most patients with hepatitis C have very mild symptoms that can easily be misdiagnosed as other diseases. After being infected with the hepatitis C virus, they often do not feel it themselves, and once symptoms appear, they are likely to have missed the best treatment.
The relevant items for hepatitis C screening are.
1. Anti-HCV:
Most people infected with hepatitis C virus (HCV) have anti-HCV in their bodies, so testing for anti-HCV is valuable in the diagnosis of hepatitis C. Doctors often use anti-HCV testing as a “primary screening” test to diagnose HCV infection. However, a positive hepatitis C antibody does not necessarily indicate the presence of HCV in the body, but may be a residual antibody from the clearance of the virus. Therefore, a positive anti-HCV test should be followed up with further testing for HCV RNA.
2. HCV-RNA (hepatitis C virus replication).
A positive HCV-RNA is direct evidence of hepatitis C virus (HCV) transmission and is an indicator of HCV replication. Because HCV-RNA appears earlier than anti-HCV, it can be used for early diagnosis and screening of blood donors. If anti-HCV is persistently positive and HCV-RNA is positive, it indicates the presence of HCV in the body; if anti-HCV remains positive but HCV-RNA is negative, HCV has been cleared or passively acquired hepatitis C antibodies. In addition, HCV RNA should be tested before and during hepatitis C treatment, and the decision of whether to treat and judge the efficacy of treatment should be based on the HCV RNA level.
3. Liver function, blood routine, fetoprotein and ultrasound of liver, gallbladder and spleen, etc.
If hepatitis C infection is found, how to treat the treatment?
Clinically, I often hear hepatitis C patients communicating with each other, “I’ve had this disease for more than 10 years, and my liver function is quite good, so antiviral treatment is not necessary.” But antiviral treatment for hepatitis C is not something to wait for.
Although there is still no vaccine available for hepatitis C, it is possible for patients with hepatitis C to be cured with timely, proper and reasonable treatment. Although hepatitis C is easily missed, it is relatively easy to treat, and more than 70% of patients detected early can be effectively cleared of the virus.
Antiviral therapy is currently the only way to treat hepatitis C. Only antiviral treatment can stop the progressive process of hepatitis C. Many people feel that because they currently have no serious symptoms, they relax their vigilance about the dangers of hepatitis C. Once hepatitis C progresses to advanced cirrhosis, liver cancer and liver failure, the opportunity for antiviral treatment is lost. Therefore, the latest “Hepatitis C Prevention and Control Guidelines” point out that as long as the serum HCVRNA positive hepatitis C, even patients with normal liver function need antiviral treatment.