A person usually misses the imperceptible, indistinct first signs of hepatitis C, mistaking them for symptoms of fatigue, a cold. In this imperceptibility – the insidiousness of a tiny “affectionate killer” destroying the body from within. The disease is detected by chance, during a preventive examination or when a person contacts with general complaints.
For the first time, the hepatitis C virus was isolated from the general group of such pathogens in 1989; in recent years, the disease has come out on top in the country in terms of the number of detected cases and the severity of associated complications.
This infectious agent causes changes throughout the human body, which is why hepatitis C is considered a systemic disease.
The development of the virus in the body
The hepatitis C virus (HCV or HCV in international terminology) is a formation in the form of a ball with an uneven surface, distinguishable only under an electron microscope. It is based on a single RNA chain, closed by a protein membrane and a fat layer, penetrates into a human cell with the help of proteins in its structure.
Much in the processes of penetration and reproduction of HCV is still unclear for official medicine, its effect on the body is being studied.
The carrier and distributor of the virus can only be a person, transmitting it to another with blood. This pathway is the leading one – HCV is not persistent in the environment; a large dose of viral units is required for damage.
The main ways of penetration of the pathogen into the body are as follows:
- blood transfusion and organ transplantation. Was the main one a few years ago, when there was not enough broad information about what hepatitis is and how it manifests itself. The risk group included patients who required constant blood transfusion, now all donors are tested for latent HCV carriage,
- sharing syringes by addicts (up to 40% of all detected cases of infection), in this case, an infectious agent (including HIV) is present in blood particles on needles,
- cosmetic and medical manipulations with possible skin lesions (dental treatment, tattoo, piercing, manicure), which are performed with carelessly sterilized instruments with the remaining particles of the blood of the carriers,
- infection of children during childbirth by mothers suffering from acute hepatitis C or who have had an illness during pregnancy,
- occupational infection when caring for patients with open wounds, performing medical procedures or working with blood,
- sexual unprotected contact.
The patient cannot infect other family members through dishes or common items, provided that personal hygiene is carefully observed. At the same time, relatives who use straight razors or open-bladed devices for shaving have all the chances of getting infected.
After HCV enters the body with the blood of an infected person, it immediately enters the bloodstream, through which it enters the liver. Its target will be its cells (hepatocytes). If the virus does not meet the proper resistance of the body (in all groups of potential patients, the immune system is impaired due to serious illness or injury, intoxication, pregnancy), it begins to multiply. The process of complex interaction of the hepatitis C virus and hepatocytes is launched.
The first phase of replication (reproduction of an infectious agent) is that HCV, using proteins in its structure, “sticks” to the cell membrane and penetrates into the nucleus. During the second phase, the genome of the virus is exposed and the work of the affected cell is rebuilt – the HCV reprograms its reproduction mechanism to create elements of new viruses.
The third phase of replication is the assembly of the reproduced virus (virion) and its release into the bloodstream for subsequent reproduction. The affected cell becomes a “factory” for the production of virions, “forgetting” about its immediate responsibilities.
In the extreme form of infection (several HCVs attack a cell simultaneously), hepatocytes die, releasing new viruses into the bloodstream. The virus has been clinically proven to replicate outside liver cells, in body tissues.
A feature of HCV that makes it extremely dangerous is its tendency to transform. It continues to change, already being in the human body with such rapidity that the human immune system does not have time to produce antibodies to the newly identified virus, sharply reducing its effectiveness due to excessive load.
This feature of HCV lives in the body for years without the possibility of being detected. It is believed that a “cocktail” of several mutated strains is simultaneously present in the blood of an infected person, which complicates diagnosis and treatment.
Today, 6 genotypes are known (some scientists indicate the number 11) and 90 subtypes of HCV. The rate of damage to the body, the degree of manifestation of the first symptoms depends on the type of virus.
How to identify hepatitis C
One of the main tasks related to the issue of treatment of patients infected with HCV is how to define hepatitis. Signs of an acute form of the disease appear after infection only in every sixth patient after six months, although in some patients the manifestation of the first signs is noted as early as two weeks after infection.
The patient perceives the main symptoms of hepatitis as manifestations of general malaise, overwork, and in no way connects them with liver diseases. The first signs of hepatitis, as a disease when infected with HCV, are manifested:
- rapid fatigability,
- decreased appetite,
- pain in the abdomen.
Some people have additional symptoms of infection, indicating liver damage.
In patients with a chronic form of the disease (and this is the majority of patients who were not treated, since there were no signs of hepatitis), only the following indicates the course of pathological processes in the body:
- general weakness
- constant fatigue.
Hepatitis, which is detected at a later stage, has time to significantly destroy the immune system.
The virus, multiplying in the body, does not cause pain in the early stages of the disease – this is caused by the absence of nerve endings in the liver. A person begins to feel discomfort under the rib only after most of the tissues of the organ are affected and changes occur – edema occurs, an increase in size and stretching of the sensitive capsule in which he is enclosed.
The liver ceases to fulfill its filter function, intoxication grows in the body. This explains the headache, fatigue, and irritability associated with hepatitis.
The fact of the disease is confirmed by laboratory and instrumental diagnostics, while it is important what phase the virus is in. Only the replicative phase of hepatitis allows detecting a multiplying virus in the blood, treating a person with specialized drugs. Usually, the phase of virus activity is replaced by a non-replicative one, and the cycle is repeated many times.
There are the following forms of HCV lesion:
- with staining of the skin and sclera,
- without manifestation of jaundice.
According to the severity of manifestations and the duration of the course, they are distinguished:
- severe course.
In some cases, a malignant (fulminant) form of pathology is isolated. Determine the acute and chronic (over 180 days) course of the disease.
How to detect hepatitis C at an early stage
The early stage of the development of pathology includes the first 180 days from the moment of infection, although the first symptoms may appear much later.
Deciding how to detect hepatitis C at an early stage would remove many problems in the treatment and prognosis of pathology. Modern methods of diagnosing the disease at the first stage include:
- questioning the patient with the study of anamnesis data in the case of treatment with general clinical symptoms in order to determine the date of infection,
- appointment of blood tests for general, biochemical, PCR,
- conducting immunological studies for the determination of HCV RNA, antibodies to HCV RNA,
- diagnostics using ultrasound, MRI,
- liver biopsy.
The first symptoms of hepatitis C can be confirmed using specific immunological tests in 2/3 of patients even before the onset of general clinical symptoms. Most often, the patient will complain about:
- loss of appetite.
They are typical for various infections. The most effective way to recognize hepatitis in the early stages are laboratory tests.
An immunological study of blood will reveal the presence of antibodies M to HCV (anti-HCV IgM) in the blood, which appear in the first 30 days after infection. A high indicator indicates that hepatitis manifests itself in an acute form and quickly spreads throughout the body, but meets the resistance of the immune system.
Hepatitis C in acute form
The incubation period of HCV lasts from 14 to 180 days, during this period, 15% of patients develop acute hepatitis C. How long the acute form will last depends on the immune state of the body, usually there is a recovery within 90 days.
In the acute form of pathology, HCV does not show specific symptoms. The patient will be disturbed, in addition to weakness and fatigue:
- nausea and vomiting,
- yellowing of the whites of the eyes and skin,
- enlargement of the liver and spleen,
- discoloration of feces (light) and urine (dark),
- elevated body temperature.
A characteristic feature of the acute form is the short duration of jaundice – it can be detected only with careful observation of the infected HCV and is observed in every 4 patients.
Basically, the symptoms of acute hepatitis C indicate liver damage, but in some cases there are severe immune reactions of the body – anemia, neuropathy.
Determination of the disease in the acute stage will be most accurate through a test for the presence of antibodies in the blood. Not only M, but also anti-HCV IgG (antibodies G) are determined. They appear as an immune response after 90 or more days from the moment of infection and make it possible to distinguish the primary infection from the exacerbation in the chronic form.
Acute hepatitis in 85% of cases develops into a chronic form of the disease, which can last for years. The destruction of the immune system provokes extrahepatic symptoms of the disease, which are manifested:
- joint pain
- skin rashes
- lesions of the heart and blood vessels,
- decreased vision
- joint pain
- pathologies of the urinary tract,
- persistent allergies
- frequent acute respiratory infections and acute respiratory viral infections,
- periodic unreasonable increase in temperature,
- general poisoning of the body,
- low working capacity,
- severe paroxysmal headaches,
- persistent gastrointestinal disorders,
- fatigue with minimal physical effort,
- an increase in the size of the liver and pain under the rib.
It is difficult to associate a variety of symptoms with liver damage, often the patient is diagnosed with hepatitis C after the identification of severe liver pathologies.
How not to be confused with other diseases
It is easier to diagnose a pathology when replication of the hepatitis virus is observed and a blood test can determine both the presence of antibodies and the HCV gene trace in the blood. Purpose:
- deep blood test,
- immunological tests,
- hardware examination,
- liver biopsy.
The only way how not to confuse hepatitis with other diseases and treat symptoms instead of disease.
Diagnosis and treatment
Determination of HCV infection and the diagnosis of the disease is established on the basis of blood, urine and feces tests, hardware diagnostics. Treatment is aimed at reducing HCV replication activity, eliminating pathology and supporting the liver. For treatment, interferons and ribavirin are used, which act in combination. Treatment success depends on:
- the type of HCV and its amount,
- characteristics of the patient’s body,
- the state of the immune system.
The prognosis of the disease in the early stages is favorable – hepatitis with recovery is observed with identified acute forms of the disease.
In the treatment of chronic hepatitis, the list of medicines is expanded with medicines that relieve symptoms of the disease.
The doctor chooses the type of treatment depending on the patient’s condition. He is usually treated at home with prescribed remedies, with check-ups once a month. If treatment is too late, severe complications incompatible with the patient’s life (hepatic coma, cirrhosis, carcinoma) are possible.
Simple prevention – adherence to personal and sexual hygiene, work instructions, absence of drug addiction, will help to avoid HCV infection in adults and children.
Hepatitis: symptoms. The first signs of hepatitis.
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