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Hepatitis C is an inflammation of the liver caused by HCV. Almost all hepatitis A cases and most of the hepatitis B cases recover completely after an acute infection, and by causing the formation of protective substances called antibodies in the body, it is prevented from getting sick again with the same virus.
Since hepatitis C frequently changes its structural features after entering the body, it is more difficult to be recognized and eliminated by the body’s immune system.
Antibodies formed in the blood against the hepatitis C virus are not curative or protective, unlike hepatitis A and B. Therefore, the vast majority (85%) of people infected with HCV develop chronic hepatitis C. Since the liver damage caused by hepatitis C progresses slowly, it may take 20-30 years for liver cirrhosis to develop. For this reason, most of the patients infected with HCV continue their lives without any symptoms for many years, even though they carry the virus in their blood.
There are roughly 6 different types (genotypes) of the hepatitis C virus. Genotypes 1 (a and b), 2 and 3 are the most common types. Since the course of the disease and the response to treatment differ according to the virus type, genotype determination should be made before diagnosis and treatment.
Genotype 2 and genotype 3 virus types respond better to treatment than genotype 1 virus type. While response rates to current treatments are around 40% in genotype 1, this rate rises to 90% in other genotypes.
Today, it is known that 150 million people in the world are infected with HCV. In Western countries, the prevalence of HCV in the population is around 1.6%. As of 2007, the money spent on HCV treatment is expected to reach 4 billion dollars. HCV, blood of people infected with this virus and blood products made from them and infected needle etc. transmitted by contact with medical devices. Since blood and blood products were not investigated for the presence of HCV before the 1980s, patients who received blood transfusions had a higher risk of HCV transmission. spread has largely disappeared.
However, those who have a disease that requires regular blood or blood product (such as hemophilia), hemodialysis patients, intravenous drug users (shared needle use), those who have the habit of having sex with unprotected and different partners, and healthcare workers, as expected, are susceptible to HCV virus transmission. have an increased risk compared to the normal population. It is known that hepatitis C is more common especially in South Asian societies.
Despite the different modes of transmission mentioned above, it is not possible to understand how the patient got the virus in about 40% of hepatitis C patients. This observation suggests that the virus could possibly be transmitted in other ways during community life.
In the majority of patients with hepatitis C, there are no symptoms of the disease after exposure to the virus and in the early stages of the disease. In some patients, after a period that may vary between 15 days and 6 months after the virus enters the body, a picture similar to a cold and lasting for 1-2 weeks, joint pain, weakness, loss of appetite, and nausea can be seen. In the meantime, it should not be forgotten that chronic hepatitis C infection can cause skin, kidneys, salivary glands, eye problems and some rheumatic problems in the body, apart from liver damage.
Essential mixed cryoglobulinemia [an immune complex disease that can cause various symptoms such as RF (roma factor) formation in the serum, skin rashes, vasculitis, peripheral neuropathy and glomerulonephritis], focal lymphocytic sialadenitis, autoimmune thyroiditis, prophyria cutanea tarda, lichen planus ulcer and cornea ulcer ) are extrahepatic complications that can be seen in the course of chronic hepatitis C virus infection.
Routine blood tests reveal elevations of liver enzymes called ALT and AST (see liver function tests). With subsequent tests, it is understood whether there is HCV in the blood. Tests for this purpose are to detect antibodies against HCV in the blood (Anti-HCV antibodies) and to measure the amount of HCV RNA. Genotype determination should be made in HCV positive cases. Since anti-HCV antibodies will only become positive 3-6 months after the virus enters the body, this test may not yield results in the early stages of the disease.
HCV-RNA measurement, on the other hand, is a more sensitive test that allows to understand the amount of the virus in the blood, and it can become positive in a period of sometimes as short as 15 days after the virus is taken, and it helps in early diagnosis. The response to treatment is evaluated by measuring the amount of HCV-RNA before and after treatment.
One of the most important reasons why Hepatitis C is taken seriously is the development of chronic hepatitis C in the majority of those infected (>80%), the onset of the event is silent in the majority of patients, and therefore the disease cannot be diagnosed at an early stage. . Infection of the virus at an adult age, chronic alcohol use, overweight and HIV positivity increase the risk of becoming chronic. Fatigue and fatigue are the most common symptoms in the late phase of the disease, and other additional findings occur when liver cirrhosis develops (see Liver cirrhosis).
There may not always be a correct correlation between the degree of elevation in liver enzyme levels (ALT, AST) and the severity of liver inflammation, i.e. a patient with normal or slightly elevated liver enzyme levels may have severe inflammation in the liver. inflammation may be mild). Therefore, liver needle biopsy is usually needed to understand the severity of liver damage in HCV-infected patients.
In liver needle biopsy, a tissue sample is taken from the liver with a fine needle under local anesthesia. By histopathological examination of the tissue sample taken, the degree of inflammation in the liver and whether cirrhosis has developed or not is understood. Up to 20% of patients with chronic hepatitis C develop liver cirrhosis over time (within an average of 25-30 years), and liver cancer occurs in a small portion of them (3-5% per year). Alcohol use and the development of liver cirrhosis increase the risk of developing liver cancer in chronic hepatitis C.
The progression to cirrhosis in HCV infection is slower than hepatitis B virus, and this period can vary between 10 and 30 years.
What is the biggest advancement in medicine today? If you say, the biggest improvement in treatment has been in hepatitis c treatment.
About 25-30 years have passed since the discovery of Hepatitis c, during which time the genetic structure of hepatitis c was deciphered and drug treatments for the genetic code were found.
Today, we can successfully perform hepatitis c treatment with the drug treatments we provide. With 3 months of treatment, patients can get rid of this disease.
