The latest release from the World Health Organization (WHO) on World Hepatitis Day (28.7) states that Hepatitis C virus and Hepatitis B virus are two viruses that can lead to serious illness and cause Chronic hepatitis which will progress to end stage liver disease, cirrhosis, liver dysfunction and ultimately, liver cancer. Particularly, the complications of Hepatitis C virus is extremely hazardous and the risk of death is high.
Hepatitis C is a liver disease caused by the hepatitis C virus, the virus can cause both acute and chronic hepatitis, ranging in severity from a mild illness lasting a few weeks to a serious, lifelong illness. Like Hepatitis B Virus, Hepatitis C Virus is the most formidable of the viruses that causes Hepatitis. With high incidence rates of infection, prevalence of cases are huge and the percentage of complications is very high. Hepatitis C Virus enters the body with incubation period of about 15-50 days, only about 20% of infected people show signs of acute infection. Typical symptoms are jaundice –yellowing of mucosa, skin and sclera of eye. Elevated liver enzymes (detected only in 25% of patients), which signifies active liver disease. Acute Hepatitis C virus infection gets healed on its own in 10-25% of cases, and about 75% of patients become chronically infected with HCV.
Of these, about 10-20% of patients of chronic Hepatitis C develop liver Cirrhosis, and 5% develop liver cancer. Overall, chronic hepatitis C will result in three deadly complications, i.e. Cirrhosis, liver cancer and liver failure. The infection is also often undiagnosed because the infection remains asymptomatic until decades after infection when symptoms develop secondary to serious liver damage.
Needs treatment immediately!
Hepatitis C is a blood-borne infection and spreads in similar fashion as of HIV. Accordingly, there are four basic modes of transmission: unsafe sexual activities, unsafe practices of injectable drug use, unsafe blood transfusion and mother to child transmission. Since the disease has no obvious symptoms, so most of the patients do not realize that they have been infected and may unknowingly spread the disease to the community.
Although highly contagious and dangerous, Hepatitis C can be cured if detected early, and if proper treatment is provided. The treatment that is currently popular is directly acting antiviral drugs (DAAs) i.e. Sofosbuvir/Daclatasvir, Sofosbuvir/ledipasvir, Sofosbuvir/velpatasvir, Elbasvir/ Grazoprevir
WHO recommends screening for people who may be at increased risk of infection.
Populations at increased risk of HCV infection include:
- people who inject drugs;
- recipients of infected blood products or invasive procedures in health-care facilities with inadequate infection control practices ;
- children born to mothers infected with HCV ;
- people with sexual partners who are HCV-infected;
- people with HIV infection;
- prisoners or previously incarcerated persons; and
- people who have had tattoos or piercings.
The standard of care for hepatitis C is changing rapidly. Sofosbuvir, daclatasvir and the sofosbuvir/ledipasvir, sofosbuvir/velpatasvir combination are part of the preferred regimens in the WHO guidelines, and can achieve cure rates above 95%. These medicines are much more effective, safer and better-tolerated than the older therapies. Therapy with DAAs can cure most persons with HCV infection and treatment is shorter (usually 12 weeks). Meanwhile, there remains a limited role for pegylated interferon and ribavirin in certain scenarios where currently data are limited in supporting DAA-only therapies.
The cheapest, most effective way to combat this disease is prevention. There is no vaccine for hepatitis C, therefore prevention of HCV infection depends upon reducing the risk of exposure to the virus in health-care settings and in higher risk populations: Say no to injectable drug abuse; Say no to indiscriminate sex and say no to unsafe blood transfusions.