March 18 is the National Liver Love Day, and the theme of this year's publicity is "National Participation, Active Screening, Standardized Diagnosis and Treatment, and Hepatitis Cure".
Recently, Uncle Chen, a 54-year-old Guangzhou citizen, went to the hospital because of abdominal distension and edema of both lower extremities. After a blood test, it was found that Uncle Chen’s liver synthesis function and metabolic function were obviously abnormal. CT showed that the patient had progressed to liver cirrhosis, and had ascites, spleen Major complications, the condition is developing towards "chronic liver failure", which is already very critical.
The doctor conducted a hepatitis virus investigation on Uncle Chen, only to find that he was infected with "hepatitis C virus".
It is understood that with the promotion of hepatitis B vaccination in my country in recent years, the incidence of hepatitis B in China has generally shown a downward trend, but the incidence of liver diseases such as hepatitis C, alcoholic liver disease, and non-alcoholic fatty liver disease has shown an overall upward trend.
Because of its insidious and chronic onset, hepatitis C has the risk of progressing to liver cirrhosis and liver cancer, which needs more attention.
asymptomatic chronic killer
Hepatitis C (hepatitis C), referred to as "hepatitis C", is an infectious disease caused by liver inflammation caused by hepatitis C virus (HCV) infection.
According to the World Health Organization statistics, the global hepatitis C infection rate is about 2.8%, and about 390,000 people die of hepatitis C-related diseases every year, said Pan Xingfei, chief physician of the Department of Infectious Diseases at the Third Affiliated Hospital of Guangzhou Medical University.
It is understood that the chronicity rate of hepatitis C virus infection is 60%-85%, and the risk of progression to liver cirrhosis and liver cancer is high after chronicity, and the entire onset process is relatively insidious.
Most people with hepatitis C infection have no obvious symptoms and manifestations, and often the patients have progressed to liver cirrhosis and liver cancer when they feel unwell, and liver cirrhosis and liver cancer are the main causes of death in chronic hepatitis C patients.
After hepatitis C virus infection, liver lesions progress relatively slowly.
The proportion of liver cirrhosis in the general population 20 years after HCV infection is 5% to 15%, and the proportion of HCV-related hepatocellular carcinoma after 30 years of HCV infection is 1% to 3%. in patients with stage hepatic fibrosis.
In patients with hepatitis C cirrhosis, 2% to 4% of patients will develop liver cancer each year.
Per Xingfei reminded that some factors may accelerate the deterioration of hepatitis C, so vigilance should be aroused.
If there is co-infection, or have underlying diseases such as obesity and diabetes, the deterioration of hepatitis C will be accelerated; men infected with hepatitis C virus, alcoholic patients, or patients over 40 years old when infected with hepatitis C virus are also at risk groups; hepatotoxic drugs Toxic substances and genetics caused by environmental pollution are also important factors for the accelerated deterioration of hepatitis C.
Transmissible diseases for which there is no effective vaccine
According to Per Xingfei, there are three main modes of transmission of hepatitis C.
The first is blood transmission, including transmission through blood transfusion and blood products, and transmission through broken skin and mucous membranes.
It is understood that the use of non-disposable syringes and needles, non-sterile dental instruments, endoscopy, invasive procedures and needle sticks can all cause the spread of hepatitis C virus.
In addition, some daily behaviors that may lead to skin breakage and blood exposure are also associated with HCV transmission, such as sharing razors, sharing toothbrushes, tattoos and piercing earrings, etc. are also potential blood transmission routes of hepatitis C virus.
The second is sexual contact transmission.
Sexual contact with a person with HCV infection and multiple sexual partners are at higher risk of HCV infection; those with other sexually transmitted diseases, especially those infected with human immunodeficiency virus (HIV), are at higher risk of HCV infection .
Finally, mother-to-child transmission is also a route that cannot be ignored in virus transmission.
It is understood that the risk of HCV transmission from anti-HCV positive mothers to newborns is about 2%. If the mother is HCV RNA positive at delivery, the risk of transmission can be as high as 4% to 7%; when co-infected with HIV, transmission risk increased to 20%.
However, most social behaviors of daily life, such as kissing, hugging, sneezing, coughing, food, drinking, sharing utensils and glasses, no skin breaks, and other contacts without blood exposure generally do not transmit HCV.
"It is worth mentioning that, unlike hepatitis B, there is currently no effective preventive hepatitis C vaccine available." Pan Xingfei said that the prevention of hepatitis C mainly takes the following measures:
1. Prevention of transmission through skin and mucous membranes: Use disposable syringes, and strictly sterilize dental instruments, endoscopes and other medical instruments; medical staff should wear gloves when contacting patients' blood and body fluids; psychological counseling and safety education for intravenous drug users , to persuade them to quit drugs; do not share razors and dental appliances, barber appliances, piercings and tattoos and other appliances should be strictly disinfected.
2. Prevention of sexual contact transmission: It is recommended that people infected with hepatitis C use condoms, especially to carry out correct sex education for young people.
3. Prevention of mother-to-child transmission: For pregnant women with positive HCV RNA, amniocentesis should be avoided, the delivery time should be shortened as much as possible, the integrity of the placenta should be ensured, and the chance of neonatal exposure to maternal blood should be reduced.
Hepatitis C patients should receive antiviral treatment as soon as possible
"All HCV RNA-positive patients should receive antiviral treatment as long as they are willing to treat and have no contraindications to treatment." Pan Xingfei said that the goal of antiviral treatment is to remove HCV, obtain clinical cure, and remove or reduce HCV-related liver damage. , reverse liver fibrosis, prevent the progression to liver cirrhosis, decompensated liver cirrhosis, liver failure or liver cancer, improve the long-term survival rate and quality of life of patients, and prevent the spread of hepatitis B virus.
It is recommended that patients should receive standard antiviral therapy once they are diagnosed with chronic hepatitis C and HCV RNA is detected in the blood.