Cookies? No, it's Hepatitis C!

Author: Niu Xiaoxia, deputy chief nurse of the Fifth Medical Center of the General Hospital of the Chinese People's Liberation Army

Reviewer: Ji Dong, Chief Physician, Fifth Medical Center, PLA General Hospital

When it comes to hepatitis, people often think of hepatitis B, or hepatitis B virus. Little do people know that a disease with the same name as the delicacy "cookies" - hepatitis C - is quietly eroding everyone's body. Hepatitis C is the abbreviation of hepatitis C virus, a viral liver disease caused by hepatitis C virus (HCV) infection and characterized by progressive liver inflammation.

At present, hepatitis C is spreading globally, and people of different genders, ages, and races are all susceptible to HCV. However, due to the hidden nature of HCV infection, most infected people do not know that they have been infected with HCV. Therefore, the exact incidence of chronic hepatitis C in the world is still unclear. The 2006 national serological epidemiological survey showed that the anti-HCV positive rate of people aged 1 to 59 in my country was 0.43%, which is a low-prevalence area of ​​HCV in the world. It is estimated that there are about 5.6 million HCV infected people in the general population in my country, and if high-risk groups and high-incidence areas are included, there are about 10 million HCV infected people.

1. What are the transmission routes of hepatitis C?

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1. Blood transfusion and blood products: HCV transmission through blood transfusion was once the main cause of post-transfusion hepatitis. my country began screening blood donors for anti-HCV in 1993, and began screening anti-HCV negative blood donors for HCV RNA (HCV ribonucleic acid) in 2015. The transmission of hepatitis C through blood transfusion and blood products has rarely occurred.

2. Transmission through broken skin and mucous membranes: This is currently the main way of transmission of hepatitis C, including the use of non-disposable syringes and needles, oral instruments that have not been strictly sterilized, endoscopes, invasive operations and acupuncture, etc.; in some areas, intravenous drug injection causes 60% to 90% of HCV transmission; sharing razors, toothbrushes, tattoos and ear piercing are also potential ways for HCV to spread.

3. Close contact in life: Some HCV-infected people do not have a clear history of blood transfusion and blood product injection, which is speculated to be related to close contact in family life.

4. Transmission through sexual contact: People who have sexual contact with HCV-infected people and have multiple sexual partners are at a higher risk of contracting HCV. People who also have other sexually transmitted diseases, especially those infected with human immunodeficiency virus (HIV), are at an even higher risk of contracting HCV.

5. Vertical transmission: Perinatal HCV transmission is the main route of vertical transmission.

2. How to determine whether you are infected with hepatitis C? What is the significance of HCV RNA quantification and liver function tests?

Anti-HCV testing can be used to screen HCV-infected people. HCV RNA quantification can reflect the activity of viral replication and can serve as a basis for antiviral treatment. Liver function tests mainly reflect liver function, such as liver cell damage, liver secretion and excretion function, liver synthesis reserve function, liver fibrosis and cirrhosis, etc.

3. What are the treatments for hepatitis C?

The current treatments for hepatitis C include long-acting interferon combined with ribavirin and direct-acting antiviral drugs (DAA). DAA treatment has a high efficacy rate, and depending on the different genotypes, the highest efficacy rate is close to 100%, but it still needs to be treated as early as possible to prevent the disease from progressing to cirrhosis.

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4. What will happen if HCV RNA is positive and not treated?

If HCV RNA positive patients are not treated, liver damage cannot be effectively controlled and continues to develop into liver fibrosis, cirrhosis, and even liver cancer. In addition, it can also cause functional damage to other organs, such as the immune system and kidneys. HCV RNA positive patients are the source of infection. If not treated in time, they may infect their relatives and friends around them.

5. Why can anti-HCV still be detected even though the body has cleared HCV RNA?

After treatment, HCV RNA is negative and a sustained viral response has been achieved. Anti-HCV positivity only means that the patient has been infected with hepatitis C in the past.