Beware of this disease, the "silent killer" - Hepatitis C

Beware of this "silent killer" disease - Hepatitis C

Hepatitis C (hereinafter referred to as HCV) is an infectious disease caused by infection with the hepatitis C virus (HCV), mainly causing liver damage. It is a global epidemic, and people of different genders, ages, and races are susceptible to HCV. According to estimates by the World Health Organization, in 2015, 71 million people worldwide were chronically infected with HCV, and 399,000 people died from cirrhosis or primary hepatocellular carcinoma caused by HCV infection. Hepatitis C is also a major disease facing my country, and is defined as a Class B infectious disease under Chinese law. So what are the characteristics of hepatitis C as an infectious disease, and how should we prevent and treat it?

1. What is the source of hepatitis C infection?

People who test positive for hepatitis C virus nucleic acid are the main source of infection of hepatitis C. They can be acute hepatitis C patients or chronic hepatitis C patients.

2. What are the transmission routes of hepatitis C?

Hepatitis C is mainly transmitted through blood, mother-to-child and sexual transmission. It is worth noting that hugging, coughing, drinking, sharing tableware, contact without skin damage and other blood exposure in daily life generally do not spread hepatitis C.

3. Who is susceptible to hepatitis C infection?

Humans are generally susceptible, but injecting drug users, hemodialysis patients, recipients of multiple blood or blood product transfusions, and homosexual or heterosexual people are at high risk of hepatitis C infection.

4. What are the symptoms of hepatitis C?

The symptoms in the acute phase are mild, and most patients have no obvious symptoms and signs, showing latent infection. If there are symptoms, they are mainly general fatigue, and there may also be loss of appetite, nausea, abdominal distension, discomfort or pain in the lower edge of the right rib, etc. A few are accompanied by low fever or jaundice, and some patients have enlarged liver and spleen. About 55% to 85% of infected people develop chronic hepatitis, leading to chronic inflammation, necrosis and fibrosis of the liver. Because its symptoms are hidden, it is called the "silent killer". If the patient does not receive timely treatment, it can develop into cirrhosis and liver cancer, endangering the patient's life. Therefore, timely and proactive screening for hepatitis C is crucial.

5. Which groups of people should be screened for hepatitis C in a timely manner?

(1) People at high risk of hepatitis C infection include: those with a history of intravenous drug addiction; those with a history of needlestick injuries due to occupational or other reasons (tattooing, piercing, acupuncture, etc.); those with a history of medical exposure, including surgery, dialysis, unclean oral diagnosis and treatment, organ or tissue transplantation; those with a history of high-risk sexual behavior, such as multiple sexual partners and gay men; sexual partners and family members of HCV-infected people; HIV-infected people and their sexual partners; children born to HCV-infected mothers; those whose damaged skin and mucous membranes are contaminated by the blood of HCV-infected people; and those with a history of blood transfusion or use of blood products.

(2) People who are preparing to undergo special or invasive medical procedures, including: those who receive blood transfusions or use blood products; those who undergo various invasive catheters and other invasive interventional diagnosis and treatment; those who undergo endoscopic examinations such as gastroscopy, colonoscopy, tracheoscopy, cystoscopy, etc.; and those who undergo hemodialysis.

(3) Patients with unexplained abnormalities in liver biochemical tests, such as elevated transaminase and bilirubin.

6. How to prevent hepatitis C?

There is currently no effective vaccine for hepatitis C. The current preventive measures mainly include the following:

(1) Strengthen screening and management: Screen and manage high-risk groups for hepatitis C in accordance with the health industry standard of the People's Republic of China, "Screening and Management of Hepatitis C". Medical and health institutions and physical examination institutions may include hepatitis C testing in the scope of health examinations, provided that the examinees have given their informed consent. Provide psychological counseling and safety education to intravenous drug addicts and persuade them to quit drugs. Screen women of childbearing age who are preparing for pregnancy for hepatitis C.

(2) Strictly screen blood donors: Strictly implement the Blood Donation Law of the People's Republic of China, promote free blood donation, and strictly screen blood donors.

(3) Preventing iatrogenic and damaged skin and mucous membrane transmission: Promoting safe injection and standard

Accurately prevent and strictly implement the "Nosocomial Infection Control Standards" and "Disinfection Technical Standards", strengthen the management of nosocomial infection control in medical and health institutions at all levels and types, and vigorously strengthen the key departments of hemodialysis, oral diagnosis and treatment, invasive and invasive diagnosis and treatment, etc.

Management of hospital-acquired infection control. Strengthen the sanitary disinfection management of tattoo (eyebrow) needles, pedicure tools and supplies used in tattoo, eyebrow tattoo, pedicure and other industries, and do not share razors and toothbrushes.

(4) Prevention of sexual transmission: Men who have sex with men and those with multiple sexual partners should be examined regularly and managed more strictly. It is recommended that HCV infected people use condoms. Proper sex education should be provided to adolescents.

(5) Prevention of mother-to-child transmission: Pregnant women who test positive for hepatitis C nucleic acid should avoid delayed rupture of membranes, try to shorten delivery time, ensure the integrity of the placenta, avoid amniocentesis, and reduce the chance of newborns being exposed to maternal blood.

(6) Actively treat and manage infected people. Current oral antiviral drugs can achieve a 95% viral clearance rate, and direct antiviral drugs for hepatitis C have been included in the national medical insurance catalog.

In order to continuously reduce the prevalence of hepatitis C, protect the health of the people, and help the World Health Organization achieve its goal of eliminating the public hazard of viral hepatitis by 2030, my country has formulated the "Action Plan for Eliminating the Public Hazard of Hepatitis C 2021-2023", calling on all sectors of society to take action and work together to prevent and control hepatitis C. (Author: Guan Lindong, Wang Guihua, Yangxin County Center for Disease Control and Prevention, Shandong Province)