Hepatitis C is an easily overlooked liver killer! It can easily develop into advanced liver cancer. How can we prevent it?

Primary liver cancer is one of the common malignant tumors in my country. According to epidemiological statistics, areas where hepatitis B is prevalent are high-incidence areas of liver cancer. The incidence of liver cancer in hepatitis B patients or carriers is 2-100 times higher than that in people who have not had hepatitis B.

In addition, people with hepatitis C have a higher risk of liver cancer.

Unlike hepatitis B, which is well-known to everyone, hepatitis C is considered a "silent killer" because patients with hepatitis C generally have no particularly obvious symptoms. Even if infected with hepatitis C, general liver function tests rarely find abnormalities, or only find that the aminotransferase (ALT) is slightly higher than the normal value, and there is no hepatitis C vaccine to prevent it.

Once symptoms appear, HCV has often caused a certain degree of damage to the patient's body, and may even have developed into cirrhosis and liver cancer.

1. What is Hepatitis C?

When it comes to hepatitis, many people think of hepatitis A and hepatitis B. However, they are relatively unfamiliar with "hepatitis C virus", which is abbreviated as hepatitis C or hepatitis C. It is a type of viral hepatitis caused by infection with the hepatitis C virus (HCV).

Hepatitis C is prevalent worldwide, and people of different genders, ages and races are susceptible to HCV.

This year, the 2020 national statutory infectious disease reporting and mortality statistics released by the National Health Commission showed that among the 40 statutory infectious diseases in my country, viral hepatitis is still the infectious disease with the largest number of cases. Among them, the number of reported cases of hepatitis C was 194,066, and the number of deaths was 1061.

2. How is Hepatitis C transmitted?

(1) Transmission through blood transfusion, acupuncture, drug abuse, etc.

Blood transmission is the main route of hepatitis C transmission, including the use of needles, medical and cosmetic equipment that are contaminated with hepatitis C virus and have not been strictly sterilized. Potential blood transmission methods include sharing razors and toothbrushes, tattooing, and ear piercing.

(2) Sexual transmission

People who have sexual contact with people with hepatitis C or have multiple sexual partners are at higher risk of HCV transmission.

(3) Mother-to-child transmission.

3. What are the dangers of hepatitis C?

Generally, after being infected with the hepatitis C virus, 75%-80% of people will develop chronic hepatitis and then progress to cirrhosis or liver cancer.

Studies have shown that 20 years after patients are infected with hepatitis C, the incidence of liver cirrhosis is about 20%, followed by an annual incidence of decompensated cirrhosis of 3-4% and an annual incidence of hepatocellular carcinoma of 2-4%, posing a great threat to human health.

Heavy drinking (daily alcohol intake > 60 grams), smoking, and hepatitis B co-infection are also superimposed factors that cause hepatitis C cancer.

Primary liver cancer is insidious and has no specific clinical manifestations. It is often discovered at an advanced stage, missing the best time for treatment and resulting in a poor prognosis. The natural survival period of patients with advanced liver cancer clinically discovered is usually only 3 to 6 months.

Why is Hepatitis C Screening Important?

Unlike hepatitis B, there is currently no effective preventive vaccine for hepatitis C. Therefore, the prevention of hepatitis C mainly involves screening and managing high-risk groups.

The "China Viral Hepatitis Prevention and Control Plan (2017-2020)" proposes that by 2020, the national overall HCV detection rate in blood stations will reach 100%. It also proposes to include hepatitis C testing in the scope of physical examinations, and provide necessary diagnosis and antiviral treatment and other related services to those who are found to be anti-HCV positive.

The World Health Organization has set a goal of eliminating viral hepatitis as a public health threat by 2030, with specific indicators including a 90% reduction in new infection rates and a 65% reduction in mortality rates. my country has a large population base, and how to identify hepatitis C infections among 1.4 billion people requires more precise prevention and control strategies.

Clinically, hepatitis C patients are mostly discovered during medical consultations or physical examinations.

All high-risk groups for hepatitis C infection should be screened. Blood product management should be strengthened, and HBV DNA and HCV RNA should be tested simultaneously when conditions permit.

Cancer screening is the key to early detection, early diagnosis and early treatment of liver cancer. Through screening, precancerous lesions and early liver cancer can be detected, and early intervention can be carried out to reduce the incidence of advanced cancer and reduce mortality. In addition to increasing the active screening rate of high-risk groups, if the hepatitis C screening program can be carried out in medical institutions for outpatient, emergency and inpatient patients, it will effectively identify potential patients.

5. Which groups of people are recommended to be screened as soon as possible?

These groups are recommended to be screened as soon as possible:

1. Those who have had blood transfusion or blood donation experience in the 1990s;

2. Those who have used non-disposable syringes or needles, or received oral treatment, beauty treatment, tattoos, or ear piercing in informal places;

3. Children whose mother is a hepatitis C patient, spouse of a hepatitis C patient, and other family members;

4. HIV-infected people, HIV-positive partners, homosexuals and people with multiple sexual partners, and drug addicts;

5. Those with damaged skin or mucous membranes contaminated by blood, blood stains, cotton balls or other utensils from wounds of hepatitis C patients;

6. Unexplained increase in transaminase.

7. Compared with the general population, patients with chronic kidney disease need to strengthen HCV infection monitoring:

It is recommended that all patients with chronic kidney disease be screened for HCV antibodies; high-risk groups or people in high-prevalence areas can be directly screened for RNA or HCV core antigen.

6. Hepatitis C can be cured and covered by medical insurance. Currently, three drugs for the treatment of hepatitis C have entered the Class B national medical insurance catalogue with a price reduction of more than 85%, greatly lowering the economic threshold for hepatitis C treatment and allowing patients to truly use and afford the drugs.

Although the cure rate of small molecule antiviral drugs for hepatitis C is as high as over 95% and the chance of recurrence is very low, there are still very few patients who will have recurrence. Therefore, for patients who have completed treatment, it is recommended to have a reexamination 3, 6, and 12 months after the end of treatment, and once a year after one year. The reexamination items include hepatitis C virus load (HCV-RNA), liver biochemical indicators, alpha-fetoprotein, and liver ultrasound.

References:

1. http://www.nhc.gov.cn/jkj/s3578/202103/f1a448b7df7d4760976fea6d55834966.shtml