At HC international hospital and in order to obtain higher success rates curing infections by Hepatits C, we have available new drugs marketed in Spain.
Hepatitis is the inflammation of the liver which in this case is caused by a virus called hepatitis C virus. Several types of the virus, known as “genotypes” are numbered in order to distinguish these: genotype 1,2,3…etc.
Getting infected is mainly produced by contact with blood of an infected person. Blood transfusions were until 1990 the main route of infection, date where after discovering the existence of this virus, allowed to reject the donors that were detected positive. Other forms of infection are through sharing infected needles or utensils that have been in contact with blood, such as razors, getting a tattoo, piercings or acupuncture with poorly sterilized materials, can be another source of infection. Sex with multiple partners and without protection can also encourage its transmission, being more rare infection through sexual intercourse in stable couples and only risk is significant after many years. Mothers may also infect their children during birth, but this risk has been seen especially when they are also infected by HIV.
A third of these cases is not possible to identify the source of the infection. It is very likely that in many cases it is due to an injection with re used needles.
Once the virus enters in contact with the blood, it produces acute hepatitis, but in a very high percentage, in 70-80% of the cases, the acute hepatitis becomes chronic instead of curing. Once the hepatitis becomes chronic, for many years it can be stabilised, however up to 20% develops cirrhosis after 20-25 years. This cirrhosis disrupts the liver and also has a higher risk of developing tumours.
The acute Hepatitis C produces symptoms similar to a flu, with general sickness, fatigue, loss of appetite and sometimes even jaundice, ie. Yellowing of the eyes and/or skin.
At the stage of chronic hepatitis, often no symptoms are present or can be mistaken with fatigue. When it develops into cirrhosis symptoms, complications associated with this illness may appear.
The presence of antibodies to hepatitis C virus in the blood tells us that there was a contact with the virus. the demonstration of the presence of the virus in the blood (which is what we call viral load) confirms the existence of an infection.
Once confirmed the presence of a chronic hepatisis by virus C, it is essential to perform some studies. Usually, this is done by a blood test, specific type of Virus C is analysed ( the genotype) and some characteristics of this ( various polymorphisms of the virus) that are useful to find out which can be the reaction of the virus to treatment.
A scan is also performed to see the state of the liver and if possible to determine whether is its needed to perform a biopsy to know the damage of the liver before beginning treatment, in many occasions this test is replaced by another one called hepatic elastography ( the machine that is used is called fibroscan) which is similar to a scan that measures the hardness of the liver, which reflects the extent of liver damage.
With all these information, the specialist will be in the disposition of knowing the situation of the liver and requirement for the treatment.
During many years the available treatment for chronic hepatitis C has been stalled in the combination of medication: pegylated interferon ( an injection performed weekly) and ribavirin ( daily pills ). this treatment allows eliminating the infection between 30 to 80% depending on the viral genotype.
The duration of the treatment may vary, but can be approximately a year for genotypes 1 and 4. in the case of genotypes 2 and 3, it is usually 6 months. In certain cases these times may shorten.
In the last 3 years we have witnessed the most important advances in the treatment of VHC developing drugs that take action on various targets of the virus increasing cure rates of the infection reaching 100% including with genotypes and conditions where it was more difficult to obtain a cure allowing to avoid using interferon , one of the drugs that is less tolerated . Also, recently various of these drugs are being sold , which allows to establish combinations of these in order to obtain those big cure success rates, without depending on the use of interferon, minimizing second effects.
In HC international Hospital we are able to achieve these high cure success rates in the infection by Hepatitis C with the new drugs sold in Spain, Sofosbuvir, Simeprevir and Diclastavir, and soon we will have new combinations available, allowing best possible treatment without interferon.
Dr. José Miguel Rosales Zábal
Digestive System Specialist
HC Marbella International Hospital
March 4, 2015
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