The danger of hepatitis C: the disease can go unrecognized for years
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More than 600 thousand patients, including 4.3 thousand children, are registered with hepatitis C, a dangerous infectious disease that only 8 years ago passed from chronic to completely curable. Infectionists say these numbers are just the tip of the iceberg. In fact, there are many more patients. But they are not even aware of the infection due to the lack of symptoms and the stigmatization of the disease. How to find and treat all patients with hepatitis C, experts discussed on the eve of World Hepatitis Day.
The hepatitis C virus is very volatile, so a vaccine against it has not yet been invented. It actively hits a variety of targets in the body – not only the liver, as many people think, but also the cardiovascular, endocrine, nervous and other organs and systems of the body. Hepatitis C-related liver problems alone cause one death in the world every 6 minutes.
At the same time, there are no special symptoms that help to recognize an insidious disease. More than 80% of patients within 10–20 years experience only inexplicable increased fatigue, weakness, complain of a temperature not higher than 37.5 degrees, which most attribute to overload, beriberi or a cold. The only way to find out about the disease is to take a blood test for antibodies to hepatitis C.
If there are risk factors, you can donate blood for hepatitis C free of charge at the clinic at the place of residence. However, many do not do this, because they still think that this infection occurs only in asocial individuals. In fact, most patients are socially adapted people who take care of themselves, so they go to the dentist, get manicures and pedicures, and get cosmetic tattoos. These procedures, along with piercings and tattoos, can become a source of infection if the equipment is not well sterilized, and the paint is not from a disposable tube. Infection with hepatitis C in medical settings, as well as through sexual transmission, is now rare. The risk of transmission from mother to newborn does not exceed 5%.
Surprisingly, quite a large number of people know about their disease, but do not go to the doctors because “nothing hurts”, or they think that hepatitis C is incurable or that it is unrealistic to get treatment for free. In fact, this disease is now curable, and the availability of treatment has almost doubled even compared to last year.
As the chief freelance specialist in infectious diseases of the Russian Federation, professor of the Department of Infectious Diseases of the Medical and Preventive Faculty of the First Moscow State Medical University named after I.M. half of 2023 was a huge step forward. In particular, the Clinical Guidelines for the Treatment of Chronic Hepatitis C (CHC) have been updated, the Standard Action Plan for the Control of Hepatitis C, Criteria for the provision of medical care have been approved; the disease is included in the basic program of state guarantees. All this, according to the specialist, significantly increases the availability of hepatitis C treatment. In addition, as Chulanov noted, thanks to the new differentiated compulsory medical insurance tariffs, the regions can double the treatment coverage compared to last year.
True, despite the recommendation, not all regions have retained the necessary funding for hepatitis C treatment. Therefore, specialists and the head of the patient organization Nikita Kovalenko emphasized that regions should carefully assess how many patients they need to treat annually under both compulsory health insurance and regional programs in order to stop the epidemic of a dangerous disease.
But if there are still questions about the treatment of adult patients, then all children from any corner of the country from this year can be cured of hepatitis C completely free of charge. Children should be treated for this disease as early as possible, says Yuri Lobzin, academician of the Russian Academy of Sciences, professor, doctor of medical sciences, director of the FGBU “Children’s Scientific and Clinical Center for Infectious Diseases of the FMBA”, chief freelance specialist in infectious diseases in children. Even in the absence of severe symptoms, young patients suffer from negative attitudes from peers, teachers, and even some medical professionals, so most are forced to hide the disease. Although this is not always easy – at least due to restrictions in playing sports: weakness and fatigue (common symptoms of hepatitis C) in childhood and adolescence especially interfere, do not allow to develop on an equal basis with everyone. After school, problems begin with the choice of a profession, because not all vocational schools take applicants with hepatitis C.
Hepatitis C often begins to affect health at an early age. “We often encounter misconceptions that hepatitis C is a shameful disease and that we can wait until the start of treatment,” says Professor Niso Odinaeva, chief freelance pediatrician of the Moscow Region. – Not only the liver can suffer from the virus, but also other important organs, which as a result can lead to chronic disabling diseases already at a young age. Moreover, in 4% of patients, cirrhosis of the liver develops already in childhood, and in 32% – up to 35 years, that is, in the prime of life. In addition, the disease causes developmental delays, psychological and mental problems.”
Fortunately, it is now possible to cure absolutely all children with hepatitis C from the age of 3 years. Niso Odinaeva shared the experience of the Moscow region, noting that all treated children were completely cured in just 8–12 weeks and did not experience side effects during treatment.
At the same time, doctors are concerned that a large number of children with hepatitis C are out of sight of medical workers, since the disease does not have specific symptoms, and it is difficult to suspect it. Yuri Lobzin and Niso Odinaeva proposed to include an analysis for antibodies to hepatitis C in the clinical examination of children aged 6 and 14 years, before entering school and at a time when adolescents may already be faced with this disease, for example, at an early onset of sexual activity, application tattoos, piercings. This will allow children to get rid of the disease in time, without waiting for disabling complications.
Newspaper headline:
A blow to the liver, then – everywhere
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