Summary: Hepatitis C (hepatitis C) is a global health problem caused by Hepatitis C virus infection. The purpose of this paper is to raise public awareness of hepatitis C, promote early diagnosis, effective treatment and active prevention, and reduce its personal and social hazards.
Introduction
Hepatitis C is a more hidden infectious disease, which is widely disseminated globally, and many patients are exposed to symptoms that are not visible at the beginning of the infection and are often detected only when serious complications, such as cirrhosis or liver cancer, occur at an advanced stage. The World Health Organization estimates that around 58 million people globally are infected with the Hepatitis C virus, and about 1.5 million new infections occur every year. Knowledge of hepatitis C is essential to control its dissemination and to ensure public health.
II. Causes and means of transmission
(i) Causes
Hepatitis C is infected by the Hepatitis C virus (HCV). The HCV, which belongs to the yellow hepatitis virus, is a single positive chain of the RNA virus, with a high degree of genetic variability, which makes the development of a hepatitis C vaccine an enormous challenge. HCV is primarily infected with hepatic cells, which are then replicated and transcribed using the host cell enzyme system, leading to inflammation of the liver, with chronic liver pathologies resulting from long-term infections.
(ii) Means of dissemination
Blood transmission: this is the most important route of transmission of hepatitis C.
– Blood transfusions and blood products: In the past, as a result of poor screening of blood donors, the importation of blood or blood products containing HCV (e.g. plasma, condensers, etc.) could have led to the spread of hepatitis C. Today, with the improvement of blood donation screening, this mode of transmission has been significantly reduced, but very few cases of transmission are due to, inter alia, window-stage infections.
– Shared syringes: the sharing of syringes by intravenous drug users is a high-risk behaviour for hepatitis C transmission. HCVs can survive in the blood left in syringes, and when others use contaminated syringes, the virus can enter the body to cause infection.
– Medically transmitted: this includes the reuse of unsterilised medical equipment (such as needles, acupuncture needles, dental devices, endoscopy, etc.) and cross-infections during medical operations such as surgery, dialysis and blood extraction. Although infection control measures in medical institutions are being strengthened, there are still risks.
2. Sexual transmission: Unprotected sex with hepatitis C patients can transmit the hepatitis C virus, but sexual transmission is less likely than blood transmission. Multiple sexual partners and the history of sexually transmitted diseases increase the risk of sexual transmission.
Mother-to-child transmission: Mothers infected with HCV can transmit the virus to their newborns during childbirth. The risk of mother-to-child transmission increases significantly if the mother is infected with the HIV virus (HIV). There are no effective ways of completely disrupting the mother-to-child transmission of hepatitis C, but antiretroviral treatment for mothers reduces the risk of transmission.
III. METHODOLOGY
When HCV enters the body, it first binds with receptors on the surface of the liver cell and then enters the cell through internal ingestion. Within the cell, the RNA of HCV releases and uses the host cell’s nuclei for translation, synthesising the various proteins of the virus, and then replicating the virus’s genome and the assembly and release of new virus particles. HCV infection can activate the immune system of the organism, and immunocellular cells such as T lymphocytes and natural lethal cells can attack infected liver cells in an attempt to remove the virus. However, because of the genetic variability of the HCV, the virus can be constantly modified to escape immune surveillance of the organism, leading to a persistent immune response and a recurrence of hepatitis. Long-term inflammation stimulates the fibrosis of liver tissue and the progressive cirrhosis of the liver, with some patients eventually moving towards liver cancer.
IV. Clinical performance
(i) Acute hepatitis C
About 75 per cent of patients have no apparent symptoms after contracting HCV, and a small number of patients can suffer from non-specific symptoms such as inactivity, reduced appetite, nausea, vomiting, right upper abdominal discomfort or pain, low heat, and similar manifestations of influenza, which are usually light and of short duration, with an average of 6 – 7 weeks of insulation. Some patients can experience yellow sluice, which is manifested in yellow dyes of skin and membranes, increased urine color, etc., but the incidence is relatively low.
(ii) Chronic hepatitis C
If acute hepatitis C patients are not treated in a timely manner, about 70 – 85 per cent of them develop into chronic hepatitis C. The symptoms of chronic hepatitis C patients are not visible, but they can be easily ignored, with only minor non-specific manifestations such as lack of strength and appetite. As the disease progresses, hepatic spleen swelling, spider moles, hepatic palms, etc. can gradually be shown, and hepatic function continues to be abnormal, e.g., serotransmitamase, cholesterol, etc. Chronic hepatitis C is a long-term disease that lasts for several to several decades, during which time liver disease can slowly progress and eventually develop into severe consequences such as cirrhosis and liver cancer.
(iii) Hepatitis cirrhosis and liver cancer
Chronic hepatitis C patients can develop into liver cirrhosis after a long accumulation of hepatitis and fibrosis. Patients with cirrhosis have serious complications such as abdominal water, edible dysentery dysentery fractures and hepatic cerebral disease, which seriously affect the quality of life and survival. In addition, liver cancer risks are significantly higher for hepatitis C-related cirrhosis patients than for the general population, and liver cancers are generally non-observed, and are less likely to occur when the symptoms are more advanced.
V. Diagnosis
(i) Medical history inquiries
Detailed information on the patient ‘ s history of blood transfusions, intravenous drug use, indecent sex, hepatitis C family history, etc. is an important reminder for the diagnosis of hepatitis C.
(ii) Clinical performance
Hepatitis C can be initially suspected on the basis of symptoms such as lack of strength of the patient, reduced appetite, yellow salivation, and hepatic spleen, spider moles, liver palms, etc., but these are not specific and need to be diagnosed with laboratory tests.
(iii) Laboratory inspection
1. Anti-HCV testing: This is a common method of screening hepatitis C for the detection of anti-HCV antibodies in serums to determine whether a patient has been infected with HCV. However, anti-HCV positives only indicate that they have been infected with HCV, and do not distinguish between past or current infections or reflect the replicability of the virus.
2. HCV RNA test: is a key indicator for the diagnosis of hepatitis C, which detects the viral load of HCV in blood and determines whether there is a replicability of the virus. The HCV RNA positive induction of hepatitis C infection can be used to assess the efficacy of antiretroviral treatment.
3. Hepatic function screening, which includes indicators such as serotransmase (e.g. ALT, AST), cholesterol, proteins, and the original time of condensation, reflects the extent of hepatic inflammation and damage, but hepatic abnormalities are not specific to hepatitis C and require identification with other liver diseases.
4. Testing of liver fibrosis indicators, such as serotransparent acids, adhesive proteins, pre-heavy platinum type III, adhesive platinum type IV, etc., can be used to assess the extent of liver fibrosis, but these indicators are of limited accuracy and often need to be combined with a comprehensive determination of liver imaging.
(iv) Visual inspection
1. Hepatic ultrasound: the liver can be observed in form, size, echo, vascular texture, etc., and there are signs of hepatomas, dysentery, fibrosis, cirrhosis, etc., as well as abdominal and spleen complications. Ultrasound examination has the advantage of being ingenuity, simplicity and repetitivity, and is one of the common methods of screening and disease monitoring for hepatitis C.
2. CT and MRI examinations: The diagnosis of liver pathologies is more accurate, with a clearer picture of the nuanced structure and pathologies of the liver, which helps to identify the cirrhosis of the liver and its cancers, and to assess the feasibility of spacing and surgical removal of liver cancer. However, CT and MRI examinations are expensive and are generally used when ultrasound examinations reveal abnormal or high clinical suspicion of serious pathologies such as liver cancer.
Treatment
(i) Anti-virus treatment
Antiviral treatment is at the heart of hepatitis C treatment. Direct antiviral drugs (DAAs) are now the preferred option for hepatitis C treatment. DAAs can play a role in the different stages of the HCV life cycle, with the advantages of efficiency, low toxicity and short treatment. Depending on the genetic type of HCV, different DAAs packages are available. For example, in the case of type 1 C, sophosphate/Vipatavi, Ladipeve/Sophosphate, etc., are commonly used; in the case of type 3 C, sophosphorus is available. The general course of treatment is between 8 and 24 weeks, and most patients can achieve a viral cure after the standard antiviral treatment, i.e. the continuous negativeness of HCV RNA tests at the end of 12 or 24 weeks.
(ii) Treatment
Adequate nutritional support and treatment of disorders such as vitamin supplementation, micronutrients and the use of digestive drugs to improve the quality of life of patients can be provided for such symptoms as infirmity and appetite. Complications such as diarrhea, dysentery diarrhea and liver cerebral disease in patients with cirrhosis require appropriate treatment, such as urine, blood stoppage, reduction of intracranial pressure and improvement of liver and cerebral symptoms to alleviate the condition and extend the duration of life.
(iii) Hepatitis transplant
For those with end-stage hepatitis C cirrhosis or liver cancer, liver transplant is an effective treatment. However, hepatitis C has a high rate of re-emergence following liver transplants, which requires antiretroviral treatment before and after liver transplants to reduce the risk of relapse.
Prevention
(i) Control of transmission sources
Standardized antiviral treatment for hepatitis C patients to reduce their load and risk of transmission. Strict HCV screening of blood donors, organ donors, etc. to ensure the safety of blood and organs.
(ii) Cut off transmission channels
1. Strengthening blood management: strict implementation of the system of free blood donation, comprehensive health screening of blood donors and HCV screening, introduction of advanced testing techniques to shorten window periods. (c) Strengthen the regulation of the production of blood products and ensure their safety.
2. Prevention of medical transmission: Medical institutions should strictly observe a system of disinfection and isolation, thoroughly sterilize medical devices or use one-time medical devices, regulate medical procedures and prevent cross-infection. Increased training of medical personnel to improve their awareness and operational skills in the control and control of hepatitis C.
3. Safe sex education: promote safe sex, use condoms and reduce the risk of sexual transmission. For sexually active persons, hepatitis C screening is carried out on a regular basis.
4. Prevention of mother-to-child transmission: close monitoring of pregnant women infected with HCV, assessment of liver function and viral load. For pregnant women with a high viral load, antiretroviral treatment may be considered under the guidance of a doctor to reduce the risk of mother-to-child transmission. Hepatitis C testing should be carried out in a timely manner after the birth of the newborn child and breastfeeding should be avoided (in cases of a broken nipple, haemorrhage or high load of HCV RNA for the mother).
(iii) Protection of vulnerable populations
Hepatitis C vaccine is not currently on the market, but research and development is under way. In everyday life, attention should be paid to personal hygiene, avoiding the sharing of items that may cause blood contact, such as toothbrushes and razor blades, and reducing the risk of infection.
Conclusions
Hepatitis C is a serious infectious disease that spreads in a variety of ways, with complex mechanisms, invisibility of clinical performance and an evolving diagnostic and treatment approach. By raising awareness of hepatitis C, increasing public awareness of prevention, controlling the sources of infection, cutting off transmission channels, actively developing vaccines and providing early diagnosis and standard treatment to patients, hepatitis C morbidity and mortality can be effectively reduced, its personal and social hazards reduced and its contribution to global public health.
Hepatitis C virus
