Hepatitis C, known as HCV, is an infectious disease caused by the hepatitis C virus, mainly through blood. Hepatitis C has a high chronicity rate, which, if not diagnosed and treated in a timely manner, can lead to chronic hepatitis, hepatitis cirrhosis and even liver cell cancer. The treatment of hepatitis C has made significant progress in recent years with the widespread use of direct antiviral drugs (DAAs). This paper will elaborate on the diagnosis of hepatitis C, the treatment strategy and its importance.
I. Diagnosis of hepatitis C
Hepatitis C diagnosis relies mainly on laboratory and video examinations, combining patient history and clinical performance.
(i) Clinical performance
The clinical performance of hepatitis C varies according to the course and severity of the disease, with the majority of patients suffering from no visible symptoms during the acute period, and some of them may suffer from mild signs of weakness, reduced appetite, nausea and yellow sluice. Chronic Hepatitis C patients usually have no specific symptoms, with visible clinical manifestations only as the disease progresses to the cirrhosis or liver cancer stage, such as abdominal water, salivation, digestive haemorrhage, etc.
(ii) Laboratory inspection
1. Anti-HCV antibodies testing
Anti-HCV antibodies testing is the preferred method of screening for hepatitis C. Anti-positive patients have been or are being infected with HCV but cannot distinguish between acute, chronic or prior infections.
2. HCV RNA testing
HCV RNA testing is the gold standard for the identification of hepatitis C. Testing of HCV RNA levels in serums using the PCR technology will determine the existence of the virus and the high and low load of the virus.
3. HCV Genetic Speculation
Hepatitis C virus is multigenerative (e.g., type 1, type 2, type 3) and the response to treatment varies from one gene to another, so genetic speculation helps to develop individualized treatment programmes.
4. Liver function testing
Indicators such as sero-grenade acetamase (ALT) and savanna amitase (AST) were tested to assess the extent of liver damage.
5. Hepatitis fibrosis assessment
Hepatic fibrosis is assessed by serophysics markers (e.g., transparent acids, pre-gela type III) or by no-fibrous imaging (e.g., instantaneous elastic imaging techniques) and, if necessary, hepatoorganisation is performed.
(iii) Visual inspection
Visual examinations (e.g. abdominal ultrasound, CT or MRI) can be used to assess changes in liver structure and to exclude the possibility of cirrhosis or hepatic cell cancer.
II. Treatment of hepatitis C
Hepatitis C is treated with the objective of removing HCV, improving liver function, preventing or reversing hepatitis fibrosis and reducing the risk of cirrhosis and liver cancer. In recent years, the availability of direct antiviral drugs (DAAs) has led to a significant increase in the cure rate for hepatitis C.
(i) Treatment of adaptability
1. Acute hepatitis C
Acute hepatitis C patients usually recommend six months of observation and, if the virus is not self-cleaned, initiate antiretroviral treatment.
2. Chronic hepatitis C
All chronic hepatitis C patients are recommended for antiretroviral treatment, especially those with high viral loads, abnormal liver function or hepatitis fibrosis.
(ii) Therapeutic drugs
1. Direct antiviral drugs (DAAs)
DAAs are the main drug currently used to treat hepatitis C, with high efficiency, low toxicity and short treatment. Common DAAs include:
Sofosbuvir
Dakatasvir
Glecaprevir/Pibrentasvir
Ledipasvir/Sofosbuvir
The treatment programmes of DAAs are usually based on the HCV genotype, liver fibrosis and historical history of treatment, generally for 8 to 12 weeks, with a cure rate of over 95 per cent.
2. Interference in Ulybavirin
Prior to the advent of DAAs, Interference Ulybavirin was the main treatment for hepatitis C, but was gradually replaced by DAAs because of more side effects and limited efficacy, only in certain exceptional circumstances.
(iii) Treatment impact assessment
1. Virus response
The HCV RNA level is tested 12 weeks after the end of the treatment, and if the virus is not detected, it is called the Continuous Virus Response (SVR), indicating that the patient has been cured.
2. Improved liver function
Post-treatment liver function indicators (e.g., ALT, AST) have returned to normal, indicating an improvement in liver damage.
3. Hepatitis fibrosis reversal
Long follow-up shows that hepatitis C is reversible after successful treatment.
III. Importance of hepatitis C prevention and treatment
Hepatitis C is a curable disease, but many patients are not able to detect and treat in a timely manner after infection, with serious health consequences, because of hidden transmission routes and early symptoms. Strengthening the fight against hepatitis C is important:
Reducing the burden of disease
The cure of hepatitis C not only improves the quality of life of patients but also reduces the incidence of cirrhosis and liver cancer, thus reducing medical costs and social burdens.
Interrupting transmission
The early detection and treatment of the virus can effectively disrupt the spread of hepatitis C and protect public health.
3. Achieving global elimination goals
The World Health Organization (WHO) proposes to achieve the global eradication of hepatitis C by 2030. This can be achieved through universal screening, promotion of DAAs treatment and improved management of high-risk populations.
Concluding remarks
Hepatitis C is a preventable disease, but its hidden and chronic characteristics prevent many patients from receiving timely diagnosis and treatment. Hepatitis C morbidity and mortality rates can be significantly reduced through improved screening, promotion of direct antiviral drugs (DAAs) treatment and increased public health awareness. In the future, as medical technology progresses and the global response advances, the full elimination of hepatitis C will be possible.
Acute hepatitis C, chronic hepatitis C, hepatitis C virus
