Patients often ask doctors if they can cure hepatitis C completely. A couple of years ago, experts were convinced that the disease does not go away forever. The activity of the virus is only suppressed for an indefinite period by taking antiviral agents and immunomodulators.
However, to date, doctors have developed drugs that promote lasting remission. There are cases of complete cure. The likelihood of a positive therapeutic effect depends on many factors. Treatment success is affected by:
- lifestyle of a sick person
- having bad habits
- psychological mood
- conscientious observance of doctor's instructions.
What is the probability of complete cure
The virus invades the liver cells and gradually destroys the organ. In the absence of timely treatment, a sick person develops cirrhosis or cancer. Pathologies are irreversible, they cannot be cured. If hepatitis C is diagnosed earlier than cirrhosis and cancer, it is possible to get rid of it forever. For a speedy recovery it is necessary to combine the experience and knowledge of the doctor with the efforts of the patient. The sooner you begin therapy, the higher the likelihood of killing the virus.
Today, with well-planned treatment of hepatitis C can be cured in 90-98% of cases. The chronic form of pathology is more difficult to treat. To select effective antiviral drugs, the patient undergoes a comprehensive examination. During the diagnosis are determined:
- virus genotype
- phase of infection,
- the degree of liver damage,
- the presence of concomitant diseases.
Whether or not hepatitis C can be cured depends on many factors. Despite the cases of complete deliverance from the virus, doctors do not give a 100% guarantee of recovery. Hepatitis C is sometimes compared with HIV. Both infections gradually destroy the human body. Antiviral drugs inhibit the activity of pathological microorganisms, but do not completely destroy them. Although in the case of hepatitis C exceptions are possible. Doctors have developed drugs that can completely destroy the virus. It is important that the doctor correctly selects and arranges the medication.
Chronic hepatitis C requires complex therapy. Medicines should interact with each other, and not suppress each other. Thanks to new drugs, each patient can really choose an individual course of treatment. The cost of therapy is high. Not all people infected with hepatitis C can afford expensive pharmaceuticals. Therefore, along with innovative drugs, doctors continue to prescribe standard medicines, the price of which is more affordable.
Whether to cure hepatitis C using a standard approach is difficult to determine. You can give a forecast after a comprehensive examination of the patient. In medical practice, cases of complete recovery are recorded at an early stage, but they are rare. It is possible to recover with the help of standard therapies used since 1990. But while the probability of getting rid of the virus is low and is only 30%.
Standard treatment approach
Before starting treatment, refer to a hepatologist. For many years, viral liver damage has been treated with interferon and ribavirin-based drugs. Even if the patient has ALT and AST values within the normal range, antiviral agents are still prescribed. Combination therapy helps delay the appearance of pathological changes in the liver.
Ribavirin alters the virus RNA. The component is active only in combination with interferon. It penetrates into the structure of pathogenic microorganisms and slows down their activity. The disease stops progressing in 60% of cases. With the correct and systematic use of drugs, stable remission is possible over the years. In some cases, even when using the standard treatment regimen, the disease does not escalate to old age. Doctors call it a complete or partial recovery.
It is possible to cure the chronic type of the disease or slow its progression using drugs that include both interferon and ribavirin. Hepatologists are often prescribed to patients:
It is rarely possible to cure hepatitis C permanently with the above pharmaceuticals. The outcome of therapy is affected by:
- pathogen genotype,
- physiological features of a sick person,
- the amount of virus in the blood,
- pathogen sensitivity to interferon,
- the degree of liver damage.
The first course of treatment lasts six months. Every month a sick person is tested to determine the effectiveness of therapy. If after six months the concentration of the virus in the blood has not decreased, the treatment is prolonged for another 6 months. If necessary, the doctor prescribes other drugs. Instead of the combined means often used ribavirin and interferon separately.
There are domestic and imported drugs. They have the same efficiency, differ only in price. Ribavirin is part of Rebetola, Ribavin, Ribamidil, Ribapega. Interferon include Reaferon, Altevir, Interal, etc. Additionally, vitamins and hepatoprotectors are prescribed. They are needed to restore the liver and maintain immunity.
Some sick people have a negative reaction to the use of drugs containing interferon. Sharp activation of immunity is fraught with fever, weakness, poor appetite, nausea, depressive conditions. Many patients are interested in whether it is possible to slow the progression of the pathology without the use of interferon. In 2012, physicians developed anti-hepatitis drugs that do not contain immunomodulators. They are called inhibitors and act directly on the virus.
Drugs of direct action - this is a breakthrough in the traditional treatment of hepatitis C. They prevent the reproduction of viruses in 97% of cases. In the early stages of the disease, inhibitors contribute to complete recovery in 90% of sick people. The only drawback of direct-acting drugs is the high price. Only a few can afford to buy inhibitors without the help of the state and charitable foundations.
Today, in pharmacies in Russia, you can find only 2 antiviral agents of direct action: Insivo and Viktralis. The following inhibitory drugs have been successfully tested and registered in Europe and the USA:
Whether hepatitis C is treated with the above medicines in a particular case, only a hepatologist can say.
There are 1-6 genotypes of the virus, each of which is amenable to therapy with a specific drug. In order to cure the disease forever, it is necessary to follow all the recommendations of the doctor, not to drink alcohol and fatty foods. Patients should be tested regularly, taking vitamins and drugs to restore hepatic function. Only in this case, you can count on a full recovery.
Hepatitis - a problem for people at risk?
At that moment, when a person becomes ill with hepatitis, other urgent problems for him fade into the background. The main task of the patient is a speedy recovery and return to the usual way of life. Human infection with group B hepatitis can occur not only when in contact with the patient’s biological material.
There are a large number of cases in which this viral infection has penetrated into the human body during a visit to the dental office, tattoo salon, manicure cabinet, medical institution, etc. one syringe is used by the whole company.
How can you get hepatitis C?
Hepatitis C is transmitted exclusively by parenteral administration. During infection, a viral infection penetrates into a person’s wound, which is contained in the biological material of the patient with hepatitis.
Unlike group B hepatitis, this form of the disease is rarely transmitted during unprotected sex. According to available statistics, the chance of hepatitis C infection among sexual partners who do not use condoms is approximately 5% of the total number of patients over 10 years.
Features of the hepatitis C virus
Hepatitis C virus group can not for a long time to maintain its viability in the environment. After drying of the blood, the virus dies, so that when particles of dry biological material enter the open wound of a person, the disease does not occur.
Unlike hepatitis C, viral infection of group B has an amazing vitality. It can retain its activity for decades under any external influence.
The only opportunity to clean any object from the presence of contaminated biological material is to conduct a two-hour sanitization at high temperature conditions. Hepatitis B virus can be destroyed at 300 ° C.
How can you protect yourself from hepatitis?
Experts suggest that people regularly carry out preventive measures that will help protect against infection with hepatitis C.
Modern medicine strongly recommends that precautions be taken both for people and employees of medical institutions and services:
use disposable instruments when performing medical procedures,
regularly carry out sanitization of tools used by masters of manicure, tattoo and beauty salons,
when taking blood, it is necessary to carry out a thorough check of biological material, which must be kept in quarantine for a certain amount of time
in case of any suspicion of the presence of a virus in the blood, it is necessary to repeat, more detailed analysis, etc.
How to behave when visiting the dental office or beauty salon?
For medical institutions and institutions in which cosmetic services are provided, sanitary standards have been developed that relate to both the cleaning of premises and the processing of tools. At present, these requirements are strictly followed, since each institution is responsible for the life and health of its clients and does not wish to provoke any problem situations on its own.
In tattoo parlors, the situation is much more complicated, since many cabinets work informally and save on expensive disinfectants.
For how long can the hepatitis virus be in the patient's body without symptoms?
After penetration of a viral infection into the human body, it should take some time before it starts to multiply. At this time, the patient will not experience any discomfort or other symptoms inherent in group C hepatitis. Even laboratory blood tests will not be able to detect the presence of the virus.
Most patients learn that they are carriers of the hepatitis B virus during a comprehensive examination carried out before a planned surgical intervention.
What forms of hepatitis differ from each other?
Modern medicine classifies hepatitis as follows:
Form A hepatitis is treatable and does not become chronic (an effective vaccine has been developed against it),
Hepatitis Form D - is a rare virus that develops in patients infected with hepatitis B,
Hepatitis forms F and E - do not progress on the territory of the Russian Federation,
Hepatitis forms B and C are the most common forms of this disease, against which cirrhosis or liver cancer often develops (the highest mortality rate for these forms of hepatitis today).
Who can be a carrier of the virus?
When hepatitis C virus penetrates the human body, the following occurs:
a person becomes a carrier of the virus
a person is sick and needs urgent treatment.
Group C hepatitis may be dormant for the rest of life and not cause anxiety in a person. Cirrhosis of the liver in this case, some patients may develop after 20 years from the moment of infection, and in other patients it will not develop even after 60 years.
Should I treat group C hepatitis?
With timely diagnostics and complex treatment prescribed for patients, there is a very positive prognosis. Modern methods of treating hepatitis C make it possible to completely cure a patient and, a few years after the end of therapy, to rid his blood of the presence of antibodies of this virus.
According to the available forecasts, in the near future new drugs will be presented that can help more than 90% of patients with hepatitis. Some drugs will be transferred to the state registration already this year. With their help, it will be possible to significantly increase the effect of drug therapy.
Can hepatitis C disappear on its own?
There is a category of patients whose hepatitis C antibodies are detected during laboratory blood tests, but the RNA virus itself is not detected.
These results suggest that the patient had recently suffered from hepatitis, but had recovered at the time of the examination. In 70% of cases, hepatitis just goes into a chronic stage, and cured 30% of patients can re-suffer the disease.
Does hepatitis B vaccine protect against infection with this virus?
With the progression of hepatitis B, patients are prescribed special drugs that can suppress the virus and prevent its reproduction. Such drugs patients should take regularly, until the restoration of liver function.
Vaccination against hepatitis B will protect the patient for 5 years, after which re-vaccination should be given. If a pregnant woman is the carrier of this form of the virus, she can infect her child at the time of labor. That is why these newborns are immediately vaccinated against hepatitis, which prevents the further development of the infection.
At what age should be vaccinated against hepatitis B?
Participation in vaccination is an individual affair of each person. Before visiting a medical facility, the patient should consider for himself all possible risks of hepatitis B infection at a young age, when people are wild, it is necessary to be vaccinated against this disease.
In old age, for a person, the probability of direct contact with the biological material of a sick person does not decrease, therefore it is best to provide additional protection to your body. Each person should remember that after 5 years after vaccination it is necessary to carry out revaccination.
Can I get hepatitis B through unprotected sex?
Due to the fact that the hepatitis B virus is contained not only in the patient’s blood, but also in all mucosal secretions, the risk of contracting this disease increases several times during unprotected sex. When kissing, the virus can only be transmitted if a healthy person has fresh lesions on the tongue or oral mucosa.
Will there be a vaccine against group C hepatitis?
When a person is infected with the hepatitis C virus, the immune system immediately enters the battle, which negatively affects the liver cells. Self-immunity of the patient will not be able to cope with this disease. For these purposes, a drug has been developed that is able to cope with this form of the virus. Despite all the clinical trials, which were very successful, this drug was never presented on the domestic market. In the event that annual vaccination is conducted, the patient’s body will no longer recognize this viral infection.
What should the patient do if he suspects that he has the hepatitis virus?
In the case when a person suspects that he has hepatitis, he needs to contact an infectious diseases specialist in a medical institution. A narrow specialist will conduct a comprehensive examination and, after confirming the diagnosis, will prescribe a constructive treatment.
Currently, there are special hepatological centers that employ highly qualified specialists who can treat any form of hepatitis. Many patients are treated in such medical institutions according to regional programs or special quotas, due to which their overall costs are significantly reduced.
Who chooses a patient treatment?
To determine which therapy is appropriate for a particular patient, a specialist must conduct a comprehensive examination of it. Based on the collected history of the disease, the results of laboratory blood tests and a liver biopsy, the doctor will determine how likely it is for the development of cirrhosis.
In the case when the patient comes to the reception, who has been suffering from hepatitis for 15 years and there is a high probability for him, 10 years later, to get liver cirrhosis, the doctor prescribes constructive therapy.
If a young man comes to the doctor with symptoms of hepatitis, who has been carrying this virus for not more than a year, the specialist will recommend that he wait a few years with therapy, subject to all the instructions and recommendations. After 5-6 years, such a patient will undergo a course of treatment that will deliver him from the hepatitis virus in just a few months.
What should patients do?
In developed foreign countries, patients who have been diagnosed with hepatitis C form are undergoing comprehensive treatment at the expense of the state. For example, in Hungary, 3,500 patients diagnosed with hepatitis B have been identified. The state pays for their treatment in full and makes sure that they cannot infect other citizens. For patients with hepatitis C, 14 centers have been created, in which they undergo not only a hepatological examination, but also receive free treatment.
In Russia today there is no legal basis for the state to take responsibility for the life and health of this category of patients. Today, only HIV-infected patients receive free medicines and medical care in specialized institutions. In the event that patients with hepatitis will more actively express their position, then in the near future the state will be treated for free.
Education: A diploma in “Medicine” was obtained at the Military Medical Academy. S.M. Kirov (2007). In the Voronezh Medical Academy. N. N. Burdenko graduated from the residency in the specialty "Hepatologist" (2012).
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Can I get hepatitis C at home?
Relatives of patients often ask hepatologists the question: “Is it possible to get hepatitis at home?” It is possible to infect if the items used by an infected person get his blood or other biological fluids (lymph, bastard, genital tract discharge, semen), and then a healthy person contacts these items.
Every person who has learned about the diagnosis of hepatitis C is worried about a lot of questions. Is it possible to recover from it? How should it be treated to forget about the problem forever? How quickly will recover? Today there are effective treatments that allow you to fully recover from HVGS in 12 weeks. The duration of antiviral therapy depends on the genotype of the virus and complications from the liver and other organs. Consequently, the treatment regimen for HVGS 1 genotype will differ from the genotype 3a scheme. At the same time, the effectiveness of therapy in an infected liver without fibrosis will be higher than in a patient with severe fibrosis of grade 3 or 4.
How to understand that the patient is recovering?
The result of therapy is controlled by laboratory methods. The disease is considered cured when 6 months after the therapeutic course of the patient's blood is not detected the genetic material (RNA) of the virus. In this case, antibodies to the virus will circulate in the blood. If six months or more of the virus's RNA is not detected in the blood of a person treated, but there are antibodies to it, this is not a reason for further laboratory monitoring.
It is believed that such a patient successfully underwent treatment and recovered. Treatment with modern drugs is not cheap: originals - tens of thousands of US dollars, and generics - tens of thousands of rubles. However, you should not refuse this treatment: its effectiveness reaches 95-100%. If the patient has no money to buy expensive drugs, they can always be replaced with cheaper counterparts. In some cases, when the disease is detected in the initial stage, therapy can be postponed, but periodically screened for screening, elastometry (elastography) of the liver, and blood tests - OAK, transaminase ALT and AST, and others, if necessary. With F1-F2 fibrosis, treatment for the patient is recommended, with F3-F4 it is urgently needed. The disease is dangerous for its complications: fibrosis and cirrhosis of the liver, carcinoma of the liver cells.
Where is the best place to learn about treatment?
Usually, when they become aware of their diagnosis, they become self-absorbed and become asocial. To help them perk up and become confident that it is quite possible to fully recover from the disease, can live communication. People diagnosed with hepatitis C can read reviews about the effectiveness of various modern treatment regimens in specialized forums. There you can talk directly with those who cured hepatitis C. "Experienced" answer various questions: how therapy is transferred, what foods and dishes are better to eat during treatment, is it possible to drink alcohol. By the way, the “alcoholic” question interests many patients, since the therapy lasts quite long - from 12 weeks to 24 weeks.
But to use the advice of members of the forum as a guide to action should not be. Testimonials, of course, are important, but only a competent doctor should prescribe drugs that can cure hepatitis C. There is no universal best medicine that cures all patients. Some infected people need a combination of sofosbuvir with Ledipasvir (MPI Viropack plus, Ledihep), others cured a combination of Sofosbuvir with Velpatasvir (Velasof, Velpanat), and the third should be supplemented with Ribaverine or other aids. Only a hepatologist can correctly determine which combination of drugs will be effective in a particular patient.
How to cure hepatitis C forever?
Is it possible to completely cure HVGS with the help of new antiviral drugs? Yes. But only a well-appointed combination of different interferon preparations can help here. The World Health Organization, based on the results of clinical studies conducted by US companies developing innovative antiviral drugs (Sovaldi and Daklinsy), recommended effective CVHC regimens of different genotypes. If treatment is carried out in accordance with these recommendations, pathology can be completely eliminated in the majority of cases. Modern standard therapy includes two interferon-free drugs with different mechanisms of action. During this treatment, you do not need to take additional hepatoprotectors ("Phosphogliv", "Essentiale", "Ursodez"). But guaranteed to cure the disease forever, only the right combination.
Can chronic hepatitis C be cured?
Cure chronic viral hepatitis C is possible forever! Effective remedies for this disease have already appeared on the market, but the original medicines (Sovaldi, Daklins, Harvoni, Epcluza) are very expensive. The cost of a 12-week course of treatment for them "starts" from 84 thousand US dollars.
There are no federal programs for combating HVGS with the help of new drugs in our country, because such large sums cannot be allocated for each Russian Ministry of Health. But there are regional free treatment programs. Can patients rely on these programs? Alas, for the majority of patients they are not available, because they cover only a small part of patients in whom CVHC is combined with:
- 4 degree liver fibrosis
- cirrhosis of the liver,
- HIV infection.
Under this program, expensive interferon drugs are not prescribed: the therapy is carried out according to old schemes based on interferon and ribavirin, in some regions, for example, in Moscow and the region, Daclins 60 mg can be obtained as part of the program. The remaining patients should rely only on themselves and look for an opportunity to pay for the treatment themselves. Reducing the cost of treatment and making it available to most patients will only allow the replacement of the original interferon preparations with their low-cost counterparts - generics produced by pharmaceutical companies from India and Egypt.
How to cure hepatitis C at home?
The high cost of drug treatment is the main cause of self-treatment of patients. But is it possible to get rid of hepatitis C using folk remedies? Various Internet sites dazzle with miraculous means that will cure people infected with hepatitis C forever. But, alas, there are no miracles: you cannot defeat the virus with any herbs. Also, one should not believe the false reviews of those patients who were cured with hepatoprotective agents (“Legal”, “Essentiale” or “Phosphogliv”). Indeed, these medications are included in the schemes of complex treatment of CVHC, but they do not treat viral hepatitis, but only restore the structure of the damaged liver, increase its resistance to harmful effects, and normalize functions. They are not prescribed for monotherapy, since they do not affect the pathogen itself.
Who cured hepatitis C: reviews
Chronic hepatitis C has long become an epidemic. The number of people newly infected with a dangerous virus is increasing every year. Thus, as of January 1, 2017, the number of sick and carriers of the CVHS virus in the world exceeded 71 million people. And this is only official statistics. Scientists believe that the real numbers are several times larger. Every patient needs hope. Every patient wants to get rid of the hepatitis C virus forever. The situation is quite standard when a person who has learned that he is ill with this pathology, seeks support from those who have been in such a situation and have been able to fully recover. "New" patients are psychologically easier to tolerate the fact of infection when dealing with patients who have had the disease. But to ask the question whether it is possible to completely get rid of the pathology, it is still necessary not to forum users but to competent hepatologists.
Is the chronic virus curable?
There are two forms of HCV: acute and chronic. The first develops a few weeks after infection, but rarely accompanied by any symptoms. In the vast majority of patients, the pathology proceeds without clinical manifestations, gradually reaching the stage of chronicity of the process. But even with a long course of hepatitis C, it is rarely accompanied by a characteristic clinical picture.
Often the patient is concerned only with weakness and fatigue. Contrary to popular belief, HCV usually does not cause a marked increase in bilirubin levels. Therefore, the yellowness of the epidermis is either completely absent or only slightly expressed. Symptoms of hepatitis C occur at the stage of impaired functional activity of the liver tissue.
The prognosis depends on the stage at which the disease was diagnosed. The danger of chronic pathology is the gradual proliferation of connective tissue in the foci of necrosis of hepatocytes. First, these pathological disorders cause fibrosis. Subsequently, these changes cover almost the entire body and become irreversible.
The most severe complication of HCV is hepatocellular carcinoma (liver cancer), which is practically not treated. At the stage of severe violations of the structure of hepatocytes, the only way to restore health is liver transplantation.
Can chronic hepatitis C be cured? Yes, taking prescribed medications is enough. But it is not always possible to restore the structure of the liver. Currently, a lot of effective hepatoprotectors are available, information is provided about the features of the diet and the principles of proper nutrition in HCV, which increases the patient's chances for recovery.
Fully recover from chronic hepatitis C is real only with timely diagnosis and compliance with all recommendations of the attending physician.
Prognosis for concomitant diseases
The liver is one of the main, kind of, body filters. Accordingly, any disease, long-term medication adversely affects the function of the body.
Complicates the course and therapy of hepatitis C the following diseases:
- virus and human immunodeficiency syndrome
- autoimmune pathologies,
- metabolic diseases,
- systemic infections
- lesions of the gastrointestinal tract,
- diseases of the cardiovascular system
- alcoholic hepatitis, fatty hepatosis, liver fibrosis, cirrhosis and other organ pathologies.
Such complications are more common in adults. Children are diagnosed extremely rarely, usually against the background of congenital or acquired in infancy pathologies. These diseases are not a contraindication to the start of antiviral therapy. Some modern medicines can be used even at the stage of decompensated liver cirrhosis.
In the presence of associated pathologies pay attention to the following aspects:
- The possibility of drug combination. For example, the simultaneous use of modern antiviral agents and Amiodarone, some drugs for the treatment of HIV, are contraindicated. Dose adjustment is also required for medicines that reduce the level of acidity in the stomach.
- The state of the immune system may affect the final results of clinical studies.
- The degree of liver damage determines the scheme of antiviral therapy.
When a virus is detected at an early stage, the risk of irreversible disruption of the structure of the organ is minimal (provided there is no alcoholic damage to the liver and fatty degeneration). According to doctors, hepatitis C is successfully treated in adult patients with the help of modern antiviral agents that have a direct inhibitory effect on the replication of the virus.
The overwhelming majority of drugs are metabolized in the liver, which cannot affect both the course of the disease and the effectiveness of targeted therapy. But almost always there is the possibility of selecting safe analogues, which minimizes the risk of complications.
A complete cure for hepatitis C is possible with co-infections and associated diseases.But therapy must be carried out under close medical supervision, including hospitalization if necessary.
Is it possible to cure hepatitis C completely in children?
The pharmacological properties of direct-acting antiviral drugs have been well studied in numerous clinical trials. They were attended by thousands of patients over 18 years of age. But in the summer of 2018, WHO recommendations were officially published regarding the possibility of safe and effective therapy for hepatitis C in children over 12 years old.
In accordance with the new rules, treatment of HCV in adolescents can be carried out with combinations of the following medicines:
|Virus genotype||Used drugs and duration of treatment|
|1, 4–6||sofosbuvir + ledipasvir for 12 weeks|
|2||sofosbuvir + ribavirin for 12 weeks|
|3||sofosbuvir + ribavirin 24 weeks|
Can hepatitis C be cured completely and permanently in young children? Statistics regarding this problem favors a favorable prognosis. However, cases of hepatitis C in infancy require thorough diagnosis.
The probability of intrauterine penetration of the virus into the body of a developing fetus does not exceed 3-5%. But after delivery, an antibody, usually class G, is always detected in the child’s blood. Treatment begins only after the PCR detects the virus RNA. For children younger than 7–12 years old, therapy is carried out with the help of interferons (IFN).
As soon as the age group allows, antiviral agents are added to the IFN, which significantly increases the effectiveness of the treatment. It is difficult to predict the outcome of the disease, but in the absence of aggravating factors and following the recommendations of the doctor, the probability of a positive outcome reaches 100%. In addition, in children and adolescents, hepatitis C rarely causes severe complications, and more often occurs in an asymptomatic form without an increase in viral load.
Structurally, HCV species differ in the order of construction of nucleotides at certain sites of the virus. Genotypes of infection affect the activity and speed of the spread of the pathological process. Types of the disease determine the territorial prevalence of pathology. To date, doctors know about 11 genotypes, but usually diagnose one of the 6.
In Russia, half of the patients are diagnosed with the first genotype, the remaining cases occur in 3, less often 2 genotypes. Others are more common in Asia, North and South America, Africa. The order of the nucleotide chain of the virus determines its susceptibility to the action of antiviral agents.
When interferon and ribavirin were the only drugs for treating hepatitis C, the first genotype almost did not respond to therapy. After the appearance of pangenotypic (universal) drugs, the situation has improved. But coping with this type of infection is also not easy. Some modern combination drugs are designed exclusively for the treatment of the first type of HCV. The remaining genotypes of the virus are more easily treatable.
Before answering the question of whether hepatitis C can be cured, the doctor necessarily performs genotyping - a precise definition of the type of infection with the help of a polymerase chain reaction.
Does viral load affect the prognosis?
Viral load (HV) is also determined by quantitative analysis of PCR. The study allows to accurately assess how many HCV particles (copies of RNA) are contained in a certain volume of blood. Standard units for measuring viral load are IU, the test volume is 1 ml of blood.
Depending on the result obtained, BH can be low, moderate and high. This indicator primarily indicates the activity of virus replication and the severity of the pathological process. However, the principle of application and dosage of the drug does not depend on the level of viral load. But in severe cases, the doctor may recommend an increase in the duration of treatment from 12 to 24 weeks.
VL is measured immediately before the start of treatment, as well as during the treatment process. Reduced performance indicates the effectiveness of prescribed drugs. If the viral load remains at the same level or the parameters increase, immediate consultation with a doctor is required to replace the treatment protocol.
Effective treatment regimens
Doctors prefer to use modern medications of direct antiviral action in therapy. But interferons and ribavirin do not lose their relevance. These funds are prescribed in the presence of contraindications to the reception of targeted agents, or in combination with them in the presence of cirrhosis, or re-infection.
The answer to the question of how to get rid of hepatitis C permanently, is to comply with the recommendations of the doctor regarding medication, diet, lifestyle.
Currently, it is not easy to cure the hepatitis C virus with interferon and ribavirin. But such a scheme is still considered the “gold standard” of HCV therapy. Doctors insist on replacing standard interferons with pegylated, differing in prolonged action. Previously, only the original Pegasys was available on the pharmaceutical market, but now domestic counterparts that do not differ in effectiveness, for example, Algeron, are also available.
Apply the drug as a monotherapy (in the acute form of hepatitis C) or in combination with ribavirin. The standard dose is 0.18 mg per week. Ribavirin is prescribed in a dose dependent on body weight - 1 g each if the weight does not reach 75 kg, and 1.2 g per day with a weight over 75 kg. The number is divided into two steps.
Pegylated interferon α-2b is suitable for use in monotherapy. In this case, the dose is 0.001 mg / kg once a week. In combination with ribavirin, they take in a dosage of 0.0015 mg / kg of body weight weekly.
The duration of treatment is at least 48 weeks. At the same time, the effectiveness of therapy rarely exceeds 60% with a favorable course. In the presence of aggravating factors (cirrhosis, HIV, relapse of the disease, 1 genotype), this figure is 40% or less. For this reason, the combination of peginterferon + ribavirin is now used very rarely in practice.
Direct acting antiviral drugs
Today, in specialized forums there are many topics dedicated to drugs of direct antiviral action. Reviews cured confirm the high efficacy of drugs in this class.
The use of such tools has several advantages:
- relatively short duration of treatment (maximum 24 weeks, minimum - 8 weeks),
- a small list of contraindications (pregnancy, individual hypersensitivity),
- low probability of adverse reactions (refusal of treatment due to severe undesirable effects occurs in less than 0.5% of cases),
- the possibility of optimal selection of a combination of antiviral agents that are as safe and effective for the patient as possible,
- dosage form and mode of use (all modern preparations are made in tablets and drunk 1 time per day),
- the lack of dependence between the state of the liver or kidneys and the pharmacological properties of the drug.
To achieve the complete absence of RNA virus in the body, the doctor prescribes the following medications (or combinations thereof):
It is proved that hepatitis C of the first genotype is cured in the process of applying the combined drug Vikeyra Pak. More recently, a new drug, Maviret, has been registered, which includes a combination of ingredients with antiviral activity.
Sustained virological response (the main indicator of the absence of viral load) is achieved in more than 98% of patients taking modern targeted drugs for the treatment of HCV.
As a rule, the claims that hepatitis C is incurable are related to non-compliance with the recommendations of the doctor. The basis of HCV therapy is antiviral drugs, but the result of their admission can be reduced to zero by errors in diet, use of alcoholic beverages. In addition, the doctor always prescribes hepatoprotectors necessary to stop the development of pathological changes in the liver tissue on the one hand and accelerate the regeneration of hepatocytes on the other.
For this purpose, one of the following medications is prescribed:
- Essentiale Forte,
- Espa-Lipon et al
The course of receiving hepatoprotectors begin even before the start of therapy, when the results of laboratory tests demonstrate liver damage. The use of drugs continues for at least a year.
Mandatory prescribe multivitamin complexes. For the liver, it is important to maintain the balance of macro-and micronutrients, B vitamins, essential amino acids. Progressive tissue damage can be slowed down with antioxidants (tocopherol, retinol, vitamin C).
Complete cure without taking medication
A specific feature of hepatitis C is the frequent asymptomatic course, not only in the chronic form, but also in the acute form. Doctors admit that after infection, the probability of independent resolution of the disease without medical intervention is about 20–30%, depending on the genotype. At the same time, a person is often unaware of the infection. This is demonstrated only by specific antibodies (assuming negative PCR).
Now there are fairly accurate methods of diagnosis, allowing time to "catch" the stage of the chronicity of the process and start therapy. In some cases, if the pathology is detected at an early stage, the decision on treatment is taken after a few weeks. During this time, the doctors evaluate the strength of the immune response and determine whether the person will be able to cope with the disease, and then decide whether to undergo treatment. With the growth of virological load or deterioration of health, immediately begin an antiviral therapeutic regimen.
When using the interferon + ribavirin protocol, the risk of resuming the pathological process was about 30%. The use of direct-acting antiviral drugs has reduced this figure to 5-7%.
The likelihood of relapse increases with:
- previous treatment of liver damage,
- previously diagnosed cases of hepatitis C,
- the first genotype of the virus
- immunodeficiency states.
However, when symptoms reappear, the doctor should differentiate the recurrence of infection from a new infection. But as a rule, the treatment is carried out according to the schemes used to continue the previously conducted therapy.
Anna Sergeevna Danchenko, hepatologist
8 years ago, patients perceived the diagnosis of hepatitis C as a sentence. A similar reaction was also after the appearance of the original antiviral medications - not everyone could pay tens of thousands of dollars for a course of therapy. But generics appeared, even if they are not registered in Russia, but they are quite accessible, and full recovery has become real. The main thing is not to delay the diagnosis and regularly undergo tests for the timely detection of the virus.
Diagnostic signs of recovery
Monitoring the effectiveness of therapy is carried out using quantitative and qualitative PCR. The second study is more sensitive. Therefore, it is advisable to carry out at the end of therapy and a negative result of quantitative PCR. Studies are prescribed for 4, 8, 12 weeks and additionally - for 24 if the treatment course lasts about six months.
The tests are not stopped after the end of treatment. High-quality PCR is performed at 24 and 48 weeks after discontinuation of targeted medication. The fact that the patient is cured, say negative research data. With a positive result of qualitative analysis, the virus is quantified and a decision is taken on the tactics of further therapy.
Is it possible to cure hepatitis C completely
Many people are wondering whether hepatitis is treated or not. If at the end of the last century the answer was negative, now the situation has become more rosy: Hepatitis C can be cured. Therapy of the acute form of the disease occurs successfully, if it is diagnosed in a timely manner. When hepatitis enters the chronic stage, the treatment will be delayed, but the result will also be.
The patient is required to help his weakened immunity: to give up bad habits, from excessive fat in the diet. It is necessary to avoid stress, to respect the daily routine, to make long walks in the fresh air.
Indications for treatment
Cure hepatitis is sometimes obtained independently, without any medication. History knows cases when the patient turned into a healthy person without the help of doctors. The reason for this is a strong immunity. There are quite a few such cases: during a routine examination, every fifth patient is fully recovered.
The first external symptoms can occur only with significant liver damage, the occurrence of liver failure, the development of cirrhosis.
Hepatitis C can be cured, but the decision on the appropriateness of these measures is taken by the attending physician. Drug therapy is justified if:
- the pathology is at an early stage
- too high risk of cirrhosis,
- a steady increase in the blood level of alanine aminotransferase (ALT) was recorded over the course of six months,
- revealed the presence of cryoglobulins.
Features of treatment of different genotypes of the virus
A feature of HCV is its variability, which interferes with the immune system quickly produce appropriate antibodies. It only depends on the viral genotype whether hepatitis is curable. All genotypes have different properties, according to which scientists unite them into groups. For the treatment of each genotype and the scheme used are different, but it can be cured in most cases.
This genotype is widespread, especially frequent in Eurasia. It has more than 20 subspecies. The most aggressive strains include 1b. In Russia, the genotype of virus 1b accounts for 80% of all cases. Its characteristic features are the rapid transformation into the chronic stage and the low efficiency of therapy with interferon preparations (less than 60%). The question of whether hepatitis is treated completely in each case remains open. This is influenced by many factors: the stage of the disease, the presence of other pathologies, the availability of drugs.
At high risk of developing cirrhosis, Pegintron (peginterferon) is more often used in combination with ribavirin, Sofosbuvir and Simeprevir are used in addition to them. Antiferone-free treatment is safe and effective: Daclatasvir is added to Sofosbuvir, in Europe - Velpatasvir or Ledipasvir. Vikeira Pak is successfully used, containing 2 types of tablets: brown with Dasabuvir, pink ones with Ritonavir, Ombitasvir, Paritaprevir. Therapy lasts from 12 (antiviral agents only) to 72 (with interferon) weeks.
Hepatitis C genotype 2 has the same number of subspecies as the first. It is also widespread everywhere, but it is most often found in western Africa, on the Iberian Peninsula. Its difference from 1 is a slow progression of the disease, a rather benign course.
Sometimes (rarely) recombination is observed with other subtypes. In this case, the course of the disease is more severe. In addition to interferon regimens, a combination of Sofosbuvir with Daclatasvir is used, however, the first drug in this case is not combined with Ledipasvir. It takes 12 weeks to heal from the virus.
The ubiquitous genotype 3 has 9 subspecies, it is more common in the countries of the former CIS, on the Indian subcontinent, in southeast Asia.In Russia, this is one of the two most common genotypes: both 3a and 3b. Such hepatitis C is curable, and the chances of a successful outcome are high.
A combination of antiviral agents (Sofosbuvir with Daclatasvir) is used, to which ribavirin is added. The course of treatment takes 12 weeks, the chance for a successful recovery due to the last component increases from 85 to 94%. Interferon regimens are also used. But increasing the duration, as with the first genotype, is usually not required.
This type of hepatitis is characteristic of Egypt and the center of the African continent. In Russia, it is very rare (about 1%). It is not difficult to cure it, since it is possible to permanently get rid of hepatitis C with the help of Sofosbuvir in combination with Peginterferon and Ribavirin. The duration of treatment is 12 weeks, and the effectiveness is 100%.
Other schemes are no less effective: Sofosbuvir / Velpatasvir, Sofosbuvir with Simeprevir or Daclatosvir, the combination of Elbasvir and Grazoprevir. Sometimes inexpensive combination generics are used to treat this type of hepatitis. Their production is established in India. The effectiveness of these drugs is proven.
HCV 5, HCV 6
These and the remaining genotypes are not found in Russia. HCV 5 is characteristic of the Republic of South Africa, HCV 6 is very common in Southeast Asia. The therapeutic guidelines for getting rid of these pathogens of hepatitis are developed by EASL (Association for the Study of the Liver, located in Europe).
These types of hepatitis can be cured with a combination of Sofosbuvir and Daclatasvir for 12 weeks. The combination of these drugs with Ribavirin is required only in two exceptional cases: when associated diseases are diagnosed - compensated cirrhosis or HIV infection.
Antiviral treatment of the liver affected by hepatitis implies a comprehensive disposal of the infection. The effectiveness of therapy increases markedly when vitamins, dietary supplements, as well as hepatoprotectors are included. Hepatitis can be cured relatively quickly.
During and after the main course of antiviral therapy, prescribing vitamin complexes is a necessary measure. This is especially true of the mandatory intake of a group of B vitamins responsible for the successful and speedy recovery of the affected organ. Treatment may be administered intravenously or orally.
In addition to group B, the liver needs vitamins A, C, E. To replenish them, doctors prescribe ascorbic acid, syrup Alvitil, Alphabet, Vitaspectrum, Leviron Duo. Hepatrine detox containing B helps to eliminate the deficiency in the body of group B8and Demoton-B12.
These drugs have protective and restorative functions. They are essential for liver damage from viral activity. Hepatoprotectors help the body to cope with the outflow of bile, quickly evacuate toxins. It is impossible to cure an organ without them.
- Hepadif. Available in capsules or powder. The main component of the drug is carnitine. This substance is involved in the evacuation of fat from the body.
- Hepa-Mertz contains ornithine, which is involved in protein metabolism and the synthesis of urea. Pharmacies sell powder and ampoules.
- Heptral There are 2 dosage forms - tablets, powder (its analog is Geparetta). The active substance is ademetionine, which helps to eliminate toxins.
- Phosphoglive (powders and capsules). Contains phospholipids, restoring the structure of the organ, and glycyrrhizic acid, which suppresses the reproduction of the virus.
- Essentiale forte - capsules. The active ingredients are soybean phospholipids, which help in the regeneration of liver cells.
For the treatment of patients with cirrhosis, plant hepatoprotectors are used, which facilitate the work of the affected organ, accelerating its regeneration. This component of the treatment of hepatitis C must be approved by a doctor.
The following medications can cure hepatitis:
- Bonjigar - capsules, syrup. The preparation contains extracts of barberry, nightshade, tamarix, milk thistle, chicory, licorice roots. The medicine normalizes the structure of damaged cells.
- Galstena - drops or sublingual tablets. The composition contains extracts of dandelion, milk thistle and celandine. The tool has a choleretic, antispasmodic effect, normalizes evacuation function, biliary tract motility.
- Hepabene These capsules contain extracts of two plants - milk thistle and dymyanki. The drug relieves spasms, normalizes the evacuation of bile, accelerates protein synthesis, restores the liver cells.
- Kars - pills, capsules, in which the only active ingredient is dry thistle extract. Due to the stimulation of protein and phospholipid synthesis increases the speed of regeneration processes.
- Liv-52. The tablets contain a variety of herbal ingredients: prickly capers, cassia, black nightshade, tamariks, terminalia (cucbitha), chicory. The drug improves digestion, protects against toxins, stimulates the recovery of organ cells.
Without the support of a weakened immune system, it is impossible to cure the chronic form. Therefore, immunomodulating therapy is used, which is designed to eliminate disruptions in the immune system, normalize and stimulate its effective work. The most effective drugs in the fight against viral hepatitis C are Zadaksin, Timogen, Timalin.
Hepatitis cure will help change habits. The nutrition correction helps to ease the life of the diseased liver, so all patients without exception are prescribed Pevzner's diet No. 5. It limits food intake, which leads to increased secretion of digestive juices. Prohibit fatty, fried, smoked, salty foods, do not allow food canned.
All alcohol is taboo. It is impossible to cure hepatitis without parting from a bad habit. Coffee, strong tea fall into this category. But drinks are not irritating the digestive system. These include compotes, fruit drinks, fruit or vegetable juices. Their daily intake is recommended - the volume of liquid is 2-3 liters.
How much time is hepatitis treated and the liver recovers
Hepatitis C can be cured permanently for 6-12 months, but the patient will be required to strictly follow all the rules. The control of the presence of RNA virus in the body is carried out using a polymerase chain reaction, during which sections of DNA with the pathogen are repeatedly copied.
If the PCR analysis for hepatitis C is negative, antiviral therapy is continued for another 24-48 weeks. Its duration depends on the genotype.
Positive changes appear after several months of treatment. The liver is able to fully recover in 6-8 months.
Complications of the disease and treatment
It is possible to cure the disease, but the danger of hepatitis C in the absence of severe symptoms. This allows the virus to multiply with impunity and destroy the liver. Years later, serious pathologies are found in the patient. The most common of these is cirrhosis of the liver, developing in 20% of patients.
In 30% of cases, hepatitis C is treated without medical intervention.
In 5% of cases it is followed by liver cancer. Now the deadly disease is increasingly developing immediately, without pronounced cirrhotic changes. Therefore, testing for this type of hepatitis should be done in a timely manner to patients. The insurance will allow you either to catch the infection and cure it in time, or to make sure that it is missing.
When treatment of hepatitis C is contraindicated
Drug therapy needs to be started urgently, but sometimes it is contraindicated at all. These cases include:
- recent organ transplant,
- cirrhosis or liver cancer (decompensation stage),
- non-infectious hepatitis,
- age up to 3 years
- pregnancy or her planning,
- hypertension, ischemia, decompensated diabetes.
In all other cases, the optimal course of treatment is prescribed without delay: the less changes are found in the liver tissue, the more effective the therapy will be. It will be possible to cure the diseased organ in a relatively short time.