When to seek evaluation from gastroenterology doctors Overview Chronic hepatitis caused by the hepatitis C virus (HCV) is a public health problem worldwide since it affects a large number of people and leads to terrible complications that put at risk the quality of life of patients, so It is therefore very important to carry out an early diagnosis through the establishment of an adequate screening system in order to apply timely treatment and reduce the morbidity and mortality associated with this disease.
Hepatitis C
Infection with the hepatitis C virus (HCV) represents one of the main causes of liver disease and a potential cause of significant morbidity and mortality worldwide. It is estimated that approximately 3% of the world population is infected with this virus, which is transmitted mainly through sexual contact and parenteral route, which includes the use of injectable drugs, blood transfusions, and unsafe injection practices. HCV causes acute hepatitis whose symptoms often go unnoticed; however, approximately 80% of infected people gradually develop chronic hepatitis. Several scientific studies have proven that 60% of people with chronic infection with hepatitis C virus develop liver cirrhosis. In addition, it is estimated that 5% of individuals with advanced fibrosis or cirrhosis develop hepatocellular carcinoma in a period of 5 years (1).
The treatment of chronic hepatitis C has advanced a lot in recent years, achieving a high percentage of cure in people receiving treatment in the early stages of the disease. The elimination of HCV prevents progression to cirrhosis and the development of hepatocellular carcinoma. Nowadays, once the diagnosis of hepatitis C is made, patients can receive a highly effective treatment that improves their life expectancy free of complications.
It is imperative to make an early diagnosis of HCV infection in high-risk populations so that they can benefit from antiviral therapy
Risk factor’s
- Intravenous drug use
- Patients who received blood transfusions or organ transplants before July 1992.
- Patients who have received hemodialysis
- Children born to an HCV-positive mother
- Sexual risk behavior
- Have an infection with the human immunodeficiency virus (HIV).
- Persons who have suffered needle-stick injury or mucosal exposure to HCV-positive blood (health care personnel, medical emergency, and public safety).
HCV screening
At present, it is recommended to perform the screening of hepatitis C in those people who have high-risk factors of contracting the hepatitis C virus (HCV). Also, because in the USA UU 76% of patients infected with the hepatitis C virus were born between 1945 and 1965 (population known as Baby Boomers) the US Prevention Services Task Force (USPSTF), the Centers for Disease Control and Prevention (CDC), and the American The Association for the Study of Liver Diseases (AASLD) recommends carrying out HCV screening in this group of patients once in a lifetime, regardless of the risk factors they may present.
Screening should be done through the detection of HCV antibodies by the ELISA method of 4th generation. This method has a sensitivity of 98% and a specificity of 100%. A sensitivity of 98% indicates that the test can detect at least 98% of people who have been exposed to hepatitis C virus. A specificity of 100% indicates that 100% of people without hepatitis C had a screening test negative. It is important to bear in mind that a positive result does not mean that the individual currently has the disease, it only indicates that he was previously exposed to the hepatitis C virus. In the case of a positive result, a test for the detection of viral RNA should be performed. If the detection is positive, this indicates that the individual is a chronic carrier of HCV(2).
Conclusions
The early diagnosis of chronic hepatitis C through the establishment of a screening system in high-risk patients allows us to establish an adequate treatment that prevents the progression of the disease to liver cirrhosis and/or liver cancer, which undoubtedly allows improving the quality of life and prolong the life expectancy of these patients. The newest guidelines suggest that anyone over the age of 50 get checked! https://www.cdc.gov/hepatitis/hcv/guidelinesc.htm. Le tour team of experts at Gastroenterology of Greater Orlando help you. You can check out our website to learn more https://greaterorlandogi.com