How to treat hepatitis C

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With medical advances in technology, many new developments hepatitis treatment, today saw the newspaper and television news reported new chronic hepatitis C treatment clinic will encounter several patients ask: Do you have this hospital Drugs do? Are there any side effects? When should I treat it? When to stop it? Will not heal it? In fact, these are very real, but not the three words two languages ​​will be able to understand the problem.
 Preparation before treatmentComes to the treatment of hepatitis C, we must first understand the diagnosis and assessment of hepatitis C virus infection method. There are three types: (a) detection of serum anti-hepatitis C virus antibody (Anti-HCV); (two) Detection of serum hepatitis C virus RNA (HCV-RNA); (three) liver biopsy pathology . Detect antibodies in the side aspect, mainly using enzyme immunoassay to detect whether subjects serum antibodies to the virus exists, the current health Neiliao institutes and Blood Center is through this method, blood samples for people to do routine inspection. Note that this anti-hepatitis C antibody positive significance represented subjects infected or infected with hepatitis C are now, and more than seventy percent of chronic infection. Such testing is mainly used in the preliminary examination and a large number of screenings.In addition, the detection of viruses, it is the use of molecular biology methods to detect the presence of virus in the blood. This test method, as long as there is a small amount of serum to test out virions, a high degree of sensitivity and accuracy. And the virus in the patient's body can provide qualitative, quantitative and genotype testing information, which will contribute to the choice of treatment and treatment outcome evaluation. Therefore, generally considered in patients receiving antiviral treatment recommendations such checks to determine whether it is necessary to accept antiviral therapy. This check is also acceptable antiviral determined before treatment and duration of treatment, and assess treatment efficacy is very important basis.Pathological examination of liver biopsy to confirm the diagnosis of chronic hepatitis is the only basis on which assess antiviral treatment regimens indicators. Of liver tissue from a patient can clearly understand the severity of inflammation of the liver and liver fibrosis. Completion of the above three checks whether the patient can understand need antiviral treatment.If after checking the above three equally important assessment of patients who received antiviral therapy when needed, then arrangements shall be further interrogation history, physical examination, white blood cells, red blood cells, platelets, ECG, fasting glucose, thyroid function, kidney function, liver function, autoimmune antibodies, urine, alpha fetoprotein, abdominal ultrasound and other tests to rule out interferon and ribavirin (Ribavirin) of contraindications, before starting treatment.In general, people with significant systemic infection, major mental or brain disease, poor control of diabetes or thyroid dysfunction, significant autoimmune disease, severe liver function decompensation bad or cardiovascular disease patients and pregnant women, etc. not suitable for the interferon and ribavirin combination therapy. In addition, heart disease, renal insufficiency, white blood cells, red blood cells or platelets are low, the use of interferon and ribavirin combination therapy care must be taken when, like Shen.
 How to treat chronic hepatitis C? How effective?Existing chronic hepatitis C viral efficacy are judged by the sustained response (sustained virologic response, SVR) based, generally defined as the end of treatment, and treatment of patients six months after the end of the hepatitis C virus nucleic acid in serum showed negative, it is determined that the success of the treatment; do not meet the above criteria is considered non-sustained viral response, which is not a successful outcome.Especially if the virus continued to reach sexual response that the virus does not recur, can be considered cured. However, there are sporadic reports found that a very small number of patients reaching viral Although the sustained response, but the virus is still twelve months after the end of treatment relapse.Treatment of liver diseases currently used drugs, such as oral medication or liver and gallbladder drugs may be able to promote liver function, hepatitis C virus but no effect. The only proven and approved anti efficacy of hepatitis C virus is influenza A (alpha) interferon (a-Interferon), and ribavirin (ribavirin) is confirmed and approved interferon alpha have strengthened anti-hepatitis C virus effect. Its treatment of chronic hepatitis C virus is mainly transmitted by direct killing effect and enhance immune function and other two effects-based turn fulfilled. Alpha interferon and ribavirin consolidation of HAART is the treatment of chronic hepatitis C, the most effective therapy is recognized worldwide as the standard therapy.With the advancement of medical technology to interferon-based therapy also progress. From the 1980s onwards, interferon treatment was found to have hepatitis C effects to conventional interferon three million units subcutaneously three times weekly treatment for six months to a year, about 8 - 20% of people can be reached sustained viral response, which is only about two percent of patients effectively.If a dose increase to six million units, three times a week treatment for six months to a year, the effect can be increased to about thirty to forty percent or so. Subsequently, the new approach to the treatment of antiviral ribavirin (Ribavirin) and interferon combination HAART greatly improve the efficacy of chronic hepatitis C, ribavirin is a synthetic analogue of guanosine, its role may widespread antagonism viral nucleic acid.Interferon 3-6000000 units subcutaneously three times a week, combined ribavirin 800-1200 mg per day, were treated for six months to one year, may be the treatment of chronic hepatitis C is more effective to improve to about 50 - 55% . Recently, biotechnology, polyethylene glycol (polyethylene glycol, PEG) molecules on interferon, it lengthens the effect in the body, just one week injections once to maintain efficacy, the so-called long-acting interferon (Pegylated interferon).Studies have shown that pegylated interferon combined with ribavirin, treatment six to twelve months, could further improve the efficacy of the treatment to 65-70%. Therefore, pegylated interferon combined ribavirin of HAART has become recognized worldwide as the treatment of choice for chronic hepatitis C and standard therapy.According to domestic and international studies have shown that pegylated interferon combined with ribavirin for chronic hepatitis C patients infected with the efficacy of the hepatitis C virus genotype, pre-treatment of hepatitis C virus concentration, the degree of fibrosis of liver tissue are closely related, the most important is the hepatitis C virus genotypes.Infected with viral genotype non-1 type were its efficacy up to 90-95%; while genotype 1 infection by about 50% of its efficacy. Before treatment, the higher the concentration of hepatitis C virus, its treatment less effective. Before treatment of liver fibrosis in more severe cases, especially in patients with liver cirrhosis, its therapeutic effect is also poor. Others such as age, higher in patients with diabetes and heavier body weight may also affect treatment.So now the world on the treatment of chronic hepatitis C are recommended: (a) genotype 1 infection who pegylated interferon combined with ribavirin year of treatment; (two) virus genotype non-type 1 who pegylated interferon combined with ribavirin treatment for six months. The latest report also pointed out that most of the type 2 virus genotype in patients, pegylated interferon combined with ribavirin 16 weeks of therapy can achieve good results!In addition, patients with blood during treatment of hepatitis C virus concentration decreased extent and efficacy are also relevant. In general, the treatment of blood in full four weeks of hepatitis C virus RNA negative by means that if a good response to treatment, if the full twelve weeks when the treatment of hepatitis C virus in blood nucleic not show negative, or less than one hundred times the concentration decreased that the treatment is not good. Therefore, patients with blood during treatment hepatitis C virus nucleic acid can be used as therapy monitoring of indicators, and duration of treatment planning reference.
 Treatment Side EffectsInterferon and ribavirin use of two drugs will cause side effects. Injections of interferon common side effects include: fatigue, tiredness, muscle aches, chills, headache, poor appetite, nausea, diarrhea, irritability, depression, lack of concentration, emotional instability, insomnia, rashes, and bone marrow suppression injection part The resulting white blood cells, red blood cells, or platelets low blood counts.Also occasionally produce thyroid dysfunction, hair loss and so on. However, most of the side effects are tolerable or by taking drugs, such as acetaminophen, etc., have been alleviated, only a small part of the patient to tolerate due to side effects which can not be controlled or reduced dosage or termination of therapy. As for the side effects of hair loss usually occurs in the first three months of treatment onwards, will not fall out, and almost three months after stopping long back into shape.Taking ribavirin common side effects include: hemolytic anemia, low hemoglobin, skin itching, skin rash. Occasionally there will be nasal congestion, cough, sore throat and breathing difficulties and other symptoms. Anemia is the main reason for reduction of ribavirin, about 20 to 40% of patients during treatment because of anemia and ribavirin dose must be lowered, but rarely severe enough to require discontinuation of treatment. Hemoglobin decreased to four weeks before treatment is most obvious. If after treatment, about four to eight weeks after recovery or stable. The general approach to cut ribavirin dose based. In addition, injections of erythropoietin (Erythropoetin) can stimulate human bone marrow function, improve anemia and reduce the chance Leiba Wei reduction or withdrawal. General recommendations hemoglobin concentration is preferably maintained at 10 g / dL or more, at least at 8 g / dl or more; But in patients with heart disease shall be particularly careful, hemoglobin concentration is preferably maintained at 12 g / dL or more. Skin itching and skin rashes are also common side effects ribavirin, especially in the dry skin and the winter is particularly evident. Generally not recommended to wash the hot hot bath after bath rub moisturizing lotion. Symptoms can Cayao on the affected area or take medications to control locally.Special attention is that ribavirin may cause birth defects may be, it is not recommended for use during pregnancy, therefore, not only in the treatment of women before pregnancy test or inquiry to be made sure that no pregnant women and treatment of patients before treatment period shall have in place sound contraceptive measures. General recommendations, both men and women, the best six months after the withdrawal line considering pregnancy.Overall, the use of interferon and ribavirin may lead to many side effects, but most of the side effects are tolerable, and some can rely on drugs to be avoided or eased. In general, younger patients not only better treatment, treatment side effects are also a lot less. Therefore, physicians encourage patients to receive treatment as soon as possible.
 How to complete the full course of treatment for hepatitis CCurrently the treatment of hepatitis C varies from four months to more than a year, or even a year or more, combined with interferon-ribavirin therapy, although the efficacy of good, but not every person suitable for the treatment, and treatment will produce Many side effects. Therefore, the treatment must have a professional specialist of prudent management of public assessment, treatment and after treatment should have an excellent track evaluation system.In the treatment of the first one or two months, the best back to the clinic at least once every two weeks, and then back to the clinic once every four weeks until six to twelve months after the end of treatment. Treatment period should be based on the results of periodic inspection and condition as the basis, under the direction of a physician, timely adjustment of drug dosage and control side effects. During treatment should avoid strenuous exercise, such as hiking, climbing a ladder too much, or too large consumer Mao physical activity, it is best avoided.Hepatitis C patients receiving treatment decision, you should first do the inspection and preparation before treatment, adequate mental construction, re-entering the treatment of hepatitis C; soon after starting treatment, fully cooperate with the physician, back to the clinic on time, accepting Drug treatment and follow if you have any questions, immediate and medical communication and consultation, by accepting the integrity of antiviral therapy is to determine the efficacy of a very important factor, such as to complete the full course of treatment for hepatitis C accepted, it will certainly increase their chance to defeat the hepatitis C virus.