Diagnosis and Treatment Help of HCV in Pakistan

HCV

Hepatitis C is a liver disease caused by the hepatitis C virus (HCV). It is the most common chronic bloodborne infection in Pakistan.
 During the year 1995, people started to know about this disease in Pakistan an started checking in blood sample. Immediate after these years, all the blood banks and other screening center started checking this disease.
GCC,Gulf Countries Council also made it mandatory to check for this disease before going for work to these countries. This also helped people come to know about  threat of this disease in Pakistan.
Now it is estimated that about 8% to10% people in Pakistan are infected by this virus.
Some of those infected with hepatitis C are able to clear the virus from their blood within about 6 months from the time of infection. However, about 75% of people with hepatitis C infection do not get rid of the virus and therefore have chronic (long-term) hepatitis C. Chronic infection can lead to serious liver problems, including cirrhosis (scarring of the liver) or liver cancer.

How is it transmitted?

Hepatitis C is primarily transmitted by direct contact with blood. The most common ways are:

• Contact with HCV-infected blood through sharing of needles or other injecting equipment during intravenous drug use that have not been properly cleaned between users. At present, injection drug use is the most common risk factor for contracting the disease.
• Organ transplants and blood transfusions prior to 1992.
• Sexual contact. Hepatitis C can be spread by vaginal or anal sex, but this does not occur very often. Factors found to be associated with sexual transmission of HCV are: sex with multiple partners, presence of other sexually transmitted diseases, or sex with trauma (for example, rough sex, rape, or sexual abuse).Transmission through oral sex has not been documented.
• Hepatitis C may be passed from an infected mother to her baby. Neonatal transmission may occur at birth if the mother is infected. The rate of infection is the same regardless of method of delivery (Caesarean section or vaginal). There are no recommendations to avoid pregnancy or breast-feeding if infected with HCV, because transmission of HCV infection through breast milk has not been documented. However, if nipples are cracked or bleeding, hepatitis C-infected mothers may not want to breastfeed because of increased risk.

What are the symptoms?

Most individuals with hepatitis C (70-80%) do not have signs or symptoms. Liver disease progresses so slowly that a person can have hepatitis C for years without having symptoms. Many individuals with chronic hepatitis C have mild to moderate liver damage but do not feel sick. The possible symptoms for an acute infection (newly acquired or short-term) and a chronic (long-term or persistent) infection are different.

Acute Infection (newly acquired)

• Often, people with an acute HCV infection have no symptoms.
• Some people with an acute HCV infection will have jaundice (a yellowing of the skin and eyes) or mild flu-like symptoms.

Chronic Infection (persistent)

• Most people with chronic HCV will have only mild to moderate liver disease. Symptoms of this may include: jaundice, fatigue, loss of appetite, nausea, or malaise.
• Most people with chronic infection have abnormalities in liver enzyme levels that can fluctuate widely.
• If a person develops cirrhosis (scarring) of the liver, symptoms and signs may be more prominent. In addition to fatigue, symptoms may include muscle weakness, poor appetite, nausea, weight loss, itching, dark urine, jaundice, fluid retention, and abdominal swelling

• How is hepatitis C diagnosed?

  
  There are several blood tests that can be done to determine if a person has hepatitis C. If you think you've been exposed or infected with HCV, talk to your healthcare provider. They may order one test or a combination of tests. You and your healthcare provider can discuss whether your sex partner(s) need to be tested for hepatitis C.
  
  

  • The only FDA-approved tests are anti-HCV tests. These tests look for antibodies to HCV in the blood.
  • The average time it takes for a person infected with hepatitis C to develop antibodies to the virus is 8-9 weeks after exposure. Most people will develop the antibodies by 6 months, but it can take up to 12 months. If you believe you have been recently exposed to hepatitis C and the test comes back negative, consider retesting at a later time.
  • RNA tests are able to detect the presence or absence and amount of HCV in the blood. These tests are not FDA-approved, although they are commonly used for research purposes. With these tests, it is possible to find HCV in the blood within 1 to 2 weeks after being infected with the virus.
  • People with hepatitis C should be evaluated for the presence and severity of chronic liver disease and possible treatment. Talk to your health care providers for specific recommendations. The degree of liver damage may be determined by: Liver function tests, which tests to see if enzymes are higher than normal levels, which indicates damage to liver cells; ultrasound, which tests for signs of liver damage and cancer; or, liver biopsy, to detect signs of liver damage and cancer.
  • None of the available tests to detect hepatitis C virus or its antibody can tell the difference between acute or chronic infections.
  • People who clear the virus from their bodies may still have antibodies to hepatitis C virus in the blood for many months.

  Testing is recommended for:

  • People who ever injected illegal drugs (including those who injected once many years ago).
  • People who were notified that they received blood from a donor who later tested positive for the hepatitis C infection.
  • People who received blood transfusions or organ transplants before July 1992.
  • Healthcare professionals if exposed to HCV-infected blood.
  • Children born to HCV-infected women.
  • People who used kidney dialysis (a process for people with kidney failure, in which excess water and waste from the blood are removed and purified).
  • Persons who received clotting factor concentrate produced before 1987.
  • Persons with signs or symptoms of liver disease (for example, abnormal liver enzyme tests).

  Routine screening for hepatitis C is not recommended for:

  • Healthcare providers
  • Pregnant women
  • Household contacts of HCV carriers
  • The general population

  How is hepatitis C treated?

  
  Treatment may differ depending on the stage of illness at the time treatment is sought. Your health care provider can help you make the best decisions about your treatment based upon your individual health needs.

  Acute (newly acquired):

  • People with acute viral hepatitis experience a self-limited illness (one that runs a short course) and go on to recover completely.
  • Relatively few people seek medical care for acute hepatitis C, since most people are have no symptoms or have only mild, flu-like symptoms.
  • There are no restrictions on diet or activity, although alcohol use may be restricted.
  • New studies indicate that treatment with interferon shortly after infection with HCV may be effective in reducing the risk of chronic infection and liver disease. Contact your healthcare provider for more information
  • Consult your healthcare provider before starting any new medications, including over-the-counter or herbal remedies.

  Chronic (persistent):

  Treatment options for people with chronic HCV and/or liver damage include:

  • Treatment with interferon alone:
  • alpha interferon or a new, longer-lasting interferon called pegylated interferon.
  • Combination therapy with interferon and ribavarin. In most cases, combination therapy is more effective than interferon alone.
  • Your healthcare professional may know of therapies in the clinical trial stage for which you may be a candidate. Discuss these possibilities with your healthcare provider and let him or her help you make the best healthcare choices for you.

  Drugs used to treat hepatitis C are not licensed for persons under 18 years of age. Children with hepatitis C should contact a children's specialist in liver diseases

Advice for healthy people who might have HCV virus n their blood in Pakistan.
1. Go to an nearest collection center of Sahukat Khanum, Agha Khan , Zeenat lab or Chugthai Lab ask for routine Liver Function tests, commonly know as LFTs.
These tests will cost approximately Rs.1000.
Or go to any near govt healthcare center like THQ DHQ or any teaching hospital and get your check up by GP if you feel loss of appetite or ay stomach related problem or fatigue.Your tests will be done free of cost.
The get the screening test for HCV and HBsAG, it will also cost abut Rs.500.
If this is also positive, go for HCV ,PCR test, this will cost Rs2200.
If it is also positive or the disease s showing in the blood then go to some Gastero  doctor in your district and get the free treatment from DHQ, the government has given free funds to all the 36 districts for the treatment of this disease.
 This was a simplel guide to treat and manage HCV.you can get information abut doctors in Pakistan from any other website like
http://www.pakdoctors.info/doctors.htm
 The message was published keeping in view the Hepatitis Day.