"In the last 20 years the treatment of hepatitis C has progressed in a remarkable way, so that it has gone from being a disease not well known and for which there was no treatment, to become a pathology with a total cure of more than 50% of cases".
DR. BRUNO SANGRO
DIRECTOR. HEPATOLOGY UNIT
Hepatitis is a group of diseases characterized by inflammation of the liver. Infection by these viruses increases transaminases and only in some cases symptoms appear.
The hepatitis C virus is a virus of the flavivirus family, consisting of a chain of RNA.
There are some variants of this virus, called genotypes, whose behavior can be somewhat different, especially in response to antiviral treatment. Six major genotypes of the C virus are described.
The acute hepatitis C virus, difficult to detect, becomes chronic in 80-90% of cases. Once chronic hepatitis is established, spontaneous cure of the disease is very rare.
The speed of the evolution of this disease depends on the characteristics of each patient, characteristics of the virus itself, and also external factors such as alcohol intake, which greatly accelerates the progression to cirrhosis.
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What are the usual symptoms?
Acute hepatitis, in most cases, does not cause any symptoms and goes unnoticed by the patient and those around him.
There may be nonspecific symptoms such as general malaise, tiredness or nausea, but rarely does jaundice develop, i.e., yellow pigmentation of the skin and mucous membranes, accompanied by dark urine and white or yellowish stools. This acute hepatitis becomes chronic in more than 80% of cases.
Chronic hepatitis C virus is also characterized by very few symptoms over many years, so it is most often diagnosed by chance, when tested for other reasons.
When there are symptoms, the most common are fatigue and mild discomfort in the right side of the abdomen. Some patients may develop symptoms related to diseases associated with the C virus infection, such as skin manifestations, joints, dry syndrome, etc.
Only in advanced stages of the disease, when liver cirrhosis develops, will the symptoms of this pathology and its complications appear.
What are the most common symptoms?
- General malaise.
Do you have any of these symptoms?
You may have hepatitis C
What are the causes?
Hepatitis C virus is mainly transmitted by what we call parenteral route, that is, through blood transfusions and blood products (currently with a minimal probability due to detection measures, but very frequent before 1990) and punctures with contaminated material (tattooing, piercing or dental manipulations before the introduction of good hygiene measures).
This virus can be transmitted through sexual relations, but with a very reduced effectiveness, so the incidence of this disease in spouses of patients infected by the virus C is very close to that of the general population.
Can it be prevented?
Blood banks test all samples for hepatitis C virus infection, so the spread has been greatly reduced in recent years.
Avoiding syringe sharing and applying reasonable hygiene measures in all practices involving contact with blood can virtually eliminate this route of transmission.
With these measures, the incidence of hepatitis C in younger generations has been drastically reduced in the developed world. Unfortunately, there is still no vaccine to prevent infection by the C virus.
How is it diagnosed?
The data that initially leads to the diagnosis is the increase in the blood levels of transaminases, enzymes that are released into the blood by cell death produced by the inflammation of the liver.
The elevation of transaminases can be very important in acute hepatitis, and is mild or moderate in chronic hepatitis.
From there, the diagnosis is completed with other analytical determinations that will also help find the cause of hepatitis and determine its severity and prognosis.
For a definitive diagnosis, in many cases it is necessary to perform a liver biopsy.
How do we treat it?
Hepatitis C infection is treated with antiviral drugs designed to rid the body of the virus. The goal of treatment is to ensure that no hepatitis C virus is detected for at least 12 weeks after treatment is completed.
Due to the pace of research, drug recommendations and treatment regimens are changing rapidly. Therefore, it is recommended that you consult with our specialists for the best treatment for you.
Recently, researchers have made significant advances in the treatment of hepatitis C using new "direct acting" antiviral drugs, sometimes in combination with existing ones. As a result, better results are achieved with fewer side effects and shorter treatment periods. The choice of drugs and duration of treatment depends on the hepatitis C genotype, the presence of existing liver damage, other conditions, and previous treatments.
In cases where treatment is not effective and the disease progresses to the development of liver cirrhosis and its complications, the only possible treatment is liver transplantation.
Research into new treatments for the C virus is very active.
New antiviral drugs, such as protease inhibitors, are currently undergoing clinical trials and are likely to increase the cure rates of the disease in association with other drugs such as peginterferon and ribavirin.
The different forms of immunotherapy, the therapeutic vaccines, allow us to be confident that in the near future it will be possible to fight this disease more effectively.
Where do we treat it?
IN NAVARRE AND MADRID
The Hepatology Unit
of the Clínica Universidad de Navarra
We are pioneers in the application of gene therapy in the treatment of liver tumors and hereditary metabolic diseases, and we have extensive experience in the diagnosis and treatment of viral hepatitis and in the treatment of liver cancer using radioembolization systems with Ytrium-90 microspheres.
The Clinic is at the forefront in Spain in performing liver transplantation between living people.
Diseases we treat
Why at the Clinica?
- Highly specialized team of professionals with more than 25 years of experience.
- Nursing team specialized in hepatic patients.
- Important research activity on the molecular mechanisms that cause some of these diseases.