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Hepatitis C and B

Гепатити B і D

Hepatitis B is an infectious disease caused by the hepatitis B virus (HBV) that damages liver causing its inflammation, which is called hepatitis.

Hepatitis B virus influences the functions of the liver replicating in its cells that are called hepatocytes. Hepatitis B can be acute (self-limited) or chronic (long-term). Patients with self-limited infection recover in three weeks or months.

Over 95% of patients who were infected by the virus in the adulthood make a full recovery and develop a protective immunity against the virus. However, this probability drops to 30% in smaller children, and only 5% of newborns that were infected by their mother in the process of childbirth get rid of the virus. With a 40% probability, these people will die of cirrhosis or hepatocellular carcinoma. 70% of those infected in the age from 1 to 7 will discard the infection.

According to the estimates, 350 million people of the world were infected in 2004. National and regional spread varies from 10% in Asia to less than 0.5% in the USA and Northern Europe. Ways of contagion include vertical transmission (at birth), horizontal transmission in the early years of life (bites, injuries, and sanitary habits), and horizontal transmission in adulthood (sexual contacts, intravenous injection of preparations).


Hepatitis С

Hepatitis C is an infectious disease caused by hepatitis C virus (HCV) that damages mainly the liver. Infection is often asymptomatic, however, chronic infection leads to fibrosis and, eventually, cirrhosis or liver cancer (hepatocarcinoma). Transmission takes place parenterally due to virus penetration into blood during intravenous injection of drugs or blood transfusion because of using poorly sterilized medical accessories. The virus is preserved in the liver of about 85% of infected people. Usually, hepatitis C is treated by long-term combined anti-virus therapy, and 50-80% of people undergoing such treatment recover.

According to some estimates, 130-170 million people in the world are infected by hepatitis C.

Hepatitis C is often asymptomatic, but chronic infection may cause fibrosis, and in several years - cirrhosis. If cirrhosis progresses, liver failure occurs, and cancer/cirrhosis of liver may develop. Dilatation of esophagus and stomach veins may cause fatal bleeding.

Pegylated interferon and ribavirin are the standard HCV medications. Patients with cirrhosis or liver cancer require liver transplantation, however, the virus usually recurs after transplantation.

According to the WHO, Ukraine belongs to the countries with the average spread of hepatitis C: approximately 3% of the population, i.e. 1,170,000 people, are infected. However, the results of selective monitoring of risk groups showed that the level of infection by hepatitis C in some of them exceeds the average indicators and reaches 40-60%.

According to the negative influence on the health of the population and the extent of incidence, viral hepatitides dominate in the structure of infectious pathology in Ukraine along with flu and acute infectious diseases of the upper airways.

A tendency to increase in the incidence of viral hepatitis C, including cases of chronic forms of the disease, has been noticed over the last years. According to WHO, approximately 150 million people suffer from chronic hepatitis C, and 350 thousand people die annually due to liver damage by hepatitis C virus. Disease incidence and lethality resulting from hepatitides B and C have been increasing progressively on the planet, and, according to the experts, will double by 2015-2020. Even now, the general number of patients with hepatitides in the world is 14-15 times bigger than the number of HIV-infected people. Viral hepatitides are 50-100 times more contagious than HIV.

Viral hepatitides with blood-borne causative agent transmission mechanism, and mainly hepatitis C, are a pressing problem of contemporary medical science and applied healthcare in all countries of the world. It is caused by wide spread, high level of incidence, extensive polymorphism of clinical signs, numerous ways and factors of causative agent transmission, as well as extremely adverse outcomes of the hepatitides like chronic liver damage, including cirrhosis and hepatocellular carcinoma.

According to WHO evaluation data, 57% of liver cirrhosis cases and 78% of primary liver cancer are caused by the influence of hepatitides B or C viruses. In addition, hepatitides B and C have many extrahepatic manifestations, which complicate their diagnostics and can impede prescription of the adequate treatment.

Viral hepatitis C. Adapted clinical guide based on evidence to the Decree of MOH of Ukraine No. 233 of 02.04.2014

Unified clinical protocol of primary and secondary (specialized) medical assistance to adults and children with viral hepatitis C.