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- The third genotype and its subtypes: features
- Third genotype: methods of transmission and clinical picture
- Diagnostics
- Third genotype: treatment
- Adverse reactions
- Recovery prognosis
Hepatitis C is a viral infection that affects liver cells. The virus genome is constantly mutating. Today, experts distinguish six varieties of hepatitis C. Each genotype has several subtypes: they are labeled in Latin letters. Hepatitis C genotype 3 is detected in 36.3% of those infected. In Russia, only subtype 3a is diagnosed.
The third genotype and its subtypes: features
The first genotype of hepatitis C has long been considered one of the most dangerous and severe. All the rest, respectively, were classified as lighter. However, if we compare hepatitis C of the 3rd genotype with any other, including the first, it becomes clear that this pathology has many factors that complicate the course. Since HCV subtypes have several significant differences, each requires a specific therapeutic approach.
The causative agent of viral hepatitis, regardless of type, kills liver cells: connective tissue is formed in their place. Gradually, there are more and more scars, the functionality of the gland decreases, cirrhosis of the liver begins to develop.
The rate of liver damage depends on the age of the person, his state of health and the genotype of the disease.
The third genotype of hepatitis C (both 3a and 3b) is different:
- A high rate of fibrosis formation: on average, it is able to affect the liver in 21.8 years, and in the first subtype - in 28.3 years;
- The rapid progression of steatosis (accumulation of fats) in the gland: for the same period of time in patients with the 3rd genotype, 73% of tissues are affected, with the first - about 50%;
- A low degree of susceptibility to treatment with antiviral drugs and, as a result, a longer course of therapy;
- The rapid development of cryoglobulinemia - causes the accumulation of sediment of serum proteins in blood vessels;
- Rare cases of extrahepatic manifestations.
Hepatitis C 3a is a more common form than 3b. The latter is not only rarely diagnosed, but also proceeds in a completely different way.
Why each hepatitis C genotype has its own clinical picture, experts cannot say for sure yet. Today, chronic hepatitis is being fought with a new generation of medicines: these drugs affect only the causative agent of the disease. But in order to choose the right means of directed action, it is necessary to correctly determine the genotype.
Third genotype: methods of transmission and clinical picture
Most often, infection occurs through contact with the blood of an infected person. Also, the pathogen can be transmitted from a sick mother to an infant during childbirth or in utero. You can get sick with unprotected intercourse, using someone else's razor, toothbrush and poorly sterilized medical instruments. Airborne infection with the third genotype of viral hepatitis cannot occur.
As soon as the viral agent enters the human body, its mutation begins. The immune system stops recognizing and destroying foreign RNA. To choose the right treatment, it is necessary to determine the genotype of the virus: for this, genotyping is carried out.
There are no specific manifestations that would relate specifically to the third genotype of hepatitis C. An infected person complains of the appearance of:
- Fatigue, weakness, depression, depressed mood;
- Headaches, dizziness;
- Increased body temperature;
- Joint and muscle pain;
- Nausea, vomiting.
Hepatitis C is not in vain called a gentle killer: an asymptomatic disease causes the development of irreversible changes in the liver.
Clinical symptoms begin to appear only after the death of 50% of the cells of the gland:
- There is pain in the right hypochondrium, nausea and vomiting;
- Yellowing of the skin, whites of the eyes and mucous membranes;
- There are veins on the abdomen and itching on the skin;
- Faeces brighten and urine darkens;
- The patient becomes aggressive and irritable;
- Appetite disappears.
The third genotype of viral hepatitis C is not characterized by specific symptoms. However, it is distinguished by a very short interval between the absence of a clinic and the occurrence of complications.
Diagnostics
To identify the hepatitis virus in the blood, use the following methods:
- Linked immunosorbent assay;
- polymerase chain reaction;
- Immunoblot.
ELISA is a serological method that allows you to detect not HCV itself, but the antibodies of the immune system that it produces against it. The intensity of the immune response and the avidity of the complexes formed during the struggle (the degree of connection between globulin and antigen) show how long a person has been infected. ELISA will be positive no earlier than six weeks after infection.
PCR (qualitative and quantitative) allows you to identify the virus and assess the viral load. The result of the analysis does not show the immune response to the infection, but the RNA of the pathogen itself. Also, this test is necessary for genotyping, that is, determining the genotype of the virus.
With the help of a serological test and PCR analysis, the presence of hepatitis can be absolutely accurately detected. If the results of the studies are in doubt, a biopsy of the gland is performed to examine the biopsy under a microscope.
To assess the patient's condition, you need to get the results:
- Complete blood count (markers of pathology are an increased level of leukocytes and a reduced level of platelets);
- Biochemical analysis of blood (the presence of pathology is evidenced by an increase in the level of liver enzymes ALT, AST and bilirubin);
- Coagulograms.
Additional methods for examining the gland include ultrasound, MRI, CT. If the liver is inflamed, then its echogenicity and size will be changed.
Third genotype: treatment
As soon as the genotype of the virus and the level of viral load are determined, the patient will be prescribed treatment. There is no single therapy regimen to combat the third genotype of hepatitis C: medications are selected individually, taking into account the duration of the viral process, the presence of concomitant diseases, the severity of clinical symptoms and liver tissue damage.
A few years ago, interferons and Ribavirin were used to treat the third genotype. The course of therapy was long, which often led to side effects, adversely affecting the functioning of the liver and pancreas.
In 2010, specialists changed their approach to the treatment of hepatitis. To destroy the virus, targeted drugs began to be used: Daclatasvir, Ledipasvir, Sofosbuvir and their generics. Also, hepatitis C of the 3rd genotype is successfully treated with the drug "Maviret", which includes glecaprevir and pibrentasvir.
Medicines are quite effective: they destroy the causative agent of hepatitis, prevent the occurrence of relapse, and allow the patient to be completely cured. Unfortunately, these drugs have a big disadvantage - they are very expensive.
The cost of a course of therapy is more than $100,000. However, the emergence of generics could reduce this figure by 50 times. Viral hepatitis cannot be cured with folk remedies.
Adverse reactions
Long-term use of "Ribavirin" and medicines with interferon adversely affects the work of the respiratory, cardiovascular, digestive, nervous systems, liver, skin, thyroid and pancreas. Patients taking these drugs often complain of:
- severe weakness and dizziness;
- Anemia and tachycardia;
- Bouts of coughing and shortness of breath;
- Noise in the ears and visual disturbances;
- Tearing and hair loss;
- Spots and rashes on the skin;
- Problems with the prostate in men and with the menstrual cycle in women;
- Decreased libido.
Often, in the results of the very first tests after the start of therapy, hormonal changes in the body (both in men and women) and malfunctions in the functioning of the reproductive system are noted. If severe side effects appear, the treatment strategy should be reconsidered.
Recovery prognosis
Thanks to the use of modern medicines, the duration of the course of therapy has been reduced. At the same time, the number of those who defeated the disease increased. Direct antiviral drugs are most effective when patients start taking them before cirrhosis develops.
Statistics confirm that hepatitis of the third genotype is easier to treat if the patient:
- Woman;
- Under 40 years old;
- Not overweight;
- Has no dangerous pathologies and insensitivity to insulin-containing drugs;
- Started therapy before the onset of cirrhosis;
- Has no bad habits.
Also, the life expectancy of patients is directly dependent on the degree of viral load. The prognosis will be more favorable when the concentration of the virus in the blood is less than 400 thousand IU / ml (determined by quantitative PCR analysis).
The genotype of the virus is a factor that must be taken into account by a specialist when developing treatment tactics. In addition, the patient must strictly follow all the recommendations, be observed by his attending physician, undergo examinations, and follow a diet.
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