Hepatitis C is a viral infectious liver disease transmitted transfusion, characterized by a mild, often subclinical, less often moderate course in the primary infection phase and a tendency to chronic, cirrhosis and malignancy. In most cases, hepatitis C has anicteric, low-symptoms onset. In this regard, it can remain unrecognized for several years and is revealed when cirrhosis is already developing in the liver tissues or a malignant transformation into hepatocellular carcinoma occurs. The diagnosis of hepatitis C is considered to be sufficiently justified in the detection of viral RNA in the blood and antibodies to it as a result of repeated studies by PCR and various types of serological reactions.
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Hepatitis C is a viral infectious liver disease transmitted transfusion, characterized by a mild, often subclinical, less often moderate course in the primary infection phase and a tendency to chronic, cirrhosis and malignancy. Viral hepatitis C is caused by an RNA-containing virus of the Flaviviridae family. The tendency of this infection to chronization is determined by the ability of the pathogen to stay in the body for a long time without causing intense manifestations of infection. Like the rest of the flaviviruses, the hepatitis C virus is capable of multiplying, forming quasi-strains having a variety of serological variants, which prevents the body from forming an adequate immune response and does not allow the development of an effective vaccine. Gandhi Medicos Buy Hepatitis C Medicine price From India a leading Supplier and Exporters from Russia, Mexico, Poland, Latvia, Moldova, USA, UK, Romania, and China for The Best Price.
Hepatitis C virus does not multiply in cell cultures, which makes it impossible to study its stability in the external environment in detail, but it is known that it is slightly more stable than HIV , it dies when exposed to ultraviolet rays and can withstand heating to 50 ° C. The reservoir and source of infection are sick people. The virus is contained in the blood plasma of patients. Infectious as suffering from acute or chronic hepatitis C, and people with the asymptomatic infection.
The mechanism of transmission of hepatitis C virus is parenteral, it is mainly transmitted through the blood, but sometimes infection can occur and in contact with other biological fluids: saliva, urine, semen. A prerequisite for infection is the direct entry of a sufficient amount of the virus into the blood of a healthy person.
In the overwhelming majority of cases, at present, infection occurs with the joint use of drugs intravenously. The spread of infection among drug addicts reaches 70-90%. People who use drugs are the most dangerous epidemic source of viral hepatitis C. In addition, the risk of infection is increased in patients who received medical treatment in the form of multiple blood transfusions, surgical interventions, parenteral injections and punctures using non-sterile reusable instruments. The transfer can be carried out with the application of tattoos, piercings, cuts during a manicureand pedicure, manipulations in dentistry.
In 40-50% of cases, it is not possible to track the way of infection. In medical professional groups, the incidence of hepatitis C does not exceed that of the population. Transmission from mother to child is carried out when a high concentration of the virus accumulates in the mother’s blood, or when the hepatitis C virus is combined with the human immunodeficiency virus.
The possibility of developing hepatitis C with a single hit of a small number of pathogens in the bloodstream of a healthy person is small. Sexual transmission of infection is rare, primarily in people with concomitant HIV infection, prone to frequent changes in sexual partners. The natural susceptibility of a person to the hepatitis C virus depends largely on the received dose of the pathogen. Postinfectious immunity is not well understood.
Symptoms of viral hepatitis C from India?
The incubation period of viral hepatitis C ranges from 2 to 23 weeks, sometimes delaying up to 26 weeks (which is due to one or another transmission route). The acute phase of infection in the vast majority of cases (95%) is not manifested by severe symptoms, leaking in the jaundiced subclinical variant. Later serological diagnosis of hepatitis C may be associated with the probability of an “immunological window” – a period when, despite the infection, antibodies to the pathogen are absent, or their titer is immeasurably small. In 61% of cases, viral hepatitis is diagnosed laboratory after 6 months or more after the first clinical symptoms.
Clinically, the manifestation of viral hepatitis C can manifest itself in the form of general symptoms: weakness, apathy, decreased appetite, rapid saturation. There may be local signs: severity and discomfort in the right hypochondrium, indigestion. Fever and intoxication in viral hepatitis C are quite rare symptoms. Body temperature, if it rises, then to subfebrile values. The intensity of manifestation of these or other symptoms often depends on the concentration of the virus in the blood, the general state of immunity. Usually, the symptomatology is insignificant and the patients are not inclined to attach importance to it.
In the analysis of blood in the acute period of hepatitis C, a low content of leukocytes and platelets is often noted. In a quarter of cases, short-term mild jaundice is noted (often limited to sclerosis and biochemical manifestations). Later, with chronic infection, episodes of jaundice and increased activity of hepatic transferases accompany exacerbations of the disease.
A severe course of viral hepatitis C is observed in no more than 1% of cases. In this case, autoimmune disorders can develop agranulocytosis, aplastic anemia, peripheral nerve neuritis. With such a current, a lethal outcome is possible in the pre-infantile period. In normal cases, viral hepatitis C proceeds slowly, without significant symptoms, for years remaining undiagnosed and manifesting itself even with the significant destruction of liver tissue. Often for the first time patients are diagnosed with hepatitis C, when there are already signs of cirrhosis or hepatocellular liver cancer.
Complications of viral hepatitis C are cirrhosis and primary liver cancer ( hepatocellular carcinoma ).
Diagnosis of viral hepatitis C
Unlike viral hepatitis B, where virus viral antigen release is possible, clinical diagnosis of viral hepatitis C is performed using serological techniques (IgM antibodies to the virus are determined with the help of ELISA and RIBA), as well as the determination of viral RNA in the blood by PCR. In this case, PCR is carried out twice, since there is a probability of a false positive reaction.
When detecting antibodies and RNA, it can be said about sufficient reliability of the diagnosis. The determination in the blood of IgG can mean both the presence of a virus in the body and the previously transferred infection. Patients with hepatitis C are assigned to carry out biochemical liver tests, correlograms, ultrasound of the liver, and in some complex diagnostic cases – liver biopsy.
Treatment of viral hepatitis C
Therapeutic tactics for hepatitis are the same as for viral hepatitis B: diet No. 5 is prescribed (restriction of fats, especially refractory, with a normal ratio of proteins to carbohydrates), exclusion of products that stimulate the secretion of bile and hepatic enzymes (salted, fried, canned food ), saturation of the diet with lipolytic active substances (fiber, pectins) a large amount of liquid. Alcohol is completely excluded.
Specific therapy of viral hepatitis is the appointment of interferon in combination with ribavirin. The duration of the therapeutic course is 25 days (if the variant of the virus is resistant to antiviral therapy, the course can be extended to 48 days). As the prevention of cholestasis in a set of therapeutic measures includes drugs ursodeoxycholic acid, and as an antidepressant (because the psychological state of patients often affects the effectiveness of treatment) – ademetionine. The effect of antiviral therapy directly depends on the quality of interferons (the degree of purification), the intensity of therapy and the general condition of the patient.
According to the indications, basic therapy can be supplemented with oral detoxification, antispasmodics, enzymes (mezim), antihistamines and vitamins. In severe hepatitis C, intravenous detoxification with solutions of electrolytes, glucose, dextran is indicated, if necessary, therapy is supplemented with prednisolone. In case of complications, the course of treatment is supplemented by appropriate measures (treatment of cirrhosis and liver cancer ). If necessary, produce plasmapheresis.
Forecast for viral hepatitis C
With proper treatment, 15-25% of cases are completed. Most often, hepatitis C turns into a chronic form, contributing to the development of complications. Death with hepatitis C usually occurs due to cirrhosis or liver cancer, the lethality is 1-5% of the case. The prognosis of co-infection with hepatitis B and C viruses is less favorable.
Prevention of viral hepatitis C
General measures for the prevention of hepatitis C include careful adherence to the sanitary regime in medical institutions, control over the quality and sterility of the transfused blood, as well as sanitary supervision of institutions providing services to the population using traumatic techniques (tattooing, piercing).
Among other things, awareness-raising and educational activities among young people are being conducted, individual prevention is being advertised: safe sex and abandonment of drugs, medical and other traumatic procedures in certified institutions. Among drug addicts, disposable syringes are distributed.
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