Hepatitis C is a chronic infectious liver disease, caused by a virus. The virus is transmitted via blood or other bodily fluids. It is estimated that 150–200 million people, or ~3% of the world’s population are living with chronic hepatitis C. About 3–4 million people are infected per year. No vaccine against hepatitis C is available.
The virus persists in the liver in about 85% of those infected and can lead to scarring of the liver and cirrhosis, which is generally apparent after many years. In most cases it will later develop into liver failure, liver cancer or life-threatening oesophageal and gastric varices. Hepatitis C is the leading reason for liver transplantation, though the virus unfortunately usually recurs after transplantation. More than 350,000 people die yearly from it.
Ultra-sensitive tests reveal the virus
The infection caused by the hepatitis C virus (HCV) is not detectable with conventional testing but can be found with ultra-sensitive tests. Quantitative HCV RNA can be measured by polymerase chain reaction (PCR) typically one to two weeks after infection. Chronic hepatitis C is defined as virus persisting for more than six months based on the presence of its RNA. Chronic infections are typically asymptomatic during the first few decades, and thus are most commonly discovered following the investigation of elevated liver enzyme levels or during a routine screening.
Fibroscan is an easy and fast examination to evaluate liver’s condition
Liver biopsies are often used to determine the degree of liver damage present; however, there are risks in the procedure. A modern way to evaluate liver damage is Fibroscan, also called transient elastography. It is a technique used to assess liver stiffness without invasive investigation. The result is immediate, it shows the condition of the liver and allows physicians to diagnose and monitor disease evolution in conjunction with treatment and collateral factors. Fibroscan provides immediate results, it’s easy and fast (5-10 minutes) and is used in HYKSin.
New and effective medication is now available
Earlier there was no curative nor well-tolerated treatment for hepatitis C but new drugs are now available. These new treatments are very effective and can achieve cure rates of over 90%. In most situations now, there is no need for interferon treatment, which was responsible for many adverse effects previously associated with hepatitis C treatment. The new medication require shorter treatment durations (usually 12 weeks), have reduced side effects and appear to be effective at all stages of the disease. So far these drugs are not available in every country, but they can be prescribed in Finland. Unfortunately this treatment is expensive.
Experts in diagnosis and treatment at your service
Since these drugs are new and surveillance is needed, it is recommended that these patients are treated in university hospitals. Helsinki University Hospital has a long experience of hepatitis C patients. There are two experienced gastroenterologist specialized in examining and treating these patients, Dr Perttu Arkkila (MD, PhD) and Dr Kalle Jokelainen (MD, PhD). Helsinki University Hospital has an internationally appraised laboratory with long experience of HCV RNA PCR testing.
How to get started
The process starts by providing all relevant medical information to us to evaluate whether the drug therapy is most likely indicated. If it is, the HCV-package is recommended including the physician’s evaluation visit with liver screening (Fibroscan), all relevant laboratory tests, 12 weeks dose of drug therapy and surveillance visits. Laboratory tests are scheduled 3 days before doctor’s appointment, and the medication can be collected day after the visit.
If it is questionable whether the drug therapy is needed, then HCV-appointment can be scheduled. This includes doctor’s visit with liver screening (Fibroscan) and all relevant laboratory tests, but not drug therapy nor surveillance.
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