How are they transmitted?
- Through blood: non-sterile medical and dental instruments, shared needles, blood transfusions before the screening era
- Tattoo, piercing, manicure and pedicure with non-sterile instruments
- Sexually: for hepatitis B the risk is high, for hepatitis C it is low, but exists
- From mother to child in labor
- General razors, toothbrushes, manicure supplies
Гепатиты B и C НЕ передаются через посуду, рукопожатия, объятия, поцелуи, кашель, общую еду и бассейн. Изолировать человека с гепатитом не нужно — это распространённое и травмирующее заблуждение.
Who needs to get checked
- Everyone at least once in their life - this is the recommended approach, since the disease is asymptomatic
- Before any elective surgery and during pregnancy
- When ALT and AST increase in tests
- After previous medical procedures, blood transfusions, tattoos and piercings
- If a family member or sexual partner has hepatitis
- Medical workers
- People who have injected drugs
What tests to take
- HBsAg — main скрининг на гепатит B. Положительный результат означает наличие вируса.
- Анти-HCV — скрининг на гепатит C. Положительный результат означает контакт с вирусом, но не всегда активную инфекцию.
- ПЦР на РНК HCV — обязательный второй шаг при положительном анти-HCV: определяет, есть ли вирус сейчас. Примерно у части людей вирус был устранён иммунитетом самостоятельно.
- ПЦР на ДНК HBV и HBeAg — при выявленном гепатите B.
- АЛТ, АСТ, билирубин, альбумин, коагулограмма — оценка функции печени.
- Эластография или УЗИ печени — оценка фиброза; ключевой показатель для выбора тактики.
Treatment
- Hepatitis C: Modern direct-acting antiviral drugs are taken in tablet form for 8–12 weeks and result in cure in more than 95% of patients. Interferon, with its severe side effects, is no longer the standard
- Cure is considered to be the absence of the virus in the blood 12 weeks after completion of the course.
- Hepatitis B: Complete elimination of the virus is not yet possible, but antiviral drugs reliably suppress its reproduction and prevent cirrhosis. Treatment is long-term, often lifelong
- Not everyone with hepatitis B needs treatment right away - those who are inactive carriers undergo regular monitoring
- For severe fibrosis and cirrhosis - surveillance with ultrasound and alpha-fetoprotein every 6 months for early detection of liver cancer
- Complete abstinence from alcohol, weight control, vaccination against hepatitis A and B (if not available)
Излечение гепатита C не даёт пожизненного иммунитета: повторное заражение возможно. Поэтому меры предосторожности сохраняются и после успешного лечения.
Prevention
- Vaccination against hepatitis B - reliably protects; is included in the vaccination schedule for newborns; adults can be vaccinated at any age
- There is no vaccine against hepatitis C - protection is only behavioral
- Individual razors, toothbrushes, manicure accessories
- Tattoos, piercings and manicures only in places where instruments are sterilized
- Barrier contraception with new partners
- Examination of all family members if hepatitis is detected in one of them