2024-07-19 17:14:14
From July 1, 9 new medicinal products were added to the lists of reimbursed medicinal products, including those intended for the treatment of chronic viral hepatitis C infection. Infectologist Judita Minickaitė-Katinienė, doctor of the Department of Adult Infectious Diseases of the Republic Šiauliai Hospital, says that this decision will contribute to the ambitious goal set by the World Health Organization (WHO) – to achieve the elimination of hepatitis C by 2030.
Medicines improved
Although there is no hepatitis C vaccine yet, and it is up to you to protect yourself from the infection, the liver disease is no longer as scary as it was 30 years ago, when the famous infectious disease expert Harvey Alter identified hepatitis C, and doctors called it the “silent killer.”
The virus, which causes almost no symptoms, can lurk in the human body and slowly progress until liver cirrhosis or even cancer develops. From 60 to 80 percent. virus carriers do not feel any symptoms of the disease, so the disease is called asymptomatic.
In 2015, the first drug was developed that works against the hepatitis C virus. During those years, infectious disease specialists and gastroenterologists of the Republic Šiauliai Hospital had to treat a considerable number of patients, but only 40-60 percent. they were able to recover. Only such effectiveness of treatment was guaranteed by drug manufacturers.
But not everyone could be treated. Medicines were prescribed only to those infected with hepatitis C of the first genotype. Six genotypes of this virus have been identified in the world. Three are common in Lithuania, the other three are mostly found in Africa.
In December 2018, patients began to be treated with innovative drugs, so it is possible to treat those infected with all genotypes of the virus from the insidious, silently killing disease. Over 99% recovery. treated patients.
The previous four-pill treatment, which lasted for several years, has been replaced by three or even one-pill treatments to be taken at once. “This treatment is much easier, patients do not develop liver damage, there are much fewer adverse reactions, so the treatment lasting 2-3 months can be given even to teenagers,” says the doctor.
Not everyone infected with the hepatitis C virus could receive this expensive treatment. 15% of those infected with this virus heals itself. 25-40 percent the disease of virus carriers is asymptomatic, and the activity of the inflammatory process (ALT/AST) is normal. 20 percent liver cirrhosis may progress. When fibrosis was diagnosed in the liver, it was then possible to start treatment with innovative drugs, while in the case of less damage, treatment still had to wait.
As of July 1, a new medicinal product “Epclusa” for the treatment of chronic viral hepatitis C infection has been added to the lists of reimbursed medicinal products. The drug is prescribed for the treatment of all genotypes. From now on, if you take one tablet a day, hepatitis C is overcome in 12 weeks. These drugs, unlike others, can also treat advanced liver cirrhosis.
Dr. Infectologist Judita Minickaitė-Katinienė advises patients to treat treatment with these drugs very responsibly. And not only because effective treatment cannot be interrupted, but also because medicines are very expensive – a monthly course of treatment costs the state 8,000 euros.
Diagnostics also changed
After the approval of free screening for the hepatitis C virus in Lithuania from May 2022, the flow of patients from the office of family doctors to the office of the infectious diseases consultant of the hospital’s Consultation Department has been greatly reduced. The diagnosis of hepatitis C has also increased throughout the country. Statistics say that in 2020 A total of 65 cases of chronic hepatitis C have been registered in Lithuania, and in 2022. – already over 169 cases of hepatitis C virus.
An infectious disease specialist or a gastroenterologist who treats a patient diagnosed with hepatitis C prescribes several tests that determine antibodies, the amount of the virus and its genotype. According to the doctor, treatment with innovative drugs is prescribed based on the results of tests showing the degree of liver damage and the activity of the inflammatory process.
An oncological disease can also develop in the liver damaged by cirrhosis. 1-4 percent annually. patients diagnosed with liver cancer. Research has shown that about 50-80 percent infected people get chronic form of hepatitis C, 4-20% of them. cirrhosis of the liver develops within 20 years, which is 2-25 percent. is complicated by a primary liver tumor – hepatocellular carcinoma.
The goals became real
Only joint efforts could achieve the challenge set by the World Health Organization (WHO) to eliminate viral hepatitis C (VHC) from the list of important health problems by 2030. The primary goal of doctors is to eradicate HCV. The secondary goal is to stop the progression of the disease, reduce the risk of HCC and reduce the need for liver transplants.
According to infectious disease specialist J. Minickaitė-Katiniena, these goals become real when the doctor can prescribe an effective drug that does not cause any unpleasant reactions to the patient. From now on, there are all the tools necessary to successfully cure hepatitis C patients and ensure their full lives. For infectious disease experts, it is important that people actively check their health, so that family doctors do not lose their vigilance when a person expresses his ailments, and more cases of hepatitis C are clarified. It is true that infectologists ask family doctors to be more vigilant and not to perform a program examination on patients who have already recovered from hepatitis C.
Doctors Judita Minickaitė-Katinienė, Zinaida Kovaliova and doctor Natalia Maksymtseva from the Department of Infectious Diseases perform an elastographic examination of the liver. The test is performed with a fibroscanner, which has replaced the unpleasant and risky liver biopsy procedure. Chronic liver damage caused by viral hepatitis C must be confirmed histologically by performing a liver biopsy or by measuring liver stiffness using a non-invasive liver elastography method after a blood test performed by a family doctor.
According to doctor J. Minickaitė-Katinienė, the results obtained after this painless examination often caused a negative reaction in the patient, when it became clear that the first degree of fibrosis had been diagnosed. Until now, after the diagnosis of the first degree of fibrosis, treatment is not given to the patient, because there are also cases of spontaneous recovery.
The new drug makes it possible to permanently eliminate the infection from the body, after the diagnosis of hepatitis C at any stage and in the presence of any genotype. The good news is that this insidious disease is curable, and with the new generation of drugs, there is no need to fear the disease, the tests that confirm it, or the treatment.
2024-07-19 17:14:14