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Hepatitis C – New Reality, New Horizons

29 January 2020

The Hepatitis C Virus is one of the most important chronic infections worldwide, affecting 3% of the world’s population, i.e., 170-200 million people.

It is still the most frequent cause of liver cancer and liver transplants in developed countries. In Portugal, it is estimated that there are around 100,000 people infected, with approximately a thousand deaths annually occurring as a consequence of the disease. It is a public health issue that calls for a coordinated, active and effective strategy.

Hepatitis C has been dubbed by some “the silent disease”. This is due to the fact that most of the infected patients do not have any complaints or symptoms attributable to this illness, over the course of several years. Usually, when complaints arise, the disease is already at an advanced stage, with a more guarded prognosis. It is known that 30% to 40% of untreated or ineffectually treated cases evolve severely into cirrhosis, a serious and irreversible clinic situation whose only sustained treatment is through a liver transplant. In addition, in patients with cirrhosis, liver cancer, a severe prognosis situation and with a very high mortality, occurs in 10% to 40% within 10 years time. For all these reasons, the disease should be effectively treated, ideally, as early as possible.

However, the timely diagnosis faces two limitations: firstly, the fact that, as has been said, the disease is asymptomatic for several years; secondly, the fact that one-third of patients do not have obvious risk factors of the infection they suffered, preventing any conclusion as to its identification. It is known that a history of blood transfusions before 1990, prior drug consumption or contact with contaminated blood are increased risk factors for transmission.

However, a significant number of such cases never existed and the infection is still a reality. For all of this it is suggested that people get tested at least once in their life, especially since it is a simple blood test that can be performed at the same time as your usual analysis. From there, the real situation will be known and the most appropriate strategy can be outlined.

One of the major evolutions of contemporary medicine deals with the treatment of Hepatitis C. In 1985, the first treatments revealed a 5% efficiency rate. With the development of available treatments, the efficiency rates increased significantly, which today may enable healing in 80%-90% of cases, with short treatments of 12 weeks. Equally important is the progress regarding the safety of the administered medication and its decreased side effects, which today can only be taken orally, without injections and with minimal effect on the patient’s quality of life.