Hepatis C Treatments

History of HPCTJM

This Association was born and brought to life to help others who need Yoga, Physical Health, Mental Health, Sexual Health.

After having obtained many sexual diseases, due to unhealthy behaviors, I decided to create this non-profit association to help other people who are going through transitions and ask for help. In our association you will find help with experts on the subject, you will make real changes and with new solutions to improve your life and your mental and spiritual health.

FOUNDER, DIRECTOR AND CORPORATE IMAGE

YOGUI IXCHEL MARTINEZ HERNANDEZ

CO-FOUNDER, GENERAL MANAGER AND CORPORATE IMAGE

LIC.YANIRY ANAHI MARTINEZ HERNANDEZ

1.-HEPATITIS C HISTORY AND STATISTICS

Epidemiology

Many epidemiological studies and two national health surveys indicate an incidence of around 1.4% in Mexico,2-3 being noticeably different in the north (2.0%) than in the south (1.5%) and the central entities (1.1%) of the country.2,4 There are no direct studies on the number of new cases of the disease.

The number of patients who are detected and those who are treated is still scarce, which is expressed in the fact that in 2005, liver cirrhosis (late complication of hepatitis C) was the third most common cause of mortality in men and the seventh in women.5,6 It has been described that mortality due to liver cirrhosis varies between 11.6 to 47.4 per 100,000 inhabitants, with the highest mortality in the central area of the country.

The average age is 50 years and 12 years. Approximately 50% of liver cirrhosis is due to chronic viral hepatitis C and B viruses.

In order to predict and reduce the impact of hepatitis C in Mexico, it is necessary not only to know its risk factor but also to conduct studies on the number of new cases of the disease. According to data from the Population Council in 2010 there are 108,396,211 people in Mexico, of which 53,229,849 are male and 55,166,362 are female. 51 million of these people are between 20 and 65 years of age. If we were to calculate the incidence indirectly by dividing the prevalence by the duration of the disease, taking into account whether the disease lasts 20, 30 or 40 years, the number of new cases per year in the country would be estimated at 35,000, 23,300 or 17,500. At the General Hospital of Mexico between 12/26/07 and 12/25/08, 759,158 consultations were provided, and 327 new cases of hepatitis C were detected, which would represent 0.99, 1.39 or 1.86% of the total new cases detected in Mexico.

Impact of the diagnosis of hepatitis C

A patient who has a chronic hepatitis C virus (HCV) infection may have found out about it in different ways. One of the most frequent ways is to have gone to donate blood and realize that he has a positive antibody for HCV; another possibility is that if the subject has a history of having received a blood transfusion or derivatives before 1995 and if he does a determination of antibodies against HCV it may be positive; another possibility is that the subject goes to a clinical check-up and they find alterations in the liver function tests, or, alternatively, alterations in the blood count such as platelet count that suggest a chronic liver disease, which initiates the study of the patient.

Patients who have human immunodeficiency virus infection, intravenous or intranasal drug abusers, or prison communities are at significantly higher risk of being co-infected with hepatitis C virus.7-9

Since the infection is usually asymptomatic, patients are greatly shocked when they are told they have HCV infection. The physician will have to explain to the patient that it is a curable disease and that treatment will aim to slow the progression of liver damage and prevent or delay the onset of cirrhosis and liver cancer.

The patient is fearful because he or she has sometimes been told that in order to establish a definitive diagnosis, a liver biopsy is necessary, which consists of taking a sample of the liver either percutaneously blindly, guided by ultrasound, or by laparoscopy or laparotomy. Although it is true that the biopsy gives us information about the intensity of the damage, the existence of cirrhosis or fibrosis or adding some other diagnosis, it is not essential to decide on the treatment and can be ignored.10

It is very important to understand the impact that the diagnosis can have on certain patients, so experience is needed to manage them, and they may even require psychological help once the diagnosis has been established and during treatment.

It is important to let the patient know that each patient is different and that treatment will be planned according to their clinical characteristics and age.

their laboratory tests, genotype, viral load and of course, to inform them of the possibilities of response before starting treatment.

As for their work or functional life, these patients can continue with their activities, even when they are under treatment: however, they should be advised not to share syringes, razor blades or personal items due to the possible transmission of infection.

Support groups are an essential element in these cases, as they represent an open forum for the exchange of opinions with people who suffer from the same disease. For family members, these groups are of utmost importance for exploring the situation and learning the basic facts.

The hepatitis C virus

The hepatitis C virus is an RNA virus belonging to the Hepacivirus genus of the Flaviviridae family. Based on the nucleotide sequence and phylogenetic analysis, six genotypes have been characterized, of which genotype 1 is the most frequent in Mexico, with an approximate frequency of 75%.11-12 This type of virus is the one that most frequently has a worse evolution and that responds less to treatment.

The virus has a half-life of 2.7 hr in blood and there is a high daily production of viral particles (1012) in patients with chronic infection; the kinetics of viral replication is even higher than that of HIV. Secondly, the enzyme responsible for replication has an error rate of approximately 10-4 and therefore a mutation rate (quasi-species) that facilitates escape mechanisms.

Natural history

The study of the natural history of hepatitis C virus (HCV) infection has presented limitations because the time of onset of infection is known in few cases (generally no symptoms occur upon infection), its prospective study is difficult due to its long duration and there are variations when studying different populations. What is clear is that unlike infection by other hepatitis viruses, HCV infection persists in most cases with the subsequent development of chronic hepatitis, liver fibrosis, cirrhosis and in some cases liver cancer.13 Knowledge of the natural course of chronic hepatitis C and the factors that modify it is important for prognostic purposes as well as for designing surveillance and treatment strategies.

Studies conducted in the early 1990s in patients with post-transfusion hepatitis C showed that most patients did not clear HCV and that between 43% and 86% of cases developed persistent infection,14 depending on the patient's age, sex, source of infection, inoculum size, coinfection with other viruses, race, alcohol abuse, and host immunocompetence status. For example, young women rarely develop the chronic form; the opposite occurs in those exposed to a large inoculum, for example transfusion, which confers a high risk.15

Reports on the frequency of development of cirrhosis show variable data depending on the strategy used to acquire the information.

It has been concluded that at least 20% of adults chronically infected with HCV develop cirrhosis within a 20-year period.

Risk factors

The main risk factors for acquiring HCV infection are:

• Transfusion of blood or its components before 1995 (because the final version of NOM-003-SSA2-1993, which determines the detection of HCV antibodies in blood banks, was not published until July 18, 1994).

• Organ transplant before 1995.

• Intravenous or intranasal drug use (HCV infection should be investigated even in people who have only used injectable drugs once and are not considered addicts).

• Contact with blood from an infected person through wounds, wound exudates, and lacerations of the skin or mucous membranes.

• Accidental punctures when sharing needles, intravenous injections, or syringes contaminated with HCV-infected blood.

• Tattoos, piercings, acupuncture, manicures or podiatry with unsterilized and contaminated instruments.

• Dental treatment or extractions without adequate hygiene conditions.

• HCV infection can occur in hospitals through hemodialysis, use of multidose vials, a surgeon infected with HCV or endoscopy with biopsy.

• Being a health care worker exposed to contact with HCV-infected blood through mucous membranes or by accidental puncture with infected needles.

• Vertical transmission (from mother to child during birth).

• Sexual contact in the case of multiple partners or high-risk relationships (homosexual or heterosexual) without protection. The risk of sexual transmission is minimal through contact with a person infected with HCV in stable monogamous couples.

• Hepatitis C is not transmitted by hugging, kissing, sharing eating utensils or breastfeeding.

As transfusion-related hepatitis C cases decrease in Mexico, it is expected that nosocomial transmission and intravenous or intranasal drug use will increase in importance as risk factors.

2.- PRIVATE DONATIONS

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