The main problem in creating a vaccine and drugs is that the hepatitis C virus has high mutational activity and, consequently, genetic heterogeneity. That is, in the genome of the virus there are many unstable sites in which mutations are constantly occurring. As a result, six different variants of the genotype of the virus are now known, and each variant of the genotype includes at least 10 varieties. In simple words, the "family" of hepatitis C viruses is constantly growing. It is for this reason that it is not possible to create a vaccine or medicines that would successfully fight the virus. Even in the body of one person, starting to multiply, the virus gives off a progeny so different from the parent form that it acquires the ability to "escape" from the neutralizing effect of antibodies produced by the body's immune system and active substances of medications. This explains the reactivation of hepatitis C in seemingly cured patients.
The causative agent of hepatitis C is transmitted through the blood. The group of risk for infection is primarily drug addicts. According to Russian statistics in recent years, every second case of infection with this form of hepatitis is associated with intravenous drug use. The remaining 50% falls on hemophilia patients, hemodialysis patients, nurses, surgeons, dentists, hairdressers - by the word of all those who come in contact with the blood of infected people. Also, cases of transmission of the virus with piercing, tattooing, manicure and pedicure are not uncommon with unsterilized instruments. But from the mother to the child the virus passes very rarely.
According to the World Health Organization, about 3% of the world's population are carriers of the hepatitis C virus, i.e. about 300 million people. But if you consider that in many countries only the most obvious manifestations of hepatitis C are registered, and in some countries there are no statistics on viral hepatitis, it is logical to assume that the actual incidence rates are much higher. Naturally, the level of infection of the population varies considerably by region (from 0.6-1.4% in the USA to 4-5% in African countries).
The incubation period of hepatitis C continues on average 40-50 days. The development of the disease itself can be divided into three stages: acute, latent (chronic) and a phase of reactivation (a new outbreak of the disease).
The acute phase is traditionally limited to a six-month period. It usually takes place in a latent form, so the disease is rarely found at the initial stage. Patients with an active form of the acute phase are a minority (not more than 20%). The manifestations of the disease include general weakness, rapid fatigue, decreased appetite and physical activity. Diagnosis is significantly simplified with the appearance of icteric sclera and staining of the skin, but signs of jaundice are rare - in 8-10% of cases.
In the majority of patients, the acute phase is replaced by a latent phase, with a long-term development of the virus into the body, and can last up to 10-20 years. All this time the infected people consider themselves to be healthy. The only complaint can be the heaviness in the right hypochondrium with physical activity or eating disorders. In patients during this period, a slight increase and consolidation of the liver and spleen can be detected, and blood tests show a slight increase in the level of the enzyme alanine aminotransferase (ALAT) and periodically reveal the RNA of the hepatitis C virus.
Reactivation occurs on average after 14 years and leads to cirrhosis of the liver and hepatocellular carcinoma. The virus can cause pathologies and many other organs and can cause inflammation of the kidney glomeruli, diabetes, lymph nodes, nervous system and heart damage, skin diseases, arthritis, sexual dysfunction, and this list can be continued.
The existing system for the treatment of hepatitis C needs to be improved. Existing drugs (interferon, virazol, etc.) are ineffective. According to various clinics, the therapeutic effect is achieved only in 40-45% of patients. In addition, these drugs are expensive, and their use is accompanied by serious side effects. In this regard, the importance of preventive measures that are similar to measures for the prevention of AIDS: the fight against drug addiction, the control of blood and its products, personal precautions and health education.
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