Hello dear readers. I receive letters in the mail asking me to write a continuation of the article on how hepatitis was treated, and the antiviral therapy for hepatitis C itself. I didn’t think that there would be so many responses to a series of articles devoted to the problem of treating this disease!
I noticed one thing. Most people write to me by email without leaving comments on articles. Apparently they cannot break the core in themselves that I broke in myself when I decided to publish articles of this kind. Do you understand what I'm talking about? But that’s not about that now.
I think providence itself intervened in the course of events. An article I wrote in February, talking about a diet for hepatitis C, quickly gained leading positions and is currently in the top ten search engines of Yandex and Gula. Moreover, in Yandex it is in first position. This is so true.
Having written the last article telling about the stage of my life before undergoing antiviral therapy, at first I changed my mind about writing a sequel. I advise you to read it to connect all the events together. Now I see that I was wrong.
Antiviral therapy for hepatitis C worries every person infected with the damned disease, and there are many of them lately. And if not for me, a person who has successfully undergone treatment shares his experience to the very end.
You will not hear the story from the lips of outside observers, who are doctors. For a number of reasons, they are not very talkative. And from a person who experienced everything firsthand.
Which doctor treats hepatitis C?
Several specialists are involved in the diagnosis and treatment of viral hepatitis C. Hepatologist - deals with the treatment of various liver pathologies; an infectious disease specialist specializes in infectious diseases caused by opportunistic and pathogenic microorganisms.
Important!
Hepatitis C can occur for a long time without any special symptoms, the acute form is often similar in clinical manifestation to a respiratory infection, and jaundice appears in a very small number of patients. All these factors make diagnosis difficult; regular preventive examination will help to identify a dangerous virus in a timely manner.
Side effects
Taking potent antiviral drugs in loading doses often leads to disturbances in the body. In 10-14% of cases, phenomena develop in which subsequent medication is impossible. However, less dangerous reactions occur most often.
These include:
- Constant weakness.
- Headache.
- Nausea.
- Increased body temperature.
- Depression.
- Sleep disorders.
- Irritability.
- Exacerbation of autoimmune diseases.
- Hemolytic anemia.
It is important to know! To alleviate the patient's condition, dosage adjustments are made. If necessary, stop taking it for 1-2 weeks until side effects disappear completely. Subsequently, the minimum effective dose of the drug is prescribed, followed by an increase in the absence of adverse events.
How is the disease treated: outpatient or inpatient?
Treatment for viral liver disease can be done in the hospital or at home.
Hospitalize patients with complications and concomitant liver diseases
Patients with advanced forms of the disease who have begun to develop cirrhosis due to hepatitis are placed in the hospital; hospitalization is necessary to determine the extent of organ damage and the presence of other complications. In the hospital, under the constant supervision of a doctor, acute hepatitis and exacerbation of the chronic form of the disease are treated, since it is necessary to constantly monitor the patient’s condition and the effectiveness of therapy.
The acute form of hepatitis C sometimes provokes activation of the immune system, which causes self-healing, but such cases are recorded in approximately 1–2% of patients.
Indications for treatment
Currently, it is not possible to predict with absolute accuracy the development of liver pathology in any patient. As a result, antiviral drugs are potentially indicated for every patient with hepatitis.
When deciding on the need to prescribe antiviral drugs for chronic hepatitis C, the specialist pays attention to various factors. The main indications for use are:
- The patient's age is over 18 years.
- Detection of hepatitis causative agent RNA in the blood.
- Chronic hepatitis accompanied by persistent fibrosis (according to morphological examination).
- Compensated liver damage.
- Acceptable indicators of general and biochemical blood tests. (Hemoglobin in men is 13 g/dl, in women - 12 g/dl, creatine is less than 1.5 mg/dl, neutrophils are at least 1500 per ml).
- The patient's desire to be treated.
- No contraindications.
This treatment is mandatory for patients with cirrhosis in the compensation stage, as well as for patients with bridging fibrosis (if there are no contraindications). And for patients with no fibrosis or with mild pathology (METAVIR scale 0-1, lshak 0-1), antiviral therapy is recommended to be postponed. This is explained by the low probability of an unpleasant outcome from hepatitis C.
When making a final decision on prescribing antiviral drugs to a particular patient, one should take into account the balance of harm and potential benefit in hepatitis caused by treatment.
Only with the permission of the parents, AVT for hepatitis C is used in a child over two years of age.
Treatment effectiveness
It is possible to completely get rid of hepatitis C, but to do this you need to consult a doctor in a timely manner, undergo a full course of treatment, give up bad habits, carefully monitor your own health, and lead an active lifestyle. One of the main conditions for successful recovery is diet.
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Patients with hepatitis need to eat more protein foods - 1g protein/kg, the amount of fat per day - 80 g, complex carbohydrates should leave half of the total energy value, the amount of salt should be reduced to 2-8 g.
Important!
With timely treatment, proper treatment, following a diet and the recommendations of the attending physician, hepatitis is permanently cured in approximately 90% of patients.
How long does treatment last?
The duration of the treatment course is influenced by the genotype of the virus:
1. About 50-75% of patients have 1 genotype. For them, the treatment period is up to 1 year. The drugs are used in full doses according to weight.
2. For genotypes 2 and 3 of the virus, a six-month course is carried out. Medicines are taken in a certain dosage, regardless of the patient’s weight.
3. Patients with genotypes 4 and 5 must complete a course of 48 weeks.
4. For genotype 6, therapy is selected individually.
The timing is also affected by interim test results.
Drug treatment
The basis of therapy for hepatitis C is interferon preparations; doctors recommend using several drugs from this group at once; the dosage and duration of treatment depend on the genotype of the virus, the concentration of viral RNA, and the level of decreased immunity.
Basic treatment regimen with injectable interferons:
- virus genotype II, III - Ribavirin 800 mg/day for six months;
- virus genotype I, IV - after a biopsy, Ribavirin is prescribed at 1000–1200 mg/day for 48 weeks;
- for any type of virus - Altevir three times a week.
Modern drugs based on sofosbuvir and daclatasvir are produced in the form of tablets; they have a detrimental effect directly on the virus that provokes the development of hepatitis. Original medicines Sovaldi and Daklinza are produced in Europe and America, but there are also Indian generics that are in no way inferior to the originals in their therapeutic effect.
Sofosbuvir and Daclatasvir should be taken simultaneously - 1 tablet per day of each drug. The duration of treatment is 12–24 weeks; in severe forms, the presence of HIV and cirrhosis, Ribavirin is additionally prescribed.
In case of genotype IV of the virus, only Daclatasvir can be used in therapy in combination with Interferon and Ribavirin; in the presence of HIV and drug intolerance, taking medications based on daclatasvir and sofosbuvir is contraindicated.
In addition to antiviral drugs, hepatoprotectors are prescribed - Phosphogliv, Silimar, Essentiale. Be sure to take B vitamins, ascorbic acid, folic acid, and immunomodulators.
When taking Sofosbuvir and Daclatasvir together, a positive result of therapy is observed in 50–100% of cases, depending on the specific pathology and the presence of concomitant diseases.
New generation drugs in the treatment of hepatitis C
New generation drugs in the treatment of hepatitis C
Viral hepatitis C is usually not difficult to diagnose, but complications are common. The presence of antibodies to the virus alone does NOT confirm the presence of hepatitis C.
Articles on the topic
- Viral hepatitis C: symptoms and signs in women and men
- Hepatitis A - what it is, incubation period, as well as causes and signs
- What is viral hepatitis B (hepatitis B): symptoms and therapyViral hepatitis B: treatment, symptoms, causes, prevention, diagnosis
- Hepatitis C: causes, first signs, symptoms and genotypes
- What is hepatitis D (D) - its symptoms and main methods of treatment
Author of the article:
Vyalov Sergey Sergeevich
- Candidate of Medical Sciences
- gastroenterologist-hepatologist GMS Clinic
- Member of the American Gastroenterological Association (AGA)
- Member of the European Society for the Study of the Liver (EASL)
- Member of the Russian Gastroenterological Association (RGA)
- Member of the Russian Society for the Study of the Liver (ROSPI)
- Author of more than 110 published works, in periodicals and national press, books, practical guides, methodological recommendations and teaching aids.
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Reading time: 6 min.
A new era in the treatment of viral hepatitis has arrived! Just a year ago, treating hepatitis C was a huge problem. But the time has come when we can safely and effectively cure viral hepatitis C in just 3 months, taking only 2 tablets a day and without side effects! We have been waiting for this type of treatment for a very long time, but now it has become available.
Viral hepatitis C is usually not difficult to diagnose, but complications are common. The presence of only antibodies to the virus does NOT confirm the presence of hepatitis C. The final confirmation is the determination of RNA PCR of the virus; only in this situation can we talk about viral hepatitis C and discuss possible treatment options. Let me make a reservation right away that hepatitis C can be treated differently in different situations. The key stumbling point is the presence of cirrhosis of the liver, that is, an “advanced” situation. The combination of viral hepatitis C with diseases such as diabetes, bronchial asthma and other chronic diseases is difficult to treat. Therefore, in such people, the effectiveness of treatment may be slightly lower and this requires correction of the treatment regimen.
Viral hepatitis C is a relatively new disease. Its history goes back no more than 30 years. During this time, ideas about it changed: the virus itself was studied, new drugs were researched, and the effectiveness of treatment gradually increased. The first short-term interferon treatments had low effectiveness, with only about 40% of people cured and a huge number of severe side effects.
Then ribavirin and pegylated interferons appeared, which increased the effectiveness of treatment to 60%. The next stage was the introduction of triple therapy, including two antiviral drugs in combination with interferon. The efficiency increased even more and amounted to about 70-75%.
Recently introduced interferon-free treatment options already have an effectiveness of about 90-95%. At the same time, the treatment time was reduced from 12-18-24 months to 3-6 months. Let me emphasize again, in the absence of aggravating conditions. Among the recently introduced drugs, there are several worthy of attention.
Schemes of two antiviral drugs with direct action on the virus:
- Sofosbuvir + daclatasvir
- Sofosbuvir + simeprevir
Scheme of four antiviral drugs with direct action on the virus
- 3D therapy (dasabuvir + ombitasvir + paritaprevir + ritonavir)
Today we have results of successful treatment of viral hepatitis C with direct-acting antiviral drugs. Sofosbuvir, ledipasvir, daclatasvir and ribavirin in combinations showed good results in terms of efficacy, safety and achievement of a sustained virological response . However, their high cost limits treatment options for large numbers of patients in many countries. The cost of generic drugs is about 1% of the cost of original drugs. A course of treatment for 12 weeks is estimated at $94,000 in the USA, in Europe at 50,000 €, while a course of treatment with generics costs about $1,000 with the prospect of reducing to $200 in the future.
Separately, it should be said about the quality of drugs and manufacturers. Original drugs, that is, those produced by the drug developer himself, are quite expensive. In Russia, due to the low solvency of the population, manufacturers agreed to make the price lower, at the psychological level of 1 million? for one drug for 3 months. This is the same original medicine, which is simply cheaper due to the manufacturer’s decision in relation to our country.
Recently, analogues, or so-called generics, of antiviral drugs have appeared. They are not produced by drug developers, but using the same technology and have the same formula, but by different companies. They are mainly made in India, China and Egypt. The cost of these drugs is an order of magnitude less and is about $1 thousand for two drugs for a 3-month course. This is due to the fact that people with hepatitis C in these countries are even less financially secure, and there are a lot of patients. In addition, these companies do not develop drugs, but produce them according to a ready-made formula. Of course, this is not a complete equivalent of the original drug; these drugs contain more impurities, provide a slightly lower concentration of the active substance in the blood, but still continue to be effective. Officially in Russia we cannot use these medications because they have not been registered. But as practice shows, many people bring them themselves or ask one of their friends and acquaintances.
Research data presented by Andrieux-Meyer I and James Freeman showed the results of treating hepatitis C virus with generic drugs. The researchers confirmed the quality of generic drugs using high-resolution liquid chromatography, nuclear magnetic resonance, and mass spectroscopy. Generics were used according to a standard therapy regimen with viral load assessment at 4 and 12 weeks. The intermediate result at week 4 for genotype 1 was 93% (sofosbuvir + ledipasvir) and 97% (sofosbuvir + daclatasvir). The average result for all genotypes of the virus was 94% for 1/100 of the cost of treatment with original drugs. As a result of studying the hepatitis C virus, it was concluded that cheap generics of direct-acting antiviral drugs are equivalent to the original drugs.
In some cases, “old” drugs are added to antiviral therapy to increase the effectiveness of treatment; these may be ribavirin or interferons. Typically, such a need arises again with cirrhosis of the liver or unsuccessful previous treatment. Depending on the type of virus found in the blood for hepatitis C, the preferred treatment option is selected. Also, depending on whether treatment has been carried out previously or not, and also depending on the presence or absence of liver cirrhosis, the course of treatment can be changed by the doctor.
Treatment of the Hepatitis C virus involves CONSTANT use of medications without interruptions and REGULAR monitoring of tests. DO NOT change the treatment regimen on your own or fail to carry out the prescribed tests on time. This way you make the virus stronger and make it more resistant to treatment!
Unfortunately, today, with the availability of new types of treatment, only one problem remains that prevents getting rid of viral hepatitis C completely - financial...
In this regard, there is a second goal of treatment - to reduce, if possible, liver damage. To do this, you need to give up alcohol, fatty foods in your diet, and switch to the Table No. 5 . This will slightly reduce liver toxicity, because the main “bad thing” is done by the virus. To help restore the liver, the drug most often used is ursodeoxycholic acid (UDCA). In other words, if it is not possible to start antiviral therapy right now, then it is better to at least reduce liver damage and promote its recovery than to do nothing. Also, a drug with udha (for example, ursosan ) is used as a service therapy for viral hepatitis C and is prescribed together with antiviral drugs
Accordingly, it makes sense to carry out treatment before starting antiviral therapy for hepatitis C and service therapy during antiviral therapy, then until the liver condition normalizes. , udha is an effective means of restoring the liver and preventing the development of liver cancer due to viral hepatitis C. Taking any medications during treatment should be approved by your doctor, as some medications may reduce the effectiveness of treatment.
Take care of your liver!
We recommend: Alcoholic hepatitis: diagnosis, symptoms, treatment. How to recognize hepatitis of alcoholic origin, Hepatitis C: causes, first signs, symptoms and genotypes, Viral hepatitis C: symptoms and signs in women and men,
Contraindications to drug treatment
Drug treatment is contraindicated in patients under 3 years of age and adults over 60 years of age; combination antiviral therapy is not carried out in the presence of certain chronic diseases.
Main contraindications:
- diabetes;
- heart failure, ischemia;
- severe form of hypertension;
- bronchial asthma;
- dysfunction of the thyroid gland;
- pregnancy, breastfeeding period;
- more severe mental disorders.
Pregnancy is a serious contraindication to drug treatment of hepatitis C
Drug treatment of hepatitis cannot be carried out in patients who have undergone organ transplantation or have a severe allergy to medications.
Indications for use
Antiviral drugs are prescribed when hepatitis C is diagnosed using laboratory methods.
In order to choose the right medications and dosage, it is necessary to establish the stage of development of the disease and the degree of manifestation of complications. The treatment regimen should also take into account the genotype of the virus, since drugs for different types of pathogens differ. https://youtu.be/1oIpbmma5sg
Direct-acting antiviral drugs have shown high effectiveness in the presence of the following complications of hepatitis C:
- fibrosis;
- cirrhosis;
- increased viral load;
- complications of hepatitis C on other organs.
Indications for the use of Ribavirin and interferons are AIDS and cancer, but it is not recommended to use them without direct-acting drugs.
Treatment of hepatitis C with folk remedies
It is impossible to cure hepatitis C with folk remedies, but unconventional methods help strengthen the immune system, restore, and improve liver function.
How to treat hepatitis C with home remedies:
- Brew 220 ml of boiling water and 10 g of crushed corn silk, leave in a sealed container for 2 hours. Drink 25 ml 4 times a day a quarter of an hour before meals. The drink has a pronounced choleretic effect.
- Grind 3 tbsp into powder. l. milk thistle seeds, pour 500 ml of boiling water, simmer in a steam bath for half an hour, strain. Take 15 ml three times a day after meals.
- Grate 3 tbsp. l. fresh horseradish root, pour 250 ml of homemade milk, heat over low heat, but do not boil. Drink the entire portion of the medicine in small sips throughout the day.
- To strengthen the immune system, drink honey water in the morning on an empty stomach - 5-10 g of the product per 200 ml of warm water. Aloe also helps well - take 10 ml of fresh plant juice three times a day before meals. Before going to bed, you can drink a glass of natural grapefruit juice.
- Shilajit will help restore liver cells - pour 15 g of raw material into 500 ml of hot water, but not boiling water, and stir. Start taking it with 25 drops, gradually increase the dose to 5 ml, you need to drink the medicine in the morning and evening half an hour before meals.
Taking mumiyo will help restore liver cells
Traditional healers recommend that patients with hepatitis eat 1 raw yolk of a home-made egg every morning, half an hour before breakfast, and drink 250 ml of a mixture of equal parts of fresh juice of parsley, carrots, celery and pumpkin twice a day.
On the quality of antiviral drugs prescribed for hepatitis
In the production of interferon, a genetically modified culture of Escherichia coli is used. The latter produces it, but releases not only the necessary protein, but also the results of the vital activity of the bacterium. Its cost depends on the degree of purification of the medicine. Therefore, interferons from familiar manufacturers should be prescribed.
Statistics show: since 1985, only 25% of the 80% of patients who received 3 million IU of Roferon-A three times a week managed to achieve the desired result.
There are 2 types of Peginterferons all over the world: Pegintron (manufactured by Schering Plow) and Pegasys (manufactured by Hoffman La Roche). After 2013, in our country, domestic pegylated interferon, Algeron, began to be used as an AVT. It is in no way inferior to imported substitutes, and is significantly less expensive.
Ribavirin, produced under different trade names: “Rebetol”, “Copegus”, “Ribamidil”, “Ribamidil”, “Ribaleg” and others - is no different in effectiveness. It is all made from the same raw material, produced by Asian pharmaceutical companies. There are only difficulties with the content of the active substance in the capsule or tablet. This is important for therapy.
For example, doses less than 10 mg/kg do not bring any effect, and taking an extra tablet is undesirable due to an overdose.
https://youtu.be/2Usv6Q53KU8
How much does it cost to cure hepatitis C?
Treatment of hepatitis C with modern drugs will cost about 1 million rubles. per course, since most drugs have not yet been certified in the Russian Federation, they will have to be ordered online in Europe, America, India; interferon drugs also have a high cost.
What to do if there is no money? There are quotas and benefits for receiving free therapy, but since there is no single federal program for the treatment of this disease, people with hepatitis will have to make a lot of effort to be able to receive treatment for free.
Participation in clinical trials is one way to get free treatment
Options for free hepatitis C treatment:
- public funds for the treatment of viral hepatitis - the quota applies to patients with fibrosis of III, IV degrees, elevated liver parameters;
- preferential therapy for citizens of certain categories;
- participation in clinical trials of antiviral drugs conducted by pharmaceutical companies;
- medical insurance.
Important!
If you cannot get rid of acute hepatitis within a year, the disease will become chronic, and recovery may take decades.
Antiviral therapy with direct acting drugs
DAAs are inhibitors of HCV non-structural proteins that prevent the virus from self-copying at different stages of RNA assembly. The effectiveness of therapy with direct antiviral agents reaches 96-100% even with 1 genotype of HCV. Unlike interferons, they do not inhibit bone marrow function and are less likely to provoke adverse reactions.
Several factors influence the choice of medications and duration of hepatitis therapy:
- genotype and subtype of the virus;
- complications of hepatitis;
- level of viremia;
- drug tolerance.
The first PPD drugs were released by American pharmaceutical companies in 2013-2014. After confirmation of their effectiveness, the treatment strategy for viral hepatitis changed dramatically. Now, according to the recommendations of WHO, EASL and AASLD, interferon regimens are abandoned in favor of HCV protein inhibitors.
Originals
Gilead is an American company that released Sofosbuvir in 2013. The first direct antiviral drug entered the pharmaceutical market under the name Sovaldi. A drug from the group of NS5B inhibitors prevents the synthesis of nucleic acid, without which self-copying of the hepatitis causative agent is impossible. After completing three-phase trials, the FDA approved the drug.
Bristol-Myers Squibb is a US pharmaceutical company that released Daclatasvir (Daklinza) in 2019. A drug from the group of NS5A inhibitors disrupts the replication of HCV RNA, due to which the concentration of the virus in the blood sharply decreases. In 2019, it was included in the list of vital medicines.
According to statistics, treatment of hepatitis C with DAAs increases the chances of recovery from 45-70% to 96-100%. Compared to interferons, they have many advantages:
- short course of therapy (8-24 weeks);
- high chances of achieving SVR;
- convenient release form;
- low risk of side effects.
DAAs for hepatitis C are available in tablets for oral administration, which eliminates the need for patients to frequently visit clinics for injections. The drugs are suitable for the treatment of all HCV genotypes. Due to the low risk of unwanted effects, they are prescribed for the treatment of hepatitis in children over 3 years of age.
American pharmaceutical companies have released 3 groups of HCV inhibitors:
- NS3/4A – Glecaprevir, Asunaprevir, Grazoprevir, Narlaprevir, Simeprevir;
- NS5B – Dasabuvir, Beclabuvir, Sofosbuvir;
- NS5A – Pibrentasvir, Velpatasvir, Elbasvir, Daclatasvir, Ledipasvir.
The only and serious disadvantage of DAAs is the high price. According to various sources, the cost of 1 course of therapy in the USA ranges from 84 to 160 thousand. In the Russian Federation, the price of 1 tablet of the original medicine for hepatitis is 1000-1100 USD.
Original DAAs for viral hepatitis C
| Name of medicine | Active substance | Price per package, in USD |
| Sovaldi | sofosbuvir | 3000 |
| Daklinza | daclatasvir | 2800 |
| Harvoni | sofosbuvir/ledipasvir | 6300 |
| Epclusa | sofosbuvir/velpatasvir | 8000 |
Ledipasvir, Paritaprevir, Velpatasvir are not used separately - only in combinations.
Therapy with only one drug does not lead to complete eradication of the infection. Therefore, in the fight against hepatitis, inhibitors of different HCV proteins are used simultaneously. In this regard, Gilead has released combination tablets that contain several active ingredients - Epclusa, Harvoni.
Generics
Organizations protecting the rights of hepatitis patients began to demand that manufacturers revise their pricing policies. The price of medicines turned out to be 800-900 times higher than the cost. In this regard, WHO demanded that Bristol-Myers Squibb and Gilead issue licenses to pharmaceutical companies in developing countries to produce inexpensive analogues.
In 2019, companies from:
- India;
- Bangladesh;
- Egypt;
- China (in 2019).
A generic is a structural analogue of a drug that has similar pharmacological properties. Substitutes for Sovaldi, Daklinza, Ledipasvir and other DAA drugs are undergoing clinical trials after their release. If their effectiveness is confirmed, the company receives a license for mass production of the generic.
How much does an Indian substitute for American DAAs cost?
| Drug name | Active ingredients | Company manufacturer | Cost of 1 package, in USD |
| Hepcinat | sofosbuvir | Natco Pharma Ltd | 120-130 |
| Sofokast | Aprazer Health Care | 115-130 | |
| Sofovir | Hetero Drugs Ltd. | 125-130 | |
| Dacihep | daclatasvir | Zydus Heptiza | 120-130 |
| Dacikast | Aprazer Health Care | 110-125 | |
| Natdac | Natco Pharma Ltd | 160-170 | |
| Ledifos | sofosbuvir/ledipasvir | Hetero Labs Ltd | 310-330 |
| Ledikast | Aprazer Health Care | 175-180 | |
| Hepcinat-LP | Natco Pharma Ltd | 210-220 | |
| Sovihep V | sofosbuvir/velpatasvir | Zydus Heptiza Ltd | 240-245 |
| Velakast | Aprazer Health Care | 220-230 | |
| Lucisovel | Lucius Pharmaceuticals | 210-250 |
Thanks to the advent of generic drugs, the cost of treating viral diseases has decreased hundreds of times. On average, a 12-week course of treatment will cost 1000-1500 USD.
Hepatologists categorically do not recommend using medications that have not undergone clinical trials. In 8 out of 10 cases, they do not have the declared therapeutic properties and cause damage to health.
How do you get infected with the hepatitis C virus?
The virus is transmitted through blood. You can become infected with the virus through tattooing, piercing, visiting a manicure salon, medical manipulations with blood, including blood transfusions, administering blood products, operations, or at a dentist appointment. Infection is also possible through shared use of toothbrushes, razors, and manicure accessories. Read more…
Sexual transmission is rare, as is transmission of the virus from the mother during pregnancy. Breastfeeding is not prohibited if you have hepatitis C, but you should be careful if blood appears on your nipples.
It is impossible to become infected with the hepatitis C virus through household contacts. The virus is not transmitted by airborne droplets, shaking hands, hugging or using shared utensils. Patients with viral hepatitis C do not need isolation and do not pose a danger to others. In Russia, however, they are exempt from military conscription.
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The main means of treating the disease
Among the best drugs for treating the disease are Sofosbuvir, Daclatasvir and Ledipasvir. Each of these medications has its own characteristics, so most often doctors do not prescribe monotherapy, but draw up a treatment regimen with these drugs. Combinations are individual in each case, since medications can affect all four genotypes of the hepatitis C virus.
Sofosbuvir is a new effective drug that was tested in the USA in 2013 and approved for the treatment of patients with this disease, after which the results were confirmed by a number of European health organizations.
Since Sofosbuvir has proven itself well in the treatment of patients with hepatitis C, it began to be included in the treatment regimen with two more new drugs - Daclatasvir and Ledipasvir, which were certified a year later.
The essence of the new drugs is that they suppress the virus’s copying of its own ribonucleic acids, as a result of which the virus becomes unviable and stops multiplying and developing. As studies have shown, Sofosbuvir combined with Daclatasvir and Ledipasvir cured 98 percent of the patients who were tested. This is a giant leap forward in the treatment of hepatitis C, which was previously curable in only half of patients.
To find your way around the variety of drugs and their therapeutic combinations, you can familiarize yourself with their list. The approximate cost of the drug, both original and generic and their combinations, is indicated here. Some drugs are not yet certified in Russia, so the price will be indicated in foreign currency, and drugs that can be purchased in Russia are presented in rubles.
It is worth immediately noting that drugs produced in the USA and India do not differ in effectiveness, and the difference in price is very significant. Read more about analogues of hepatitis C drugs produced in India here.
| Name of the drug or combination thereof | Manufacturer country | Package or course cost |
| Daclatasvir | USA | $63,000 per course |
| Sofosbuvir | USA | $84,000 per course |
| Sofosbuvir+Ledipasvir | USA | $90,000 per course |
| Simeprevir | USA | $70,500 per course |
| Sofosbuvir | India | $360 per course |
| Sofosbuvir+Ledipasvir | India | $555 per course |
| Sofosbuvir+Veltapasvir | India | $850 per course |
| Sofosbuvir+Veltapasvir | Bangladesh | $840 per course |
| Daclatasvir | India | $195 per course |
| Hepcinate (sofosbuvir+ledipasvir) | India | 18,000 - 20,000 rub. for 28 tab. |
| Sofab (sofosbuvir+ledipasvir) | India | $565 per course |
| Sofokem | India | 14,000 - 18,000 rub. per pack |
| Gratisovir | Egypt | $150 for 28 tablets. |
| Daklinza | USA | RUB 390,000 per course |
| Daclavirocirl (daclatasvir) | Egypt | $50 for 28 tablets. |
| Sofosbuvir + Daclatasvir | Egypt | $500 per course |
| Heterosofir Plus (sofosbuvir + ledipasvir) | Egypt | $180 for 28 tablets. |
| Gratesiano | Egypt | $150 for 28 tablets. |
| Viropak (sofosbuvir+ledipasvir) | Egypt | $180 for 28 tablets. |
The data given above allows the patient to navigate the price and, together with the doctor, select a treatment regimen with one or another means.
To find out the current prices today for the most popular drugs in Russia and the CIS, go to galaxyrus.com. In the market of companies transporting Indian medicine for hepatitis C, “GalaxyRus (Galaxy Super Specialty)” has proven itself to be excellent. This company has been successfully helping people recover from illness for more than 2 years. You can watch reviews and videos of satisfied patients here. They account for more than 4,000 people who have recovered thanks to the drugs they purchased. Do n’t put your health on hold, go to www.galaxyrus.com or call 8-800-350-06-95 , +7-495-369-00-95
Interferons
When considering drugs with the best treatment results, you should definitely focus on interferons. They are prescribed in almost all cases. They can be taken by children, adults and elderly patients.
What are interferons? Interferon is a protein molecule through which a person develops so-called “viral immunity.” Such a molecule has nonspecific activity, that is, it does not act on the causative agent of any disease, but on all viruses in general.
Before taking interferons, you need to undergo a general and biochemical blood test, a blood test for antibodies to hepatitis C, and a test to determine interleukin 28 beta using the PCR method. Interferons are available in the form of tablets and ampoules. Solutions are usually administered intravenously, that is, through droppers.
The list of the best interferons includes:
- Pegasis.
- Intron-A.
- Roferon.
- Reaferon-EC.
The above medications are contraindicated for cirrhosis, acute disorders of the liver and kidneys, thyroid diseases, epilepsy, and disorders of the central nervous system. The cost of medicine starts from 900 rubles. If you don’t have enough money, you can use Indian generic interferons. They are sold on the Internet and cost 3-4 times cheaper than original drugs.
Diet of a patient with hepatitis
Hepatitis C can only be treated through an integrated approach to therapy. Proper nutrition of the patient plays a huge role in the fight against complications. Basic rules to follow when adjusting your diet:
- process dishes only by culinary methods of cooking, stewing, steam;
- increase the daily volume of fluid you drink;
- eat food 5–6 times a day in portions not exceeding 350 grams in weight;
- eat more vegetables and fruits.
Table of excluded and acceptable products
For any liver pathologies, an important element in nutrition is a categorical refusal of alcoholic beverages.
Therapy without interferon
A relative innovation is treatment without the use of interferon. The effectiveness of this therapy has been proven in:
- I genotype of the virus;
- treatment without the use of Ribavirin;
- liver cirrhosis.
Interferon-free therapy for hepatitis C is safer and produces minimal side effects. But it has two drawbacks: permission to conduct it is not given in all countries, and its cost is extremely high.
In combination with Ribavirin, interferon-free drugs provide a 99% virological response, even if the patient has genotype 1 of the virus. Success in treatment without the help of this drug is observed in about 95% of cases. This applies even to patients with cirrhosis of the liver.
The therapy provides the opportunity to dramatically treat even patients with HIV, cirrhosis and other serious lesions that old-style drugs cannot cope with.
How the body reacts to medications
Unfortunately, interferon and ribavirin can have side effects. Young people tolerate these drugs more easily, and the negative effects are less pronounced.
The use of lighter ribavirin slightly changes the blood formula, sometimes leading to increased destruction of red blood cells. Some patients develop signs of dyspepsia, and the level of uric acid in the blood of patients increases. Sometimes patients get headaches from ribavirin and also experience an allergic reaction.
Interferon has more severe side effects:
- Because of the injections, a person gets chills and feels a general malaise, i.e. the symptoms are similar to those of a cold.
- Some time after the administration of the drug (about a couple of hours), the temperature rises and aches and pains appear. Sometimes such symptoms persist for several days, but gradually disappear. It takes about a month to adapt.
- Decrease in the number of leukocytes and platelets in the second or third month of therapy. This is a sign that it is necessary to reduce the dosage or completely stop the drug.
- The functioning of the thyroid gland is disrupted, and a person experiences depression, hair loss and weight loss. Fortunately, such cases are rare.
Extracorporeal hemocorrection in the treatment of hepatitis C
Extracorporeal hemocorrection is the purification of blood plasma through filters in a special apparatus, which not only reduces the body’s viral load, but also increases the activity of etiotropic therapy.
Also, thanks to this method, it is possible to reduce itching of the skin, pain in muscles and joints, restore kidney function, and reduce the number and severity of adverse reactions of antiviral therapy.
Other drugs
Since hepatitis C itself is a serious illness, and therapy for hepatitis does not have the best effect on the patient’s health, therefore, people taking medications for hepatitis C also undergo restorative therapy. There are a number of drugs that are recommended for use - these are Riboflavin, Pyridoxine, Rutin, Gerimax. In most cases, these are vitamins that support the body during recovery.
Hepatoprotectors that restore liver cells affected by the virus are also mandatory. Among such drugs, doctors recommend taking Heptral, Phosphogliv and Ursofalk. These medicines have detoxifying and regenerating properties. With their use, metabolic processes in the liver parenchyma improve, the elasticity of hepatocytes increases, and bile acids are detoxified. The drug Phosphogliv has an antiviral effect, and it can also prevent cirrhotic changes in the liver. The drug Ursofalk is famous for its immunomodulatory effect, which facilitates the work of the liver by normalizing the composition of bile. Also, to reduce side effects, patients are prescribed intramuscular injections of Derinat, Neupogen and Recormon; Revolade tablets are recommended.
