Dear all …Thank you for your warm welcome I received in your society which gives me the feeling that all the members of this site know each other long time ago.
Today I would like to discuss precisely a major health problem in the developing countries including my home country (Egypt) as well as some developed countries. This subject is Hepatitis C virus (HCV) infection.
It is well known that Hepatitis C Virus infection passes through the following stages:
• Acute HCV: Usually passed unnoticed in most of cases. It is accompanied by mild non- specific symptoms.
• Chronic HCV: Occurs in 85% of cases, and defined as the persistence of HCV for greater than six months.
• Liver Cirrhosis: Occurs in about 20% of chronic cases. Once patients have developed cirrhosis, they are at risk for decompensation from the complication of portal hypertension. These include variceal bleeding, ascites and hepatic encephalopathy. The other significant complication associated with HCV infection is the development of hepato-cellular carcinoma. It is generally developed on top of cirrhosis.
From my experience among such cases, I have the following comments:
• It is very rare to diagnose the acute stage of HCV infection. I only diagnosed two cases; one was in the post operative period and the other one was a nurse after an infected needle prick.
• The chronic stage usually diagnosed during screening for viruses or during routine liver function tests.
• During this stage we used to look at the liver enzymes or the liver biopsy finding to see if there is an activity of the virus or not. Accordingly; we give the patient the long acting interferon in case of activity.
• Although the course of interferon is very expensive and of long duration the results and the sustained virological response is not satisfactory in my opinion.
• After the patient passes to cirrhosis, we are just managing the complications and in my opinion it is an irreversible stage.
• My point of view is we all have to find a solution to prevent the progress of chronic infection into cirrhosis. This will be of great value.
Thank you and I hope this precise comment will be of value.
Dr. Ahmed Maher Hal