Many readers will send me private messages and share their illness with me, on the one hand, hoping that I can give them some advice, and on the other hand, it is also a sign of helplessness, because they believe in me.
A few days ago a reader sent me 2 test pictures, said that she herself hepatitis C for many years, has not been able to get effective treatment, the doctor's words are also ambiguous, she saw that I popularized the content of hepatitis C, so she went to the hospital again to test hepatitis C, asked the doctor whether to treat, how to treat, the doctor did not give her a clear answer (the original words are like this, do not know whether there is a misunderstanding), she was relieved, decided to find me to see.
Listening to her about hepatitis C, I was thinking of introducing Kisersan to her and asking her to go to the hospital and tell the doctor. But when I saw her report, dumbfounded, this is hepatitis C, hepatitis C RNA can not be detected (meaning that the amount of virus is very small, may not be), hepatitis C antibody positive, which means that the patient has been infected with hepatitis C (so the antibody is positive), but the body automatically cleared the virus, so the viral RNA can not be detected, back to normal.
In fact, only about 80% of people infected with hepatitis C virus will become chronic, and the remaining 20% can automatically clear the virus and get cured. Positive hepatitis C antibody, not counting hepatitis C, can only say that it has been infected or is now infected, which one, but also to further check the hepatitis C RNA, if the RNA is positive, it means that there are still many viruses in the body, is the real hepatitis C patients, only need treatment. Hepatitis C antibody positive alone and hepatitis C RNA negative does not require treatment.
I told this reader that she was normal, not a hepatitis C patient, and didn't need treatment.
She was overjoyed. Ask me again and again. After getting the final result, she was really very happy, because she had always been confused, thinking that she had a disease without treatment, and she was afraid of cirrhosis.
False alarm, she was lucky.
But there are also no.
Another 35-year-old male reader approached me and said he had hepatitis C for many years and had been untreated. Asked why he did not go to the treatment, the reason made me very sad, because there are no symptoms, no discomfort, has always been positive for hepatitis C antibodies, but did not check hepatitis C RNA, the doctor did not let him further check (his original words, do not know whether it was misunderstood), plus there has been no manifestation of hepatitis, liver function is not remembered, so there is no treatment.
I said it's a pity, if you can find a time to check a hepatitis C RNA, as long as you find that hepatitis C RNA is positive, you need antiviral therapy, and now the direct antiviral drugs (such as Ji Sandai) have been able to cure hepatitis C, which is much better than hepatitis B, and the drug has also entered the medical insurance, not expensive, no longer good, India's generic drugs are also very good, cheaper. Some places with good medical insurance policies, even screening for hepatitis C and curing hepatitis C, do not need to pay a penny themselves.
2 months ago, he started to feel uncomfortable and felt bloated. At first, I thought it was gastroenteritis, I bought some whole intestine pills to eat, the effect was not good, I also diarrhea, and I went to moxibustion (moxibustion is good, but he used it in the wrong place), or no effect.
That's when I have to go to the hospital. Some doctors have suggested that colonoscopy may be needed to see if there is any possibility of enteritis, bowel cancer, etc.
Because the colonoscopy requires laxatives and intestinal preparation, it is necessary to do abdominal color ultrasound before doing the colonoscopy.
As soon as the results of the abdominal color ultrasound came out, he was directly frightened.
On the advice of the doctor, further abdominal CT scan + enhancement was done.
He showed me the results: cirrhosis, a significant enlargement of the spleen, a slightly less dense shadow of the right lobe of the liver, considering the possibility of small liver cancer.
Oh my God, how is it liver cancer, cirrhosis, I have always been in good health, playing football or the fiercest one, physical strength is very good.
The only bad thing is that after every football, I will go out with my teammates for drinks, and I can drink a few bottles of beer, but I usually don't get drunk.
Can I still be treated, he asked me.
I really can't believe that this is the result, my daughter was only a few months old. There are old and young, and suddenly they get into this problem, and their lives are gray.
He checked further and there was no hepatitis B, but hepatitis C. He told me that even the doctors were very sorry, you said that it is hepatitis B caused by cirrhosis, liver cancer is still reasonable, after all, hepatitis B can not be cured, many people do not pay attention to hepatitis B. But hepatitis C, how to say it, has been cured for many years, nearly 10 years, why is it delayed to this extent.
I also feel sorry that this is completely caused by the lack of science popularization. Once hepatitis C is confirmed, he must receive antiviral drug treatment, the course of treatment is 3 months, basically can be cured, and there will be no more cirrhosis and liver cancer. However, if you do not deal with it, after a long time, liver cancer and cirrhosis may occur.
This is a map of the chronic hepatitis C diagnosis and treatment guidelines, said the natural history of hepatitis C, so many people infected with hepatitis C virus, about 55%-85% (different research data are different) turned into chronic infection, into chronic hepatitis C, this part of the people are not to say that there will be cirrhosis, liver cancer immediately, but it takes a certain amount of time, hepatitis C virus slowly invaded liver cells, researchers found that after 20 years of infection, the incidence of cirrhosis is about 10%, this probability is not too high, But given our large base population, 10% of hepatitis C patients are no small number.
If the cirrhosis of the liver is not treated, from early cirrhosis to advanced cirrhosis, it is even more desolate. On this basis, a subset of people progress to liver cancer every year, about 2%-4% per year.
He was unlucky, and it was on his side.
Obviously, a disease that can already be cured, but it has been delayed into this scene, which is really sad.
I told him that I was not a liver specialist, and I had to go to the hospital for specific follow-up treatment. But in any case, liver disease suffers from liver cirrhosis decompensation (the spleen is large, it is estimated that there will be varicose veins in the esophagus and gastric floor veins), liver cancer, and the prognosis is certainly not very good, but at this time it is still necessary to actively treat.
In fact, when he first found positive hepatitis C antibodies, today when he found liver cancer and liver cirrhosis decompensation, he had three opportunities to save himself, but he missed them, and I sorted them out to show readers, hoping to learn some lessons:
First: the first time to check the positive hepatitis C antibody, in any case, it is necessary to further check the hepatitis C RNA, only the positive antibody does not mean that it is hepatitis C, it only means that it has been infected (has healed itself) or is now infected, which one, depends on the RNA, if the RNA is high, it is a current infection and needs treatment.
If the RNA is normal, it is that the previous infection is now cured and does not require treatment. The patient said that the doctor did not ask him to further check the hepatitis C RNA, which is also possible, the level of the medical staff group is high, and it is also possible that the doctors in the community hospital do not have a systematic understanding of hepatitis C, including Dr. Li and I, who are also enriching themselves in continuous learning, and no doctor knows all diseases.
Second: Knowing that he is positive for hepatitis C antibodies, even if there are no obvious symptoms of hepatitis, there should be a review, so for many years, he has not been reviewed, which is also a very regrettable point. The unit physical examination will generally have liver function, abdomen, hepatobiliary pancreas and spleen ultrasound, but his unit does not have the process of annual physical examination, so he missed this opportunity.
Third: a hepatitis patient develops cirrhosis, generally speaking, there will be some discomfort, such as abdominal discomfort, vague pain, or occasionally feel stuffy, not necessarily obvious abdominal pain and bloating, but some will be somewhat uncomfortable (do not rule out that there are patients with no symptoms, once found that there is already cirrhosis decompensation), he mentioned to me, there will be occasional abdominal discomfort before, but generally take a break, did not want to go to the examination. It is likely to have been a manifestation of chronic hepatitis C, but it was not taken seriously, so that the situation today has emerged.
Unexpectedly, A check found that it was a ruined disease. This is his exact words, he asked me, if the treatment is not good, do not spend this money, keep the money for my daughter and wife.
I told him that he must find a professional hepatologist or gastroenterologist to see, make a treatment plan, communicate with the doctor thoroughly, see how high the remission rate is, how high the success rate is, how much it costs, etc., how much medical insurance can reimburse, how much you can pay, understand it clearly, and don't give up treatment in a confused way.
Good luck to him.
At the same time, it also reminds readers once again that whether it is hepatitis B or C, as long as it is found, it must be actively antiviral treatment. Only antiviral therapy has the opportunity to avoid cirrhosis and liver cancer to the greatest extent possible. This is the current consensus of the medical community.