How is hepatitis C diagnosed and treated in children? Methods used

Recently, hepatitis C has been diagnosed in children of all ages and adolescents. Hepatitis C is an infectious disease that affects the liver. Getting into the blood, the virus enters the liver cells and, gradually multiplying, destroys them. In addition, the structure of recognizable proteins of the cells of the affected liver changes and the body's immune system, taking cells for foreign, begins an active fight, producing antibodies. A characteristic feature of the virus is its ability to mutate. To date, at least six genotypes are known, each of which has its own subtypes.

The main causes of hepatitis C in children:

• infection from a sick mother during labor;
• infection during various medical manipulations using non-sterile instruments, as well as during blood transfusions;
• use of other personal hygiene items( razors, manicure tools);
• piercing, tattoos, etc., made in questionable salons;
• addiction among adolescents;
• sexual life during menstruation.

Symptoms of the disease

The disease develops gradually, the incubation period lasts from 5 to 12 weeks. The first signs of hepatitis C can occur even 6-12 months after infection. Depending on the clinical picture, a typical( accompanied by jaundice) and atypical( jaundice or subclinical form) hepatitis are distinguished. Depending on the duration of the disease, acute( up to 3 months), prolonged( from 3 to 6 months) and chronic( over 6 months) hepatitis are distinguished.

As a rule, the acute form of the disease passes asymptomatically and in most cases is diagnosed absolutely by accident. The chronic form of the disease has a cyclic character, that is, the phases of exacerbation are replaced by the phases of remission.

There are following main signs of this disease in children:

• increased fatigue, weakness, drowsiness;
• increase in body temperature to 37.5-38 ° C, chills, aches in the joints;
• decreased appetite, nausea, vomiting;
• frothiness and darkening of urine;
• clarification of feces;
• discomfort or pain in the right hypochondrium;
• yellowing of the skin, mucous membrane of the mouth;
• eyes with hepatitis have icteric color of varying degrees of severity;
• accumulation in the abdomen of the fluid( speaks about the development of cirrhosis of the liver).

It should be noted that childhood hepatitis is more severe and leads to liver cirrhosis and other undesirable consequences.

What is hepatitis C terrible about? Gradually progressive chronic form of the disease can lead to such consequences as cirrhosis and liver cancer, as well as diseases of the kidneys and thyroid gland.

How to diagnose a disease?

For general and biochemical blood tests, coagulogram, as well as tests for antibodies against hepatitis C virus and HCV-RNA, which are carried out by ELISA and PCR, are performed for accurate and complete diagnosis in case of suspected hepatitis C virus. The positive result of both tests is confirmation of the presence of hepatitis C. In addition, ultrasound examination of the abdominal cavity is performed. In some cases, a liver biopsy is additionally required. Based on the above studies, the doctor will be able to draw conclusions about the type of disease, the level of its development, the degree of liver damage and to prescribe an effective treatment for hepatitis C, as well as determine the timing of treatment for hepatitis C depending on its genotype.

Special attention should be paid to hepatitis in newborns, since in this case the interpretation of the results of the studies should be carried out, as some children may have the presence of hepatitis C RNA with a negative response to antibodies, which may indicate a so-called seronegative chronic hepatitis C.Laboratory tests are performed not immediately after birth, but at the age of 1, 3, 6, 12 months.

Treatment of hepatitis C in children

Hepatitis C should be treated by a hepatologist. Every day there is an increasing number of advertisements of various means and techniques that effectively relieve this disease. However, doctors warn that there is no miracle medicine or pill for this disease. To date, the only effective technique is the use of antiviral drugs interferon-alpha and ribavirin. The treatment regimen for hepatitis C is selected by the doctor individually for each patient, taking into account the genotype of the virus and many other factors. For effective treatment, these drugs are usually combined. However, if the patient is intolerant to one of them, the doctor may decide to prescribe monotherapy.

Antiviral therapy has a number of side effects. Thus, taking ribavirin in rare cases can cause headache, mild dyspepsia, changes in blood( signs of hemolytic anemia, increased uric acid levels).Intolerance of this drug is extremely rare.

As for interferon, a few hours after the first administration of the drug, the following side symptoms appeared in most patients:

• fever up to 38-39ºС, aches, chills;
• muscle pain;
• increased fatigue and weakness.

This condition can last from a couple of hours to 2-3 days. As the body becomes accustomed to the drug, the patient's well-being improves. However, weakness and lethargy may be present for a long time. In 2-3 months, changes in the analysis of blood( a decrease in leukocytes and platelets) are possible.

In addition, some patients may experience such side effects as weight loss, hair loss, dry skin.

To facilitate general condition and accelerate recovery, supportive therapy for this virus can be prescribed. It includes the use of hepatoprotectors( Essentseale, Karsil, Silibor, Silimar), which have properties that support the liver, sorbents( activated carbon, enterosgel) and immunomodulators.

The course of treatment for hepatitis C usually lasts from 6 to 12 months.

Because the disease causes a virus, antibiotics for hepatitis( as well as uncontrolled treatment with folk remedies) will not give a positive effect, but rather harm.

Therapy against this disease is contraindicated in the following cases:

• in the presence of severe chronic diseases( diabetes mellitus, heart failure, obstructive pulmonary disease);
• to people who underwent organ transplant;
• with intolerance to any drug against hepatitis C;
• children under 3 years old.

Prognosis for hepatitis C is variable. As a rule, recovery after an acute form of the disease comes about a year later. The chronic form can last for decades. Hepatitis C in young children has an unfavorable prognosis due to the fact that it is impossible to conduct therapy in full.

Do not let the disease run its course or self-medicate. A timely doctor's help will not only increase the chances of a favorable outcome, but also help to avoid the infection of other family members.