Genotypes of hepatitis C

For the hepatitis C virus, high variability in the genetic structure is typical. It is the ability to mutate that makes it difficult to treat the disease. In fact, the hepatitis C virus is a collection of viruses classified by genotypes and subtypes. Genotypes of the hepatitis C virus include 11 subspecies. But WHO singles out only 6 major ones that are found everywhere.

The first genotype of hepatitis C refers to the most frequently diagnosed subspecies (found in 46% of all cases). The second place is the genotype 3. In Russia, genotyping most often reveals 1, 2 and 3 genotypes, and 4 genotype is typical for North Africa.

Genotype 1b is often found on the territory of countries that once belong to the USSR. It is most difficult in the treatment of interferons, but with the development of new non-interferon protocols, the effectiveness of therapy has improved significantly.

Features of common genotypes

Genotype 1b is especially common in Japan, which is why it is often called Japanese. Distinctive features are:

• poor response to drug therapy - treatment takes quite a long time;
• the possibility of relapse;
• a symptomatic feature - accompanied by persistent fatigue, weakness, drowsiness, regular dizziness;
• a high risk of liver cancer.

This type of genotype is most often transmitted through the blood. During the entire period of therapy, the patient is recommended constant medical supervision, which allows making the necessary adjustments in the chosen treatment regimen. The use of modern drugs helps to achieve either complete clinical recovery, or long-term remission.

2, the genotype is more susceptible to antiviral therapy. Its features are: a low incidence of infection, a good response to antiviral treatment, a rare relapse, a reduced risk of developing liver cancer.

The prevalence of hepatitis C strains (the percentage of diagnosed cases)

Treatment of the disease can be carried out both in the conditions of the infectious disease department and at home. The average course of taking medication is no more than 48 weeks. During the entire period of therapy, it is necessary to observe the strictest diet and complete refusal of alcohol.

The third genotype, subtypes 3a and 3b, occurs most often. Description of its features:

• the age of patients does not exceed 30 years;
• damage to the liver is formed in a short time;
• Steatosis develops in about 70% of all diagnoses of pathology;
• a high risk of liver cancer.

The duration of active therapy is no more than 48 weeks. The forecast is favorable. Clinical cure comes in 90% of all cases.

The most dangerous form

Which genotype of hepatitis C is the most dangerous? The most complex and in the treatment, and in the course of the disease itself is a variety of 1b. It is this that particularly often causes fibrosis of the liver tissue.

Signs of damage to this genotype are:

• pain syndrome in the right hypochondrium;
• bloating;
• muscle weakness;
• the taste of bitterness in the mouth;
• eructation;
• increased fatigue and irritability;
• dark urine, light feces;
• increased body temperature;
• jaundice.

The prognosis of the disease depends on the timing of the initiation of therapy. When the pathology is transferred to the chronic format, the main task of therapy is not the destruction of the virus, but the suspension of its reproduction and a decrease in activity. Treatment is carried out with the help of antiviral drugs, which slows the formation of cirrhosis and reduces the severity of the symptoms of the disease.

Relapses of the disease are not ruled out. The patient is considered clinically healthy - the indicator does not exceed 25% of all cases - when a blood test shows the absence of viruses and decay products of hepatocytes. The lethal outcome for infection with the genotype of hepatitis 1b is fixed in 1-5% of patients.

What is the definition of a genotype for?

Genotyping is the most important analysis practiced in diagnosing hepatitis C and determining the existing strain. It helps to solve the following tasks: choice of treatment regimen, list of drugs, dosage, prognosis of course of pathology and total duration of therapy. The technologies used help to determine with 100% confidence what genotype is present in a person's blood.

Diagnostics

How to determine the genotype? Genotyping - an analysis that allows to identify a variety - is prescribed without fail, since the protocol of treatment depends on the type of hepatitis C virus present in the blood.

Genotyping - mandatory analysis for diagnosing hepatitis C

The necessary information can be obtained by PCR (polymerase chain reaction). The technique makes it possible to obtain a complete picture of the available viral load, and to confirm or refute the preliminary diagnosis.

The test results can be as follows:

• Positive (antibodies to the virus are detected). Indicates that a person either had hepatitis, or was sick at the time.
• Negative.
• Neutral. In this situation, a re-examination is necessary.

The analysis will be ready within a week.

Treatment of the disease depending on the genotype

Which of the genotypes is better treated? They give different reactions to the implementation of antiviral therapy with interferons. Strains 1 and 4 practically do not react to drug preparations. But a good virological response is given by genotypes 2 and 3. The latter is treated much better than the 2 strains.

How to treat the disease? The classical scheme of therapy of hepatitis C, regardless of the strain detected, is represented by a combined scheme. Traditionally, the patient is prescribed antiviral drugs, including ribavirin and interferon. With genotype 1b and 1a, the standard treatment regimen is complemented by the intake of a protease inhibitor.

The duration of the course therapy is determined by the treating doctor. To date, new generation drugs have appeared that allow treating even the most complex genotypes of hepatitis C, in particular, the Indian generic Sophosbuvir. With the development of cirrhosis of the liver or malignant neoplasm, the patient is given an organ transplant.

The need to make adjustments to the made medical appointments arises in the case of the following concomitant diseases:

• diabetes;
• the presence of excess weight;
• Thyroid gland diseases;
• allergic reactions.

In the treatment of hepatitis - regardless of the strain detected - a combined treatment regimen

During the entire period of taking medication, strict adherence to the diet is necessary. The principles of dietary nutrition help reduce the burden on the inflamed liver, which helps a more rapid recovery of impaired functionality. From the diet it is necessary to completely exclude any alcohol-containing beverages.

Therapy of chronic hepatitis C is to obtain a stable virologic response (SVR), which is evaluated as a criterion for recovery. The virus should be absent in the human blood for at least six months: normalization of the indices is observed, the development of fibrosis ceases. And yet, a person needs constant observation and regular delivery of tests to exclude the development of a relapse of pathology.