- Hepatitis C is a virus that mainly affects the liver and that in the long term can produce liver cirrhosis and cancer if not treated in time, but the appearance of late symptoms makes diagnosis difficult
- Parc Taulí has received a grant from the AEEEH for the detection and active diagnosis of pre-surgical patients over 50 who are infected and who do not yet know it
A silent, potentially fatal infection
Currently 58 million people have chronic hepatitis C virus infection, according to data from the World Health Organization (WHO), which estimates that in 2019 it caused 290.000 deaths. This viral infection, which can cause from mild to serious diseases such as cirrhosis of the liver and cancer, presents a great challenge: it is an asymptomatic infection in most people.
With the aim of finding patients with undiagnosed hepatitis C, the researcher from the group Inflammatory bowel disease, liver disease and Helicobacter pylori from the Parc Taulí Research and Innovation Institute (I3PT) Mercè Vergara has launched a project to actively detect these patients by performing serology prior to any surgical procedure.
Between 20 and 30% of people who become infected with the hepatitis C virus are cured spontaneously, that is to say, their body eliminates the virus without the need for treatment, explains the researcher. However, in the other In 70% of cases, the infection becomes chronic and, in the 20% of these cases evolve to liver cirrhosis and liver cancer over a long period of time, which can range from 20 to 30 years.
The big problem, the researcher points out, is that most cases have no symptoms.
"The patient may not find out about it for decades and the infection goes undiagnosed for many years," emphasizes Vergara
When the disease becomes visible, it does so with complications of liver cirrhosis, such as ascites (accumulation of fluid in the abdomen), jaundice (yellowing of the skin) or hepatic encephalopathy. Because they are detected late, this can eventually lead to death or require a liver transplant.
Detect and remove the virus
There are currently two large groups of people with the infection and who still don't know it. On the one hand, explains Vergara, those people who before 1992 they received unanalyzed blood transfusions or blood derivatives, since the infection was not known and could not be detected -who are now mostly over 80 years old-, and, on the other hand, people between 50 and 60 years old who had contact with injectable drugs as young people.
"We are actively looking for these two groups of people" in order to detect their infection and offer them treatment, explains Vergara. To do this, they will determine as clinical practice the hepatitis serology in 6.000 patients over 50 years of age who have to undergo a surgical process both on an outpatient basis and in a hospital coinciding with the usual analysis, as is already routinely done for pregnant women or blood donors.
This will be possible thanks to the grant received by the project entitled "Detection and elimination of active hepatitis C in the field of scheduled surgery”, within the framework of the Gilead Grants for Microelimination Projects in Hepatitis C and Epidemiology in Hepatitis D, of the Spanish Association for the Study of the Liver (AEEH), with funding of 29.400 euros. The project is led by the researcher Mercè Vergara, coordinator of the Hepatology Unit of the Digestive System Service, in collaboration with the Laboratory Service and the Anesthesia Service of Parc Taulí.
Once the results have been analyzed, the research team will carry out a cost-effectiveness study and, based on the results, will propose keep it as the Hospital's clinical practice.
current treatment
In the 90s, the first treatments for hepatitis C were 8-12% effective and had many contraindications. Over the years, there has been a very considerable improvement, especially since 2014 when they came out a group of medicines, which currently already show some 95-100% infection cure results and with non-existent or mild effects.
These new treatments have also had a great impact on the health system since the hospitalization of patients with decompensated hepatitis C is currently almost nil, explains Vergara.
"Once we have treated these patients that we had detected, we now begin the active search for asymptomatic patients who do not know that they have the infection in order to be able to administer these treatments for hepatitis C virus infection, avoiding the subsequent comorbidity of this" .
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