VIRAL HEPATITIS C - GLOBAL HEALTH PROBLEM

Purpose: to propose a multidisciplinary approach for early diagnosis and therapy of viral hepatitis C (VHC). Material/Methods: A prospective cross-sectional study was conducted on epidemiological, demographic, clinical, laboratory and viral characteristics in fifty cases of VHC confirmed with positive anti-HCV (by ELISA). Thirty-eight of the cases were hospitalized in different clinics in Pleven (2017-2018). The remainders were blood-donors for the Regional Center of Transfusion Hematology - Pleven. The genotype of HCV and the viral load had been investigated by Real-Time PCR in the Laboratory of Virology at Military Medical Academy - Sofia. Results: The most affected age groups were 30-39 years and 60-69 years (24%, respectively); males 69.81% (p<0.05). Surgical interventions, blood infusions and hemodialysis (26.32%, 23.68% and 15.79%, respectively) were at the highest risk for VHC (p>0.05). Thirty hospital patients were with chronic VHC (78.95%) (p<0.05). Clinical symptoms suggestive of viral hepatitis were fatigue (39.47%; OR 5.25), decreased appetite (28.95%; OR 2.16), abdominal discomfort (21.05%; OR 23.33); 52.63% of patients were asymptomatic (p<0.0005). Laboratory investigations revealed slightly or moderately elevated total bilirubin (mean 53.27 +/- 37.38 mu mol/L; 95% CI 18.48-88.06), ASAT (mean 231.36 +/- 155.82 IU/L; 95% CI 79.91-382.80) and ALAT (mean 294.48 +/- 196.26 IU/L; 95% CI 96.37- 492.59) (p>0.05). All isolates of HCV had been proved to be genotype 1b. The viral load was detectable in 22 samples (range 683-673,720 copies/mL). Conclusion: VHC is mostly asymptomatic. Screening for anti-HCV in risk groups and genotyping of HCV will reduce nosocomial transmission, facilitate early therapy and prevent complications of infected individuals.