Risk of Reinfection With Hepatitis C Virus With Sustained Response to Treatment

Introduction:

One of the viral infections that causes liver inflammation is hepatitis C, and this condition leads to severe liver complications and damage. The main cause of hepatitis C spread is coming in contact with contaminated blood. HCV (hepatitis C virus) is a blood-borne virus. Its spread is because of exposure to contaminated blood due to not using sterile injections, injecting drugs, unsafe sex, and unscreened blood transfusions. There are many treatments and therapies for hepatitis C infection. But the risk of reinfection is always high in this condition.

How Does Hepatitis C Affect the Body?

Hepatitis C is a blood-borne disease that leads to severe inflammation of the liver and affects the body's immunity to a great extent. If not diagnosed and treated in the early stage, it can lead to cirrhosis of the liver (a serious end-stage liver disease), scarring of the liver, and even results in liver failure. So initial diagnosis and treatment are important to avoid serious complications.

What Are the Signs and Symptoms of Hepatitis C Infection?

Initially, the HCV infection causes mild symptoms, they are:

• Nausea.

• Vomiting.

• Fever.

• Fatigue.

• Dark-colored urine.

• Clay-colored urine.

• Abdominal pain.

• Loss of appetite.

• Jaundice - yellowish discoloration of the mucous membrane, skin, and whites of the eye.

• Joint pain.

What Treatment Is Given for the Hepatitis C Condition?

• Hepatitis C is treated with antiviral drugs, and the DAA therapy’s recommended duration of treatment is 12 weeks.

• DAA (direct-acting antiviral agents) therapy's main aim is that the affected person has no hepatitis C virus for at least 12 weeks after the treatment completion.

• HCV (hepatitis C virus) creates a protein that supports its growth; these direct-acting antiviral drugs target these proteins and restrict them, which breaks the virus's lifecycle and does not allow the virus to finish its cycle and growth.

• Before starting the treatment, it is important to inform the healthcare professional about any other medical conditions and over-the-counter medications which are already taken.

What Is a Sustained Response to Treatment?

No detection of hepatitis C virus for at least 12 weeks after the treatment; that is, DAA therapy is known as a sustained response to treatment. It is almost considered a cure.

Are There Chances of Reinfection After Sustained Response to Treatment?

There are chances of reinfection after the sustained response treatment, though it is rare. Among the patients, only one percent chance of reinfection is there.

What Are the Risk Factors Affecting the Reinfection of Hepatitis C?

Reinfection depends on the individuals who are involved in high-risk activities after a successful virologic response through treatment. The risk of reinfection from those who do not engage in higher-risk activities is negligible.

The risk factors that affect are:

• Individuals who have a habit of injecting drugs.

• Sexual contact among men who have sex with men, the risk is very high.

• Among HIV co-infected patients, it is high.

• Coming in contact with an infected person.

• Sharing nail clippers and razors.

• Sharing toothbrushes and other essential items that can be a carrier of infected blood.

• Usage of unsterilized instruments during any treatment procedures.

• Tattoo piercing with unsterile needles.

How Does Reinfection Happen?

• DAA therapy is the usage of direct-acting antiviral drugs. It works on a mechanism by blocking the protein which causes and helps the hepatitis C virus to grow. This therapy successfully treats 95 % of the diseased conditions.

• Sustained virological response (SVR) is termed when there is no detection and trace of HCV ( hepatitis C virus) for about 12 weeks after the treatment; this leads to a successful cure of hepatitis C until the risk factors are involved.

• A sustained virological response does not make an individual immune to the virus; there are more chances of reinfection if the individual comes into contact with any risk factors affecting the condition.

Who Is More Likely to Get Reinfected After a Sustained Response to Treatment?

• People who have a habit of consuming opioid drugs like Heroin which increase the risk of getting hepatitis C.

• People with an age group below 35 years.

• Males are more likely to get reinfected.

• HIV (human immunodeficiency virus) infected people are more prone to reinfection.

• Children born to HCV-infected mothers.

• Health care professionals and coworkers, and public safety personnel.

• People who are medically compromised and who might have a history of hemodialysis.

• Chronic alcoholism.

• People with fatty liver or hepatitis B infection.

• Patients who are taking immunosuppressive treatment.

What Are the Measures to Be Taken to Avoid Reinfection?

• Drug-injecting people are more prone to this reinfection, so removing the exposure to the drugs can prevent reinfection.

• Other treatments like opioid therapy can be provided along with the hepatitis C treatment, which will restrict the intake of drugs, withdrawal symptoms, and cravings for drugs like Heroin.

• Safe sex practices can avoid reinfection; using a contraceptive and safe methods of sexual contact should be mandatory to avoid infections.

• The best way to avoid reinfection is by not coming in contact with infected blood, do use sterile needles and syringes.

• Depression and other mental stressful conditions have to be considered, and counseling needs to be provided to such individuals, as this condition can lead to many habits of drug abuse and unsafe sex practice.

Conclusion:

DAA (direct-acting antiviral agents) therapy is the best treatment and a way to eliminate the HCV (hepatitis C virus) and leads to a cure for infection. But due to the involvement of high-risk factors, some of the patients are prone to reinfection. Patients involved in increased use of-injecting drugs are more prone to reinfection rather than patients who do not consume such drugs. So, at a population level, the infection, which occurs again, remains high due to people who inject drugs (PWID) because of ongoing exposure risk. In order to prevent the occurrence of reinfection and adverse effects, support services have to be provided to the people, particularly those injected with drugs. Also, counseling for the needful is recommended.