{"id":8741,"date":"2015-05-28T14:37:35","date_gmt":"2015-05-28T12:37:35","guid":{"rendered":"https:\/\/dev.93-93-113-41.plesk.page\/?page_id=8741"},"modified":"2024-06-01T12:07:49","modified_gmt":"2024-06-01T10:07:49","slug":"hepatitis-cronica-per-virus-hepatitis-c","status":"publish","type":"page","link":"https:\/\/dev.93-93-113-41.plesk.page\/ca\/serveis\/aparell-digestiu\/hepatologia\/hepatitis-cronica-per-virus-hepatitis-c\/","title":{"rendered":"Hepatitis Cr\u00f2nica per Virus Hepatitis C"},"content":{"rendered":"

Qu\u00e8 \u00e9s l’Hepatitis C?<\/h2>\n

L’Hepatitis cr\u00f2nica pel VHC \u00e9s una malaltia lentament progressiva caracteritzada per la inflamaci\u00f3 hep\u00e0tica persistent, amb una progressi\u00f3 de la rigidesa hep\u00e0tica (fibrosi).<\/p>\n

La infecci\u00f3 cr\u00f2nica per virus de l’hepatitis C (VHC) \u00e9s un problema de salut p\u00fablica important. A Espanya, la prevalen\u00e7a en adults que presenten anticossos contra aquest virus \u00e9s del 1.7%. Existeixen diversos tipus virals (genotips) que varien en funci\u00f3 de factors com ara l’\u00e8tnia, sent el genotip “1b” el m\u00e9s freq\u00fcent a Espanya.<\/p>\n

Quins s\u00edmptomes presenta?<\/h2>\n

La infecci\u00f3 recent pel virus de l’hepatitis C (VHC) usualment \u00e9s asimptom\u00e0tica. Al voltant del 15-45% de les persones infectades, presenten curaci\u00f3 de la mateixa despr\u00e9s de 6 mesos de la infecci\u00f3 sense rebre tractament. Un 55-85% d’aquests pacients presentaran una infecci\u00f3 cr\u00f2nica per VHC. En aquests pacients existeix un risc del 15% d’evolucionar a cirrosi hep\u00e0tica en 20-30 anys. Una vegada que la cirrosi s’ha establert pot romandre indolent en alguns pacients per molts anys mentre que en altres progressar\u00e0 a carcinoma hepatocel\u00b7lular (CHC) o descompensaci\u00f3 hep\u00e0tica. Quan la cirrosi ja est\u00e0 establerta, hi ha m\u00e9s probabilitat de presentar c\u00e0ncer hep\u00e0tic o descompensacions, el que empitjora de forma important el pron\u00f2stic de la malaltia.<\/p>\n

Com es diagnostica?<\/h2>\n

At\u00e8s que pot cursar com una infecci\u00f3 asimptom\u00e0tica, els pacients poden ser diagnosticats si el seu metge sospita que presenten factors de risc, com ara:<\/p>\n

\u2022 Haver rebut transfusions sangu\u00ednies, productes sanguinis o immunoglobulina anti-D durant l’embar\u00e0s abans de 1990.
\n\u2022 Tatuatges o perforacions amb materials no esterilitzats
\n\u2022 Usuaris de drogues intravenoses o coca\u00efna intranasal.
\n\u2022 Treballadors del sector sanitari.
\n\u2022 Pacients en di\u00e0lisi.
\n\u2022 Aquells que participen en relacions sexuals d’alt risc.<\/p>\n

Una altra forma freq\u00fcent de diagn\u00f2stic \u00e9s al objectivar alteracions en els par\u00e0metres de funci\u00f3 del fetge en persones que es van realitzar una an\u00e0lisi de sang per qualsevol altra causa. El seu metge li indicar\u00e0 realitzar detecci\u00f3 d’anticossos dirigits contra el VHC que en cas de ser positius, obliguen a sol\u00b7licitar la c\u00e0rrega viral del VHC, per distingir entre infecci\u00f3 actual o passada.<\/p>\n

Quin \u00e9s el pron\u00f2stic?<\/h2>\n

En l’hepatitis cr\u00f2nica pel VHC \u00e9s fonamental con\u00e8ixer el grau de fibrosi ja que aquesta determina de manera important el tractament a seguir i en conseq\u00fc\u00e8ncia el pron\u00f2stic de la malaltia. La fibrosi es pot mesurar a trav\u00e9s de t\u00e8cniques de elastograf\u00eda de transici\u00f3 hep\u00e0tica (FibroScan CAP\u00ae)<\/a> o mitjan\u00e7ant bi\u00f2psia hep\u00e0tica.<\/p>\n

Quin \u00e9s el tractament?<\/h2>\n

El tractament del VHC ha evolucionat en el transcurs del temps amb taxes de curaci\u00f3 de menys del 10% el 1990 a m\u00e9s del 90% l’any 2014. El panorama del tractament de l’hepatopatia per VHC canvia r\u00e0pidament. L’aprovaci\u00f3 dels inhibidors de la proteasa NS3 de primera generaci\u00f3, Telaprevir (TPV) i boceprevir (BOC) en l’any 2011 va representar un gran avan\u00e7 en el tractament de l’hepatitis cr\u00f2nica per VHC. La combinaci\u00f3 de TPV o BOC amb Peg-INF-\u03b1 i Ribavirina (RBV) van demostrar una major taxa de resposta viral sostinguda (RVS) en pacients amb infecci\u00f3 pel genotip 1 i fibrosi \/ cirrosi avan\u00e7ada.<\/p>\n

Els tractaments basats en Interfer\u00f3 produeixen un gran nombre d’efectes adversos, especialment per a pacients amb hepatopatia avan\u00e7ada. Aquests efectes adversos inclouen risc de descompensaci\u00f3 hep\u00e0tica, infecci\u00f3 greu i supressi\u00f3 de components sanguinis a nivell medul\u2022lar. Els efectes adversos psiqui\u00e0trics de tipus ansi\u00f3s, depressiu i l’insomni tamb\u00e9 s\u00f3n molt freq\u00fcents.<\/p>\n

En poblacions seleccionades, els r\u00e8gims lliures d’interfer\u00f3 amb antivirals d’acci\u00f3 directa (Sofosbuvir, Ledipasvir, Simeprevir, Paritaprevir \/ Ritonavir, Dasabuvir i Ombitasvir), s\u00f3n el nou est\u00e0ndard de tractament. Aquests nous f\u00e0rmacs obtenen taxes de curaci\u00f3 en m\u00e9s del 90% de les persones infectades pel VHC, s\u00f3n efectius contra genotips que abans eren dif\u00edcils de tractar i s’ha incrementat l’efic\u00e0cia i disminu\u00eft la durada del tractament. Un nombre significatiu de f\u00e0rmacs es troben en diferents fases de desenvolupament i s’espera la seva aprovaci\u00f3 en els propers anys.<\/p>\n

El seu metge especialista de la Unitat d’Hepatologia li indicar\u00e0 quin \u00e9s el tipus de tractament adequat en el moment actual, segons les recomanacions vigents.<\/p>\n","protected":false},"excerpt":{"rendered":"

Qu\u00e8 \u00e9s l’Hepatitis C? L’Hepatitis cr\u00f2nica pel VHC \u00e9s una malaltia lentament progressiva caracteritzada per la inflamaci\u00f3 hep\u00e0tica persistent, amb una progressi\u00f3 de la rigidesa hep\u00e0tica (fibrosi). La infecci\u00f3 cr\u00f2nica per virus de l’hepatitis C […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":0,"parent":7391,"menu_order":4,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-8741","page","type-page","status-publish"],"yoast_head":"\nHepatitis Cr\u00f2nica per Virus Hepatitis C - Servidigest<\/title>\n<meta name=\"description\" content=\"L'Hepatitis cr\u00f2nica pel VHC \u00e9s una malaltia lentament progressiva caracteritzada per la inflamaci\u00f3 hep\u00e0tica persistent, amb una progressi\u00f3 de la rigidesa hep\u00e0tica (fibrosi).\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/dev.93-93-113-41.plesk.page\/ca\/serveis\/aparell-digestiu\/hepatologia\/hepatitis-cronica-per-virus-hepatitis-c\/\" \/>\n<meta property=\"og:locale\" content=\"ca_ES\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Hepatitis Cr\u00f2nica per Virus Hepatitis C - Servidigest\" \/>\n<meta property=\"og:description\" content=\"L'Hepatitis cr\u00f2nica pel VHC \u00e9s una malaltia lentament progressiva caracteritzada per la inflamaci\u00f3 hep\u00e0tica persistent, amb una progressi\u00f3 de la rigidesa hep\u00e0tica (fibrosi).\" \/>\n<meta property=\"og:url\" content=\"https:\/\/dev.93-93-113-41.plesk.page\/ca\/serveis\/aparell-digestiu\/hepatologia\/hepatitis-cronica-per-virus-hepatitis-c\/\" \/>\n<meta property=\"og:site_name\" content=\"Servidigest\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/servidigest\" \/>\n<meta property=\"article:modified_time\" content=\"2024-06-01T10:07:49+00:00\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:site\" content=\"@servidigest\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"4 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/dev.93-93-113-41.plesk.page\/ca\/serveis\/aparell-digestiu\/hepatologia\/hepatitis-cronica-per-virus-hepatitis-c\/\",\"url\":\"https:\/\/dev.93-93-113-41.plesk.page\/ca\/serveis\/aparell-digestiu\/hepatologia\/hepatitis-cronica-per-virus-hepatitis-c\/\",\"name\":\"Hepatitis Cr\u00f2nica per Virus Hepatitis C - Servidigest\",\"isPartOf\":{\"@id\":\"https:\/\/dev.93-93-113-41.plesk.page\/ca\/#website\"},\"datePublished\":\"2015-05-28T12:37:35+00:00\",\"dateModified\":\"2024-06-01T10:07:49+00:00\",\"description\":\"L'Hepatitis cr\u00f2nica pel VHC \u00e9s una malaltia lentament progressiva caracteritzada per la inflamaci\u00f3 hep\u00e0tica persistent, amb una progressi\u00f3 de la rigidesa hep\u00e0tica (fibrosi).\",\"breadcrumb\":{\"@id\":\"https:\/\/dev.93-93-113-41.plesk.page\/ca\/serveis\/aparell-digestiu\/hepatologia\/hepatitis-cronica-per-virus-hepatitis-c\/#breadcrumb\"},\"inLanguage\":\"ca\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/dev.93-93-113-41.plesk.page\/ca\/serveis\/aparell-digestiu\/hepatologia\/hepatitis-cronica-per-virus-hepatitis-c\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/dev.93-93-113-41.plesk.page\/ca\/serveis\/aparell-digestiu\/hepatologia\/hepatitis-cronica-per-virus-hepatitis-c\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Serveis M\u00e8dics de Cl\u00ednica ServiDigest\",\"item\":\"https:\/\/dev.93-93-113-41.plesk.page\/ca\/servicios\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Aparell digestiu\",\"item\":\"https:\/\/dev.93-93-113-41.plesk.page\/ca\/servicios\/aparato-digestivo\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Hepatologia. 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