患者从丙型肝炎转变为无丙型肝炎

Jan Barbo likely got hepatitis C from a blood transfusion. Almost 50 years ago, she suffered an ectopic pregnancy when a fertilized egg attached itself in her fallopian tube instead of her uterus. Barbo needed emergency surgery and two pints of blood after her fallopian tube, unable to accommodate the growing embryo, ruptured.“The nation’s blood supply wasn’t screened for hepatitis C until 1992, when a highly sensitive test to detect the virus was developed,” saysHarrys Torres, M.D.，副教授传染性疾病。“在此之前接受输血的人处于危险之中，因为丙型肝炎是通过血到血的接触传播的。”

Three-fourths of reported cases can be traced to people who had blood transfusions before the blood supply was screened, or who shared needles while injecting illegal drugs, Torres says. The virus can also be spread through improperly sanitized tattoo and body-piercing equipment.

托雷斯说：“如果针上有被感染的血液，它是可传播的。”

在20至30年的过程中，一种缓慢作用，昏昏欲睡的病毒，乙型肝炎静静地攻击了肝脏。Barbo的输血是在1968年，但她的丙型肝炎症状是疾病的过程，直到1982年才变得显而易见。

“我的皮肤很夸张，眼睛是黄色的，我病得很重，”住在新墨西哥州的巴尔波回忆说。

Her doctor in Sante Fe diagnosed Barbo with hepatitis, but recommended she wait for better drugs to come along before seeking treatment.

“The only therapy available at that time would take one year to complete,” Barbo recalls. “My doctor said the remedy would cause me to feel as though I had influenza every day and I’d likely become depressed. The success rate averaged only 25%.”

So Barbo waited. Instead of undergoing treatment, she focused on a healthy lifestyle. She exercised every day, ate a balanced diet and abstained from alcohol, which could further damage her liver.

多年后，她开始由于有时会导致癌症的胰腺囊肿引起的严重腹痛。

“I knew胰腺癌was serious, so I wasn’t about to mess around,” she says. “I headed straight to MD Anderson.”

To help the increasing number of patients who are battling both cancer and hepatitis C, Torres established a new clinic at MD Anderson in 2009. It’s the only one of its kind in the country.

托雷斯说：“没有其他癌症中心只专门用于管理两种疾病的患者。”

2013年，食品和药物管理局批准了一类新的用于丙型肝炎的药物，称为直接作用抗病毒药或DAAS。患者每天服用一药，持续12周。副作用几乎不存在，治愈率为95％。

“These new drugs have changed the face of hepatitis C treatment,” Torres says. “Three months, one pill a day, and you’re cured. The virus is completely eradicated.”

迄今为止，在MD Anderson的丙型肝炎诊所中已经有600多名患者，而且这一数字正在增长。

流行

在美国，大约有400万人感染了丙型肝炎，在全球范围内有1亿人感染。

托雷斯说：“实际上，这个数字可能要高得多，因为许多人四处走走。成千上万的案件未报告。”

患者不知道会被感染，因为它们没有症状，因为该病毒几十年来会造成肝脏损害。它用纤维疤痕组织代替了健康的肝组织 - 这种疾病称为肝硬化。最终，肝脏可能停止正常运行，并可能发生肝衰竭或癌症。

托雷斯解释说：“肝脏试图通过用它产生的新细胞代替疤痕来治愈自己。”

“但是您的肝脏产生的新细胞越多，发生变化或突变的机会就越高。这就是患有丙型肝炎的人的肝癌的发展 - 美国肝癌的主要原因。”

Patients have no clue they’re infected because the virus causes no symptoms as it does its damage over decades. Most people find out they have the disease through blood work collected during a routine medical exam, or while visiting the doctor for an unrelated problem.

“Most people with hepatitis C are going about their everyday business,” Torres says, “unaware they carry the virus.”

他说，好消息是，今天人们对丙型肝炎筛查的需求有所提高。坏消息是，新诊断的患者的数量正飙升，因为该病毒在几年前染色。每年在美国诊断出约17,000例新病例。

托雷斯说：“这是一种流行病。”“鉴于60年代和70年代休闲毒品的流行率，1992年之前没有血液供应筛查，以及病毒的两到三年的病程，疾病预防与控制中心anticipates a major spike in liver disease,” he says. “An overwhelming number of people will be
needing medical care, including liver transplants and cancer care, over the next two decades.”

阅读有关MD Anderson的丙型肝炎诊所的更多信息，与病毒相关的癌症及其对婴儿潮一代的风险征服杂志。