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Virus Hepatitidy C

20.02.2014 | Sekce: Zdravotní

Základní informace o virové hepatitidě C, testování a léčbě, v článku Vraťky Králové.

VIRUS HEPATITIDY C - Žloutenka Céčko

aneb Kdo ji ještě nemá, ať se přihlásí!

 

Žloutenka. Céčko. Hepka. Hepatitida.

Spousta z vás ji má a nic s ní nedělá. A kdo ji nemá, brzy mít bude - tedy ovšem, pokud se budeš chovat nezodpovědně. Počet nově nakažených v ČR za rok je zhruba 800 lidí, především narkomanů. Jde ale jen o ty, kteří se nechali testovat. Ve skutečnosti bude lidí s céčkem mnohem více. Čím déle fetuješ, tím je větší pravděpodobnost, že tě Céčko jednou dožene. Pamatuj, že věřit můžeš jenom sám sobě. Svoje buchny, svoje nádobíčko, svoje voda.

 

CO TO JE?

Virová hepatitida C je vážné zánětlivé onemocnění jater, které se nemusí několik let vůbec projevit. V tichosti ničí tvoje jaterní buňky a vytváří z nich vazivovou tkáň (tzv. fibrózu). Pokud se včas neléčí a získá převahu, játra ti „ztvrdnou" (tzv. cirhóza), což ti může způsobit rakovinu, následné jaterní selhání a smrt.

 

JAK SE PŘENÁŠÍ?

Hlavní způsob, jak se nakazit, je kontaminace krví. U narkomanů se rozšiřuje zcela běžně sdílením jehel a stříkaček. Někdy se může přenést také pohlavním stykem, ale je to málo pravděpodobné, neboť sperma či vaginální tekutina obsahuje jen velmi malé množství viru. Pokud se však při sexu poraní nějakým způsobem sliznice (např. při análních praktikách), riziko nákazy se zvyšuje.

Je zaznamenáno i pár případů, kdy se nakazí plod od matky. Většinou k tomu dochází při porodu, kdy se smíchá krev matky s krví dítěte.

Dokonce je možné, že se můžeš nakazit v tetovacím salónu, pokud pracovníci dostatečně nevysterilizují nástroje (rovněž přenos krví!).

 

Recept na získání Céčka:

-          sdílení jehel

-          sdílení vody, filtrů, lžiček

-          sdílení zubních kartáčků, žiletek, holících strojků

-          šňupání ze společné trubičky

-          sex bez kondomu

-          tetování v pochybném salóně

 

Pokud víš, že máš céčko, tak se chovej tak, abys nikoho nekakazil/a! Nepůjčuj nikomu svoje jehly, rozdělávačky ani vodu a používej kondom. I zubní kartáček může být skrytou hrozbou. Při čištění zubů si totiž můžeš poranit sliznici, na kartáčku ulpí tvá krev i s virem (ten vydrží na vzduchu i několik hodin!!), který snadno pak infikuje někoho jiného, kdo má i nepatrnou ranku v ústech.

 

JAK SE PROJEVUJE?

Tato nemoc se nemusí několik let projevit vůbec a u každého je jiná. Třeba po 10 nebo až po 20 letech můžeš pociťovat zcela nespecifické příznaky, jako je slabost, únava, problémy se zažíváním, čemuž se většinou zpočátku nevěnuje pozornost.

Pak se ale přidají obtíže, které souvisejí se změnami jaterní tkáně a její špatnou funkcí:

-          krvácení z jícnu (můžeš klidně vykrvácet)

-          volná tekutina v dutině břišní (ascités) - „obrovské břicho"

-          zhoršené dýchání

-          žluté zabarvení očí a kůže (proto název žloutenka)

-          jaterní encefalopatie (poškození mozku toxiny, které játra nejsou schopna v důsledku onemocnění zpracovat)

-          psychické poruchy

-          a mnoho dalších příznaků

 

Aby se tato infekce včas podchytila a včas se mohla léčit, je dobré chodit pravidelně na testování. Ideální frekvence je každé tři měsíce.

Pokud tě zabiják céčko nijak nevyvádí z míry a nechceš ho řešit, stejně si zajdi k lékaři nechat si vyšetřit krev. Je dobré vědět, jak na tom jsi.

A pokud se léčit chceš, tady je návod, co pro to udělat. Bude se zde často opakovat slovo pravidelně a spolehlivý. Léčba Céčka totiž vyžaduje disciplínu!

 

Žloutenka C: Základní otázky a odpovědi.

 

1. Kde se mohu nechat otestovat?

Většina káček zajišťuje nebo zprostředkovává testy na žloutenky a HIV. Otestovat se můžeš rovněž u svého praktického lékaře, nebo na specializovaných pracovištích - hepatologických poradnách. V Praze je to např. ICDZ ve Fakultní nemocnici Motol (tel. č. 224 436 930).

REMEDIS v Nuslích (tel.č.: 226 216 200).

 

2. Za jak dlouho bude výsledek?

Záleží o jaký druh testu jde. V káčku a v terénu často probíhají o orientační rychlotesty, jejichž výsledek je za 20 minut. Při testech z plné krve je výsledek za pár dní až týdnů. Většinou za 14 dní. Za jak dlouho si máš zavolat, nebo kdy se máš pro výsledek dostavit, ti řeknou konkrétně v daném zdravotnickém zařízení.

 

3. Výsledek potvrzuje, že mám Céčko. Co se bude dít dál?

Lékař si tě bude zvát na pravidelné prohlídky, udělá vyšetření jater ultrazvukem (SONO), pravděpodobně provede také biopsii (odběr malého kousku jater speciální jehlou pro zjištění jejich stavu). Tím, že budeš k němu před léčbou pravidelně docházet, si tě „oťuká" a zjistí, zda jsi spolehlivý a jestli má smysl tě léčit. Protože musíš opravdu pravidelně chodit na kontroly a pravidelně brát léky. Jestliže nejsi schopen přijít včas na prohlídku, pak se s léčbou můžeš rozloučit.

 

4. Budou mě vůbec léčit, když beru?

Donedávna pokud byl někdo beroucí, tak jej vůbec nebyli lékaři ochotni léčit. A to z důvodu, že při nedekončení zahájené léčby se výrazně zhoršuje účinnost léčby nové. A také proto, že když někdo bere jehlou, tak hrozí, že se i infikuje znovu, například jiným typem žloutenky C, a tak by byl léčba zbytečná. Nicméně již existují pracoviště (např. Remedis), kde tě budou ochotni léčit, i když bereš. Musíš ale dokázat, že jsi spolehlivý a schopný docházet na dohodnuté schůzky.

 

5. Chodím včas na všechna vyšetření a lékař usoudil, že mě bude léčit. Jak to probíhá?

Virové hepatitida C se léčí zpravidla 12 měsíců a to kombinací dvou léků: Ribavirinu a Interferonu.

Ribavirin se užívá pravidelně v tabletách 2x denně - ráno a večer.

Interferon se aplikuje 1x týdně injekčně pod kůži (subkutánně).

Mezitím musíš průběžně chodit na odběry, aby se vědělo, jak rychle klesá či neklesá hladina viru v krvi (tzv. viremie). Dostaneš „plánovací kalendář" a v něm zaznamenané dny, kdy se máš na vyšetření dostavit. (Tak to hlavně neztrať J )

 

6. Léčba interferonem a ribavirinem má prý spoustu nežádoucích účinků. Je to pravda?

Ano. Ačkoliv interferon pomáhá hubit zákeřný virus, dokáže docela znepříjemnit život. Mezi ty nejčastější nežádoucí účinky patří:

-          bolesti svalů, kloubů, hlavy, zvýšená teplota

-          nechutenství, průjem, zvracení

-          sklony ke krvácení

-          deprese, sebevražedné sklony

-          kožní vyrážka

-          dočasná ztráta vlasů

I Ribavirin může nasekat pěknou paseku - způsobuje např. anemii (chudokrevnost).

Pokud se u tebe některý z těchto příznaku objeví, neváhej to doktorovi říct. Spousta pacientů, kteří se interferonem léčí, bere např. antidepresiva.

 

7. Jsem vyléčen! Natrvalo?

Lékaři jsou v tomto ohledu v používání pojmu „vyléčen" obezřetní. Spíše používají termín Setrvalá virologická odpověď, což je stav, kdy je půl roku po ukončení léčby hladina viru v krvi (viremie) neměřitelná. Riziko, že se infekce vrátí, je v tomto případě minimální (cca 1%) avšak možné. Proto po prodělání virové hepatitidy C nesmíš být nikdy dárcem krve.

Každý člověk je však individuální a na každého to působí jinak. V průběhu léčby se proto aktivně ptej a dodržuj doporučení lékaře.

I po ukončení léčby musíš ještě několik let pravidelně chodit na kontroly, zda se virus nevrátil.

A pozor! Hepatitidou se můžeš i po vyléčení znovu nakazit! Takže bacha na sdílení!

 

8. Kolik mě ta léčba bude stát?

Pokud máš české pojištění, tak jenom minimální množství - 30Kč za každou lékařskou prohlídku a 30Kč za každý recept.

Ale abys byl v obraze, taková léčba hepatitidy přijde tvou pojišťovnu na sta tisíce korun!!

Pokud české pojištění nemáš, tak tě bohužel léčit nikde nebudou (pokud nejsi v přímém ohrožení života). O důvod víc, proč si ho zařídit. Káčkaři či teréňáci ti rádi poradí, jak na to ;-)

 

Vraťka

Komentáře

 

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