Category: Hepatitis

Abstract

The term Hepatitis refers to a group of medical conditions characterized by inflammation of the liver cells hepatocytes, the basic units of the liver. Although there are several causes of cell inflammation, a viral infection of the vital organ is the cause of more than 90% of all the cases (Longo, 2012). Currently, hepatitis types A, B, C, D, and E are the most common viral infections of the liver in humans. Infection with these viruses means that the liver plays as the host or one of the host organs that provide the virus with the required environment for replication before translation. The purpose of this paper is to discuss the cause and management of hepatitis A, B, and C. Specifically, the aim is to discuss the control and management of these diseases.

Description of hepatitis A, B, and C

Prevalence

Hepatitis viruses D and E are less important in the medical field because they are rare or depend on other factors for their virology. For instance, the hepatitis D virus co-infects with type B, entirely depending on it is causing the observable medical condition. Thus, this makes hepatitis viruses A, B, and C the most important viruses with medical importance. Hepatitis A causes more than 30,000 cases of infection every year, with more than 1.3 million people living under the condition throughout the world (CDC, 2012).

Transmission of hepatitis A

The virus is oral-fecal in nature, meaning that the mode of transmission takes place in the oral-fecal route. However, research evidence confirms that the virus is also transmitted through fluid-to-fluid contact between an infected and an un-infected individual. For instance, close person-to-person or sexual contact and blood transfusion are other important routes of transmission.

This means that the individuals at risk include people living in conditions where food contamination with fecal matter is possible, especially in cases where sewage and drainage systems are poor. In addition, people traveling to high prevalent areas are at risk because their immune system tends to be novel. Sexual contact with infected individuals, homosexual contacts, caregiving, and living with infected persons are some of the major factors that contribute to infection. Individuals with clotting factor disorders as well as those who use the injection and non-injection drugs are at risk of developing the condition (Dunn, 2011).

Once an individual is infected with the virus, regardless of the route of transmission, the virus takes between 15 and 50 days to incubate. On average, the incubation period for the virus is around 25 to 28 days. During incubation, the virus is rapidly replicating and infecting novel cells in the liver as well as other parts of the body. Replication is rapid because the virus is lysogenic, meaning that the viral DNA is integrated into the host cell genome and controls cellular functions, including programs for self-inflammation (Teufel, 2009).

After incubation, the progeny viruses infect various cells in the liver and other parts of the body. They lead to observable conditions, such as nausea, abdominal pain, loss of appetite, pain in the joints, fatigue, jaundice, fever, brown bowel movements, and vomiting. Evidently, most individuals do not portray some of the conditions. In fact, individuals may have one or a few of these symptoms. It is rare to find a case in which all or a large number of symptoms are presented in a single patient.

Young children, especially those under the age of 6 children, have the lowest probability of developing a symptomatic acute infection. It is evident that the probability of developing symptomatic acute condition increase with age. For instance, children aged between 6 and 15 years have a relatively high probability of developing the acute condition, mostly at around 40% to 50%. However, adults and adolescents aged above 15 years have the highest likelihood of developing the condition, currently amounting to 70% to 80% of the cases. In fact, these cases involve jaundice, which is the most common symptom in acute infections with the virus. However, chronic infection is not common in HVA infection, unlike in Hepatitis B and C groups. This means that condition is rarely fatal, with most people recovering within a few months and without long-lasting harm caused to the liver cells (Masuoka & Chalasani, 2013).

Transmission of hepatitis B

The virus is transmitted through direct contact with infected persons. The main routes of transmission include birth (mother to child), sexual contact, sharing of contaminated syringes, needles, and other items, such as sharp objects.

Hepatitis C

The virus is also transmitted through direct contact with infected body fluids or tissues. The routes of transmission include using the same sharp objects. such as needles, and syringes, sexual contact as well as mother-child transmission.

Test, treatment, and control

Hepatitis A

In the modern context, biomedical tools have developed rapid, effective, and high throughput techniques for the detection of viral infection in suspected individuals. Serological tests provide one of the most effective and inexpensive techniques for detection. For instance, infection with hepatitis A virus triggers the release of antibody IgM that targets human cells infected with the virus. In this case, the human immune system recognizes the infected cells and releases IgM anti-HAV antibodies. These antibodies are the hallmark molecular aspect for serological based diagnostics. Using such techniques as Enzyme-Linked Immunosorbent Assays (ELISA), it is possible to mobilize anti-IgM antibodies in a solid surface or microwells, which targets and binds the target IgM proteins.

Hepatitis B Tests

Like HAV, HBV infection triggers the release of anti-HBV antibodies. In acute infection, detection of IgM is effective in determining the presence of the virus in blood and serum. In both the chronic and the acute infection, HBsAg is the major aspect targeted in serological tests.

Hepatitis C

Unlike HAV and HBV, HCV has no serological marker for acute infection. However, screening assays, such as EIA and CIA, are effective for anti-HCV. In addition, more specific assays, such as Nucleic Acid Testing, are effective.

Molecular tests for HAV, HBV, and HCV

In addition, research has developed molecular techniques that target the specific viral DNA using such techniques as the polymerized Chain Reaction (PCR) that specifically amplifies the viral DNA for easy identification. Such methods are not only effective but also precise. Nevertheless, they are expensive and laborious because they involve molecular techniques, such as DNA isolation and polymerization.

Since both serology and molecular diagnosis are highly effective and specific, treatment and management intervention procedures tend to rely on information obtained from the tests. If these tests indicate that the individual is infected with the virus, treatment is necessary.

Management Strategies for Hepatitis A, B and C viruses

Medical interventions

Both hepatitis viruses A and B do not have pharmaceutical intervention protocols because there are no antiviral drugs targeting the virus, its proteins, or infected cells. However, HBV is best treated through regular management and monitoring of liver diseases associated with the virus. On the contrary, HCV is treated with antiviral drugs (an acute stage) and regular monitoring of liver pathologies in chronic cases.

Social support

However, there is no specific medical treatment available for managing the condition because it is mostly self-limiting and has no long-term impact on the hepatocytes. As such, the best management intervention is to provide social and psychological support. Patients should be provided with adequate material and immaterial support to ensure that they cope with the condition and enhance healing. People with other conditions, such as cancer, HIV/AIDS, and diabetes, tend to take long before the virus is cleared from their system due to immune compression. In such cases, intervention protocols should focus mainly on the disease rather than on the virus.

Lifestyle and behavior change and adaptation

It is advisable to control the disease through awareness programs. These programs aim at reducing the number of infections, which means that they are control protocols. In such cases, people are encouraged to avoid behaviors that are likely to predispose them to the virus. For instance, sexual infection is managed controlled by encouraging people to avoid unprotected sex, change sexual behavior, and reduce the number of partners.

Frequent testing is important to determine whether individuals have the virus. In addition, people should be encouraged to be careful when sharing sharp objects and needles and avoid contact with human fluids, such as semen, blood, and others (Kumar, Fausto & Abbas, 2003). People living with or caring for patients suffering from pepatitis should avoid direct contact with these fluids. Disinfection of clothes, wastes, utensils, and other objects should be done frequently.

Vaccination

One of the best ways of reducing infection rates and cases of hepatitis infections is through vaccination. Hepatitis vaccinations are developed through attenuation of the virus, conferring memory cells in the vaccinated individuals. The aim is to ensure that a novel infection or re-infection triggers anti-IgM, making it impossible for the virus to infect and replicate in the host cells (Inaba & Cohen, 2004).

Vaccinations are recommended for the groups that are at high risk of infection. For instance, children aged one year and individuals traveling from regions of low to high or intermediate prevalence should be immunized. Moreover, other individuals such as people who live or work with infected individuals, have unprotected sex with suspected partners as well as those with disorders of the clotting factor are also at high risk and should be immunized. Noteworthy, people who work with animals such as primates are prone to infection because primates harbor hepatitis in nature and easily pass them to humans due to contact.

Conclusion

This analysis provides adequate information vital for the development of effective and sustainable techniques for managing hepatitis infection. A comparison with other viruses of the same Hepatitis group is important in order to determine the condition affecting an individual before proceeding with management.

It is evident that infections with these viruses have no direct cure, although they are self-limiting in most cases. This means that healthy lifestyles, behavior change, vaccination, and mass awareness programs are the best methods for controlling the spread of these viruses.

References

Centers for Disease Control and Prevention, CDC. (2012). The ABCs of hepatitis. Web.

Dunn, M. A. (2011). Parasitic Disease. Oxford, UK: Wiley-Blackwell.

Inaba, D., & Cohen, W. B. (2004). Uppers, downers, all arounders: physical and mental effects of psychoactive drugs. Ashland, Or: CNS Publications.

Kumar, V., Fausto, N., & Abbas, A. (2003). Robbins & Cotran Pathologic Basis of Disease. New York: Saunders.

Longo, D. L. (2012). Chronic Hepatitis. New York: McGraw-Hill.

Masuoka, H. C., & Chalasani, N. (2013). Nonalcoholic fatty liver disease: an emerging threat to obese and diabetic individuals. Annals of the New York Academy of Sciences 1281(1), 106122.

Teufel, A. (2009). Update on autoimmune hepatitis. World Journal of Gastroenterology 15 (9): 10354.

The Hepatitis C virus was discovered in 1989, and since this discovery, scientists have observed that HCV has a highly variable RNA genome (Chiaho 2012). So far, six major HCV genotypes have been identified and it has been noted that their prevalence in various geographical regions varies. Genotyping is a significant development since it helps to determine the treatment regiment to be offered to the patient.

There has been an increased understanding of HCV transmission over the years. It is now known that the virus is found in various body fluids. However, the threat of infection only occurs when the virus is concentrated enough. Developments have been made in the screening of the virus. Scientists have identified many recombinant HCV diagnostic antigens and developed tests for detecting HCV antibodies (Zhang 2015). Optimal tests for HCV infection have been developed, leading to the early diagnosis and treatment of infections.

The first major treatment development took place in 1999 when scientists discovered that the combination of ribavirin and interferon was efficient in treating HCV. This led to the development of a new general of antiviral agents, which were protease inhibitors that interrupted HCV replication (Acton 2013). Combining these drugs with the IFN and ribavirin led to improved cure rates among patients.

The second breakthrough was in 2010 when the connection between the virus and the brain was made (Batool 2015). Scientists also discovered how fat contributes to the virus replication process. This led to the introduction of Direct-Acting Antivirals, which not only had higher cure rates, but they are also safer for patients. The treatment duration using DAA was 12 weeks compared to the 48 weeks needed for the Interferon and Ribavirin therapy (Mullhaupt 2015). Advances in treatment methods made over the years have greatly improved cure rates.

Hepatitis C is a disease developed from infection with the hepatitis C virus. The disease affects the liver, and it can be acute or chronic. Acute HCV results in mild illnesses that typically clear up naturally after about 6 months. Chronic infections can lead to life-threatening disease and require treatment to cure or manage. HCV infection takes a chronic course in about 80% of those infected. HCV is found in all body fluids, but it is transmitted through blood. Common forms of transmission include needle sharing among drug users and through transfusion of unscreened blood.

A significant issue with Hepatitis C is that it does not cause symptoms after the initial infection. For this reason, the Hepatitis C Virus is known as a silent disease due to its symptomless clinical course. This virus can affect an individual without producing the symptoms for many years, and diagnosis only occurs when liver cirrhosis develops. It is important to diagnose HCV infection at the earliest time possible to prevent significant damage. Screening of at-risk groups is crucial to identify the virus. Through screening, infected people can be identified and an assessment of the degree of damage done by the virus carried out.

After a positive diagnosis, a person should consider treatment. The need for treatment depends on whether the HCV is acute or chronic. Acute HCV can clear up on its own, but chronic HCV will require treatment to cure it. The current treatment regiment makes use of direct antiviral agents, which are more effective and have fewer side effects. Vaccination against HCV would be a preferred option. However, genetic diversity has made the development of a preventive vaccine difficult. Without the availability of a fully effective vaccine, optimal treatment is the primary strategy for dealing with HCV.

References

Acton, A 2013, Hepatitis C Virus: New Insights for the Healthcare Professional, Cengage Learning, Boston.

Batool, S 2015, Health Related Behaviors and Medication Adherence in Patients with Hepatitis C, Journal of Behavioural Sciences, vol. 25, no.1, pp. 15.

Chiaho, S 2012, Chronic Hepatitis B and C: Basic Science to Clinical Applications, World Scientific, NY.

Mullhaupt, B 2015, Modeling the Health and Economic Burden of Hepatitis C Virus in Switzerland, PLoS ONE vol. 10, no.6, pp. 1-13

Zhang, S 2015, Cost-effectiveness of sofosbuvir-based treatments for chronic hepatitis C in the US, BMC Gastroenterology, vol. 15, no.1, pp. 1-9.

Summary of the Article

The article written by Rena Fox (2013) is aimed at informing the audience about the approval of two drugs that can be used for the treatment of hepatitis C. These medications can be described as protease inhibitors (Fox 2013). These drugs are based on the combination of rebavirin and peginterferon.

Their main advantage is the increased SVR (sustained viral response). Nevertheless, the author notes that the treatment of hepatitis C has to become more elaborated because there are many strains of this virus (Fox 2013). However, these new drugs can offer new opportunities for patients and physicians. This is one of the aspects that should be taken into account.

The author mentions other drugs that are not tested by pharmaceutical companies. On the whole, the clinical trials of new drugs indicate that these medications can be more effective than many existing ones (Fox, 2013). Furthermore, she describes the principles that medical professionals should follow. In particular, they should evaluate every candidate for antiviral treatment (Fox, 2013).

Moreover, much attention should be paid to the possible contraindications that a person can have. Provided that contraindications prevent a person from being eligible for antiviral therapy, one should focus on the tested methods of hepatitis C treatment (Fox, 2013). Overall, the author mentions that a medical professional should decide whether the treatment can be deterred or not.

This question is particularly important at the time when there can be breakthrough treatments of hepatitis C. Under such circumstances, one should focus on the patient’s physical or mental condition and the stage of the disease. These are the main issues that Rena Fox examines in this article. To a great extent, this text can be used a guide by practitioners working with patients who have hepatitis C.

Significance to the course contents

This article can be relevant to the contents of this module as well as the entire course. First of all, it is possible to relate this text to the concept of global health. One should bear in mind that hepatitis C affects approximately 150 million people in various countries (World Health Organization, 2013).

Therefore, it is critical to find ways in which one can reduce the prevalence of this disease on a global scale. One of the tasks that should be achieved during the course is to identify the forces or factors that can shape global health. This resource shows that availability of effective drugs is the most important prerequisite for improved physical health. This is one of the main points that can be made.

Secondly, the article written by Rena Fox is closely related to the development of health promotion plans. This is also one of the issues covered during the course. As it has been said before, the author offers guidelines for determining which course of actions is most helpful for patients with hepatitis C.

Thirdly, one of the objectives that should be achieved during the course is to identify the strategies which are essential for the improvement of global health. In turn, Rena Fox (2013) demonstrates that a physician should not disregard the most recent findings of researchers, especially if these findings can be used to develop the most effective treatment methods (Roberts, 2010, p. 218).

These are the main issues that can be singled out. On the whole, this article can throw light on some of the strategies that medical professionals should adopt. This is why it should be overlooked by students.

Reference List

Fox, R. (2013). Staying Informed: Anticipating New Regimens with Direct Acting Antivirals for Hepatitis C. Web.

Roberts, P. (2010). Healthcare Research: A Handbook for Students and Practitioners. New York: John Wiley & Sons.

World Health Organization. (2013). Hepatitis C: Key Facts. Retrieved from https://www.who.int/en/news-room/fact-sheets/detail/hepatitis-c

Hepatitis B is an infectious disease of the liver that occurs due to an infection of Hepatitis B Virus (HBV). HBV infect the liver and causes hepatitis, hepatocellular carcinoma, and liver cirrhosis. Hepatitis B poses significant health problem globally because it ranks tenth among diseases that cause death.

According to World Health Organization, about 2 billion of people have experienced HBV infections and approximately 350 million have acquired chronic hepatitis B infections, hence causing about 1 million deaths annually. Across the world, there is a high variation in HBV infection as prevalence varies from 20% to 0.2% in endemic regions.

Lavanchy (2004) argues that Western countries have low prevalence because HBV infections occur mostly in adulthood, while in African and Asian countries; prevalence of HBV infection is high because it occurs in childhood (p.97). In this view, occurrence of HBV infection determines prevalence of Hepatitis B in various countries. Therefore, what are the factors that contribute to the increasing prevalence of hepatitis B in Sub-Sahara Africa?

Mode of HBV infections determines prevalence of hepatitis a given population. In African countries that lie in Sub-Sahara region experience high prevalence of hepatitis B as HBV mode of infection mainly occurs through sexual, congenital and interfamilial routes. In a study carried out in Bangui, Komas et al. (2010) reveal that, about 25% of children acquired HBV before the age of 1 year, while 48% acquired HBV infection at the ages of 10 to 15 years (p.1).

Hence, it means that the high prevalence of hepatitis B in Sub-Saharan countries is attributable to childhood infections of HBV. Assessment of the dominant mode of transmission is critical in establishing preventative strategies of HBV infections.

Given that the World Health Organization has come up with safe and effective immunization programs, chronic nature of hepatitis B is attributable to resistant strains of HBV. Resistant strains of HBV have made it difficult to prevent and treat hepatitis B among population, thus contributing to increasing incidences of the hepatitis B in Sub-Saharan countries.

According to Kukka (2010), health researchers have found out that drug resistance of HBV is a major challenge that health care system is facing in prevention and treatment of hepatitis B (p.3). Hence, preventive and treatment programs that a Sub-Saharan population employ when combating hepatitis B determines prevalence of hepatitis B among the population.

Since hepatitis B is an infectious disease, social lifestyles of people and availability of other related infections such as Human Immunodeficiency Virus (HIV), contribute significantly to increasing incidences of hepatitis. Komas et al. (2010) assert that social lifestyles such as abuse of drugs, use of alcohol, and unsafe sexual practices encourage transmission of hepatitis B and other sexual transmitted diseases (p.2).

It is evident that countries in Sub-Saharan region have a high prevalence of HIV infections relative to Western countries. Hence, examination of social lifestyles of people indicates the prevalence of hepatitis B in a given population.

High prevalence of hepatitis B in Sub-Saharan countries is due to numerous factors that promote infection of HBV. The research question is that: what are the factors that contribute to the increasing prevalence of hepatitis B among countries in Sub-Sahara Africa?

In an attempt to answer the question, the research hypothesis is that, childhood infections, resistance of HBV to drugs, and social lifestyles are dominant factors that contribute to the high prevalence of hepatitis in Sub-Saharan countries. Combination of these risk factors considerably increases the rate of HBV infections and prevalence of hepatitis B in the population.

References

Komas, N., Bai-Sepou, S., Manirakiza, A., Leal, J., Bere, A., & Le Faou, A. (2010).

The Prevalence of Hepatitis B Virus Markers in Cohort of Students in Bangui, Central African Republic. BioMed Central Infectious Diseases, 10(226), 1-6. Print.

Kukka, C. (2010). Hepatitis B. HBV Journal Review, 7(3), 1-5. Print.

Lavanchy, D. (2004). Hepatitis B Virus Epidemiology, Disease Burden, Treatment, and Current and Emerging Preventing and Control Measures. Journal of Viral Hepatitis, 1 (1), 97-107. Print

Abstract

The term “Hepatitis” refers to a group of medical conditions characterized by inflammation of the liver cells hepatocytes, the basic units of the liver. Although there are several causes of cell inflammation, a viral infection of the vital organ is the cause of more than 90% of all the cases (Longo, 2012). Currently, hepatitis types A, B, C, D, and E are the most common viral infections of the liver in humans. Infection with these viruses means that the liver plays as the host or one of the host organs that provide the virus with the required environment for replication before translation. The purpose of this paper is to discuss the cause and management of hepatitis A, B, and C. Specifically, the aim is to discuss the control and management of these diseases.

Description of hepatitis A, B, and C

Prevalence

Hepatitis viruses D and E are less important in the medical field because they are rare or depend on other factors for their virology. For instance, the hepatitis D virus co-infects with type B, entirely depending on it is causing the observable medical condition. Thus, this makes hepatitis viruses A, B, and C the most important viruses with medical importance. Hepatitis A causes more than 30,000 cases of infection every year, with more than 1.3 million people living under the condition throughout the world (CDC, 2012).

Transmission of hepatitis A

The virus is oral-fecal in nature, meaning that the mode of transmission takes place in the oral-fecal route. However, research evidence confirms that the virus is also transmitted through fluid-to-fluid contact between an infected and an un-infected individual. For instance, close person-to-person or sexual contact and blood transfusion are other important routes of transmission.

This means that the individuals at risk include people living in conditions where food contamination with fecal matter is possible, especially in cases where sewage and drainage systems are poor. In addition, people traveling to high prevalent areas are at risk because their immune system tends to be novel. Sexual contact with infected individuals, homosexual contacts, caregiving, and living with infected persons are some of the major factors that contribute to infection. Individuals with clotting factor disorders as well as those who use the injection and non-injection drugs are at risk of developing the condition (Dunn, 2011).

Once an individual is infected with the virus, regardless of the route of transmission, the virus takes between 15 and 50 days to incubate. On average, the incubation period for the virus is around 25 to 28 days. During incubation, the virus is rapidly replicating and infecting novel cells in the liver as well as other parts of the body. Replication is rapid because the virus is lysogenic, meaning that the viral DNA is integrated into the host cell genome and controls cellular functions, including programs for self-inflammation (Teufel, 2009).

After incubation, the progeny viruses infect various cells in the liver and other parts of the body. They lead to observable conditions, such as nausea, abdominal pain, loss of appetite, pain in the joints, fatigue, jaundice, fever, brown bowel movements, and vomiting. Evidently, most individuals do not portray some of the conditions. In fact, individuals may have one or a few of these symptoms. It is rare to find a case in which all or a large number of symptoms are presented in a single patient.

Young children, especially those under the age of 6 children, have the lowest probability of developing a symptomatic acute infection. It is evident that the probability of developing symptomatic acute condition increase with age. For instance, children aged between 6 and 15 years have a relatively high probability of developing the acute condition, mostly at around 40% to 50%. However, adults and adolescents aged above 15 years have the highest likelihood of developing the condition, currently amounting to 70% to 80% of the cases. In fact, these cases involve jaundice, which is the most common symptom in acute infections with the virus. However, chronic infection is not common in HVA infection, unlike in Hepatitis B and C groups. This means that condition is rarely fatal, with most people recovering within a few months and without long-lasting harm caused to the liver cells (Masuoka & Chalasani, 2013).

Transmission of hepatitis B

The virus is transmitted through direct contact with infected persons. The main routes of transmission include birth (mother to child), sexual contact, sharing of contaminated syringes, needles, and other items, such as sharp objects.

Hepatitis C

The virus is also transmitted through direct contact with infected body fluids or tissues. The routes of transmission include using the same sharp objects. such as needles, and syringes, sexual contact as well as mother-child transmission.

Test, treatment, and control

Hepatitis A

In the modern context, biomedical tools have developed rapid, effective, and high throughput techniques for the detection of viral infection in suspected individuals. Serological tests provide one of the most effective and inexpensive techniques for detection. For instance, infection with hepatitis A virus triggers the release of antibody IgM that targets human cells infected with the virus. In this case, the human immune system recognizes the infected cells and releases IgM anti-HAV antibodies. These antibodies are the hallmark molecular aspect for serological based diagnostics. Using such techniques as Enzyme-Linked Immunosorbent Assays (ELISA), it is possible to mobilize anti-IgM antibodies in a solid surface or microwells, which targets and binds the target IgM proteins.

Hepatitis B Tests

Like HAV, HBV infection triggers the release of anti-HBV antibodies. In acute infection, detection of IgM is effective in determining the presence of the virus in blood and serum. In both the chronic and the acute infection, HBsAg is the major aspect targeted in serological tests.

Hepatitis C

Unlike HAV and HBV, HCV has no serological marker for acute infection. However, screening assays, such as EIA and CIA, are effective for anti-HCV. In addition, more specific assays, such as Nucleic Acid Testing, are effective.

Molecular tests for HAV, HBV, and HCV

In addition, research has developed molecular techniques that target the specific viral DNA using such techniques as the polymerized Chain Reaction (PCR) that specifically amplifies the viral DNA for easy identification. Such methods are not only effective but also precise. Nevertheless, they are expensive and laborious because they involve molecular techniques, such as DNA isolation and polymerization.

Since both serology and molecular diagnosis are highly effective and specific, treatment and management intervention procedures tend to rely on information obtained from the tests. If these tests indicate that the individual is infected with the virus, treatment is necessary.

Management Strategies for Hepatitis A, B and C viruses

Medical interventions

Both hepatitis viruses A and B do not have pharmaceutical intervention protocols because there are no antiviral drugs targeting the virus, its proteins, or infected cells. However, HBV is best treated through regular management and monitoring of liver diseases associated with the virus. On the contrary, HCV is treated with antiviral drugs (an acute stage) and regular monitoring of liver pathologies in chronic cases.

Social support

However, there is no specific medical treatment available for managing the condition because it is mostly self-limiting and has no long-term impact on the hepatocytes. As such, the best management intervention is to provide social and psychological support. Patients should be provided with adequate material and immaterial support to ensure that they cope with the condition and enhance healing. People with other conditions, such as cancer, HIV/AIDS, and diabetes, tend to take long before the virus is cleared from their system due to immune compression. In such cases, intervention protocols should focus mainly on the disease rather than on the virus.

Lifestyle and behavior change and adaptation

It is advisable to control the disease through awareness programs. These programs aim at reducing the number of infections, which means that they are control protocols. In such cases, people are encouraged to avoid behaviors that are likely to predispose them to the virus. For instance, sexual infection is managed controlled by encouraging people to avoid unprotected sex, change sexual behavior, and reduce the number of partners.

Frequent testing is important to determine whether individuals have the virus. In addition, people should be encouraged to be careful when sharing sharp objects and needles and avoid contact with human fluids, such as semen, blood, and others (Kumar, Fausto & Abbas, 2003). People living with or caring for patients suffering from pepatitis should avoid direct contact with these fluids. Disinfection of clothes, wastes, utensils, and other objects should be done frequently.

Vaccination

One of the best ways of reducing infection rates and cases of hepatitis infections is through vaccination. Hepatitis vaccinations are developed through attenuation of the virus, conferring memory cells in the vaccinated individuals. The aim is to ensure that a novel infection or re-infection triggers anti-IgM, making it impossible for the virus to infect and replicate in the host cells (Inaba & Cohen, 2004).

Vaccinations are recommended for the groups that are at high risk of infection. For instance, children aged one year and individuals traveling from regions of low to high or intermediate prevalence should be immunized. Moreover, other individuals such as people who live or work with infected individuals, have unprotected sex with suspected partners as well as those with disorders of the clotting factor are also at high risk and should be immunized. Noteworthy, people who work with animals such as primates are prone to infection because primates harbor hepatitis in nature and easily pass them to humans due to contact.

Conclusion

This analysis provides adequate information vital for the development of effective and sustainable techniques for managing hepatitis infection. A comparison with other viruses of the same Hepatitis group is important in order to determine the condition affecting an individual before proceeding with management.

It is evident that infections with these viruses have no direct cure, although they are self-limiting in most cases. This means that healthy lifestyles, behavior change, vaccination, and mass awareness programs are the best methods for controlling the spread of these viruses.

References

Centers for Disease Control and Prevention, CDC. (2012). The ABCs of hepatitis. Web.

Dunn, M. A. (2011). Parasitic Disease. Oxford, UK: Wiley-Blackwell.

Inaba, D., & Cohen, W. B. (2004). Uppers, downers, all arounders: physical and mental effects of psychoactive drugs. Ashland, Or: CNS Publications.

Kumar, V., Fausto, N., & Abbas, A. (2003). Robbins & Cotran Pathologic Basis of Disease. New York: Saunders.

Longo, D. L. (2012). Chronic Hepatitis. New York: McGraw-Hill.

Masuoka, H. C., & Chalasani, N. (2013). Nonalcoholic fatty liver disease: an emerging threat to obese and diabetic individuals. Annals of the New York Academy of Sciences 1281(1), 106–122.

Teufel, A. (2009). Update on autoimmune hepatitis. World Journal of Gastroenterology 15 (9): 1035–4.

Introduction

Hepatitis is the inflammation of the liver that causes both soreness and swelling. Chronic hepatitis can lead to fibrosis (scarring) and cirrhosis (fibrosis plus abnormal regeneration of liver cells) or even to liver carcinoma. Hepatitis is generally caused by viruses though there are other factors such as toxic chemicals, alcohol consumption, parasites and bacteria, and certain drugs that can cause hepatitis. Symptoms of hepatitis are nausea, fever, weakness, loss of appetite, sudden distaste for tobacco smoking, and jaundice (CE, 2004). There are many kinds of hepatitis named hepatitis A through E. Hepatitis C, formerly called non-A, non-B hepatitis, is transmitted through blood although in many cases there is no proven cause (CE, 2004). It is the most common form of chronic liver disease in the United States. Many of those infected have no symptoms but become carriers, and the virus may eventually cause liver damage. Blood banks conduct tests for hepatitis C as a matter of routine. The virus that causes Hepatitis C is HCV. It is a positive, single-stranded RNA virus in the Flaviviridae family (Worman, 2002).

Prevalence

Approximately 170,000,000 people worldwide and 4,000,000 in the United States are infected with HCV (Worman, 2002). Chronic infection is found in 55%-85% of infected persons; chronic liver disease happens 70% of chronically infected persons and mortality rate is around 1%-5% deaths from chronic liver disease (CDC, 2005). However, latest statistics show that there has been a decline in hepatitis C and new infections per year has declined from an average of 240,000 in the 1980s to about 26,000 in 2004 (CDC, 2005). Illegal injection drug use and alcohol abuse can multiply the possibilities of having chronic hepatitis C(Bean and Nemitz, 2004). There is also a decline in cases of hepatitis C caused by transfusion due to efficient blood screening practices. The CDE reports that approximately 4.1 million (1.6%) Americans have been infected with HCV, of whom 3.2 million are chronically infected (CDC, 2005).

Prognosis

About 85% of individuals acutely infected with HCV become chronically infected. Hence, HCV is a major cause of chronic hepatitis. Once chronically infected, the virus cannot be eradicated without treatment. Some patients do not develop any complication while some patients develop chronic hepatitis which can later become cirrhosis. About 20% of individuals with hepatitis C who develop cirrhosis are likely to develop end-stage liver disease (Worman, 2002). Cirrhosis caused by hepatitis C is presently the leading indication for orthotopic liver transplantation in the United States. Individuals with cirrhosis from hepatitis C are also at an increased risk of developing hepatocellular carcinoma (primary liver cancer). In general, younger patients with evidence of active inflammation on liver biopsy and without advanced cirrhosis have excellent prognosis with treatment (Worman, 2002). A major problem in discussing prognosis in patients with chronic hepatitis C is that it is difficult to predict who will have a relatively mild course and who will go on to develop cirrhosis or cancer. However, alcohol abuse can increase chances of developing cirrhosis (Bean, 2004).

Diagnosis

The diagnosis of chronic hepatitis C is made by history, serological testing and liver biopsy. Most patients with chronic hepatitis C will be asymptomatic or have non-specific symptoms such as fatigue. In some individuals, the diagnosis will be suspected from the results of blood tests obtained for other reason (usually elevations in the serum alanine and aspartate aminotransferase activities) (Worman, 2002). Generally people with symptoms of chronic liver disease and those who have a history of drug abuse or alcohol abuse need to be tested for the presence of serum antibodies against HCV. If it is present it suggests the diagnosis of chronic hepatitis C. In order to confirm the diagnosis, tests for HCV RNA in blood should be carried out in persons with anti-HCV antibodies. After making the diagnosis, it is best to do a liver biopsy to assess the degree of liver inflammation and fibrosis and the presence or absence of cirrhosis (Worman, 2002).

Treatment

Treatment of chronic hepatitis C is presently based on the use of interferon-alpha. Interferon-alpha is a protein that is given by injection, usually three times a week. The addition of ribivirin, a non-specific, orally administered anti-viral agent, improves the efficacy of interferon-alpha. Although interferon-alpha with or without ribivirin works for some patients with hepatitis C, most do not achieve a “sustained response” of undetectable virus in blood 6 months after stopping therapy. The next drug available for the treatment of chronic hepatitis C is peginterferon-alpha (sometimes called “pegylated interferon”). The active agent in peginterferon-alpha is the same old interferon-alpha (Worman, 2001). It has demonstrated enhanced compliance and clinically superior anti-viral activity. Currently, combination therapy with peginterferon-alpha-2a (40kD) and oral ribavirin is poised to become a valuable first-line treatment option in chronic hepatitis C (Keating and Curran, 2003). In addition to PEG-Intron, there are three more interferon products approved by the FDA: Intron A, Roferon-A, and Infergen. These three products are injected three times a week; PEG-Intron is injected once a week (Bren, 2001). Therapeutic vaccines are also being developed to enhance the immune response against the hepatitis C virus. A therapeutic vaccine is administered to already-infected individuals to stimulate the immune system to fight the infection (Worman, 2001). Though there is no vaccine to prevent hepatitis C, but there are vaccines for hepatitis A and B. The CDC recommends these vaccines, particularly the hepatitis A vaccine, for HCV-positive individuals. Becoming infected with hepatitis A virus can be dangerous for someone with HCV infection.

Bibliography

1. Worman, J. Howard (2002). Hepatitis C.
2. Columbia Encyclopedia. Hepatitis. 2004. Sixth Edition
3. CDE (2005). Hepatitis C Fact Sheet. Web.
4. Worman, J. Howard (2001). New and Future Treatments for Chronic Hepatitis C.
5. Keating and Curran (2003). Peginterferon-alpha-2a (40kD) plus ribavirin: a review of its use in the management of chronic hepatitis C. Drugs. 2003; 63(7):701-30. Web.
6. Bean and Nemitz (2004). Drug Treatment: What Works? Routledge, New York. 2004
7. Bren, Linda (2001). Hepatitis C. FDA Consumer, Volume 35, Web.

Introduction

The word hepatitis originates from the Latin language which translates to inflammation of the liver.(Howard “Hepatitis c” Pp 1). This means hepatitis mainly affects the liver leading to its inflammation and impairment of the liver functions. Key among these functions is detoxification of the blood hence regulating its composition. Production of bile which is very essential for the digestive process is also a function of the liver. Metabolism of some metallic compounds, production of coagulation factors, storage of energy, breaking and releasing out of ammonia back to protein synthesis are all functions of the liver. There are several forms of the disease hepatitis depending on the causative agent. According to Henkel, there are five forms of hepatitis C marked by letters A, B, C, D and E (p.5).

Hepatitis C is caused by the virus hepatitis C. It is an infectious blood borne disease. The virus mainly affects the liver and may have very adverse effects on it. Once in the body the virus replicates at the lymph nodes and the hepattocellular cell lines. (Meller Gunji et al 1994 cited at Feitelson p.113) Hepatitis C occurs in two conditions both the acute and the chronic phases. The acute one has rare indications of symptoms. It only lasts for the first six months after infection by the Hepatitis C virus. The second phase is the chronic phase and as stated by Henkel (p 5) it takes over after the six months and may last for 20 to 30 years before the manifestation of symptoms. Complication of other diseases may speed up the show of symptoms otherwise, the disease is normally found accidentally or through blood screening for instance during blood donation. The other way of identifying the disease is by looking out for the patient’s history. This viral disease does not have a vaccine yet. Due to the fact that it does not show signs and the mild signs seen at the acute phase are not so serious, the patient may opt not to seek any medication. This has led to a wide spread of the disease and the current reported condition in the world is approximately 150 to 200 million people infested with about 350 000 cases not reported. The US has an epidemiology of 4 million people infected. (Remis, R. S 2001 pp12) The highest population is within the HIV population. This co infection is due to the fact that both viruses (the HIV virus and the Hepatitis C virus) are blood borne and survive well in almost the same environment. The percentage of people with co infection stands at 14% (Branch., p. 22) A high population of this disease has also been found in Egypt; Africa.

History

Hepatitis C virus was discovered in 1989 by scientist at the Chiron Corporation who had been carrying on the hepatitis research on monkeys (Fitelson pp 8-11). It was published in the Land mark paper in the journal science later that year and the formerly described Non A and Non B Hepatitis virus was named Hepatitis C (Howard” Hepatitis C” p. 7). This virus was found to be different from the known hepatitis A and B, as it spread after transfusion and was not food borne but blood borne. It was not until 1992 that a method of detecting the virus in the blood was found and now the blood could be screened for Hepatitis C before transfusion. This has reduced the risks of transferring the virus via blood transfusion from 30% to almost 0% as observed in 2000. (Feitelson pp 5). From then on so many ways of testing have been used including the use of machines but it is the biopsy of the liver at the chronic stage that has been the most effective. Some medications have also been developed to curb this disease although effective at early stages.

In the five known Hepatitis viruses (A, B, C, D and E), it is only the C virus has been found to be from the hepacivirus genus in the family flaviviridae (Feitelson pp 21). There consists of around six genotypes of this virus in the human body. It is a small virus in an enveloped form. The Hepatitis C virus is single stranded in nature and has a very positive response to the RNA. (NDDIC).

The virus spreads through blood contact which is more evident in people who use the same injections in administration of drugs. Inhalation of drugs like cocaine also accounts for the spread of the disease. Transfusion of infected blood was the main cause of spreading the virus, but since 1992 when a way of identifying the virus from blood screens in was discovered, there has been massive reduction of patients who have contracted the disease through this mode (Health Canada pp 270). This is due to the fact that all the blood is screened before giving it to the recipient. Clark JM, (Pp 3004) says Organ transplants from infected persons to healthy individuals contribute greatly to the viral transmission. Lactogenic medication and dental exposure also results to transfer of the virus from one individual to the other. This is also a matter of unsterilized equipments used in the process as well as poorly sterilized equipments. Occupational exposure is a method of contracting the virus especially for the medics. In this case, the nurses, doctors and emergency health providers come into contact with the blood of the infected persons accidentally. It may also be an accidental prick with a needle from the patient’s injections. Body piercing and tattooing are avenues that continue the spread of this virus. This is so in cases where the tools used are not properly sterilized or the ink been contaminated. Another way in which the virus can be spread is by sexual exposure especially with one who has both Hepatitis C and a sexually transmitted disease like HIV/AIDS. Sharing of personal items for instance; toothbrushes, razors and nail cutters poses a danger of spreading the virus (Centers for Disease Control and Prevention pp 22). An unborn child can contract the disease from an infected mother during birth process or even the blood circulation process at the womb. Blood products transferred to the patient in hospital like clotting factors and plasma, if not properly screened may result to the spread of the disease.

Classification

As earlier stated the disease occurs in two forms the acute form and the chronic form. The acute form is characterized by the e absence of major or any symptoms. Te few persons who develop some symptomatic signs they are too mild to be taken to hospital thus most of the patients just ignore medication and gives chance for the infection to develop to the chronic stage (Angus Reid Group pp 35). The symptoms in this stage do not direct to a specific disease live alone Hepatitis C. They include signs like; pain in the abdomen, feeling tired, yellowish discoloration of membranes (the white part of the eye, mucus membranes and the skin) called icterus or jaundice, itching and flu symptoms. Decreased appetite, sleep disturbances headaches and mood swings are also signs of the acute phase of the disease.

In the chronic form of the disease, there are very few directive symptoms but the disease is noted by a lot of fatigue where on feels so tied even early in the morning. This fatigue may be associated with the one caused by diabetes or heart problems. It is caused by the slow in toxin removal in the blood systems hence slow circulation. Flu-like signs are also carried on to this phase. Other signs noted in the acute phase which are just advanced in this phase include; itching causing sleep disturbances, abdominal pains, lowered levels of appetite, headaches and mood swings. Fever and outbursts of anger are signs associated with the chronic form of Hepatitis C. Muscle pains joint pains, and depression highlights signs of this phase. The abdominal pains further develop to diarrhea and a nausea feeling is common. There is a very great loss in weight within a short period of time. The brain is affected and causes impairment in thinking, memory, self awareness and the general behavior of oneself therefore results into some mental depression. Chronic Hepatitis C may cause indigestion problems called dyspepsia.

The chronic phase if not well treated advances to liver fibrosis and further to liver cirrhosis or even hepattocellular carcinoma (liver cancer) (NCFID). Liver fibrosis is the accumulation of tough fibrous proteins like collagen in the tissues of the liver. It entails the disarrangement of the tissues forming the scar and degradation of the matrix. This results into cirrhosis or even liver failure thus portal hypertension. At this stage (portal hypertension) no amount of drugs can reverse the situation and therefore only a liver transplant can save the individual.

On the other hand, liver cirrhosis is a total change of liver tissues by the fibrous protein tissues responding to the infection of the liver (Howard “The liver disorders” pp9). This occurs when the liver is totally damaged and is seen by development of nodules on the liver surface. This causes a major loss in the liver functions. It is characterized by fluid retention in the abdomen a case referred to as ascites. The other complication is disturbed mental condition leading to a state of coma caused by accumulation of ammonia and other toxins eliminated by the liver hence they find their way to the brain. At this stage the color of the liver changes to yellow and jaundice is evident. This also causes the urine to appear dark. Jaundice is developed due to lack of bilirubin by the liver. Along with jaundice is the change of nail color (only a third of the nail has color the rest is white) and nail shape as the nail folds at the top part. The liver is responsible for the production of coagulation factors (Rowe, W. pp 44).

Mode of transmission

When its functions stop there is a state of a lot of injury and uncontrolled bleeding. Itching continues due to deposition of bile and its products at the surface of the skin. Bone pains are also experienced in the condition of liver cirrhosis while fingers get deformed as the spleen and veins in the abdomen and esophagus enlarges. Upon examination the stools are found to be fatty. There are other reproductive associated complications like; impotence, infertility and loss of libido. In the men their breasts develop a firm mass extended at the nipples. A person suffering from liver cirrhosis is very sensitive to drugs as he has a very low level/rate of metabolism of the compounds in the drugs. In cirrhosis condition the blood does not pass normally through the lung circulation amounting to dyspnea and cyanosis (Howard J. “The Hepatitis C” p 17). It further leads to increased pressure at the lungs causing portal hypertension.

The last result of chronic Hepatitis C is the advancement of liver problems to cancer of the liver. This is a condition referred to as hepattocellular carcinoma. This is an absolute failure of the liver functions and requires a liver transplant. All this lower the immune system and expose the patient to secondary infections.

Symptoms

Several tests have been conducted to identify the presence of Hepatitis C. Although the diagnosis is rare on the acute phase, it can still be conducted. This is so due to the fact that, the symptoms at this stage do not call for any serious medical attention. The diagnosis at the chronic phase needs a lot of caution as it does not have very specific symptoms to the disease. Most symptoms are for cirrhosis which may not have occurred as a result of Hepatitis C but other factors like; excessive consumption of alcohol and fatty liver disease. Hepatitis B may also cause liver cirrhosis. The very advanced stages of this disease (Hepatitis C) may occur when one is already dead since it takes 20-30 year to manifest the symptoms as seen earlier in this work. The other choice that is now left is to consider the medical history of the patient. This calls for doctors to be very careful with patients especially if the symptoms they have are minor. At whatever case the doctors should not settle on mare assumptions after getting the signs that the patient presents but rather, they should carry out all possible tests to out rule possibilities of treating the wrong disease or just the symptoms leaving the root cause of the problem. Any history of drug abuse, inhaled drugs, alcoholism, piercing and tattooing should be taken to great considerations. Trying to get the contact trace on the individuals who had some sexual affairs with the patient may also lead to diagnosis of the disease in these people as highlighted by Mast, E, E. and M, J. Alter (p 22). Contact tracing is not much used because it creates a fear in people seeking medical assistance especially on sexually transmitted diseases.

Laboratory test are very vital in diagnosis of the Hepatitis C virus. Blood testing can be carried out to determining whether there is any form of unusual liver functions and liver enzyme formation. Blood screening especially for blood donors is a sure way of diagnosing Hepatitis C. Blood tests can also be carried out to determine the exposure of the Hepatitis C virus in the patient’s blood. This is done by checking on the antibodies that respond to Hepatitis C virus. The antibodies can be detected after a breeding period of about four months (Jennkins pp 9). A very positive answer can however be detected after six months. This test may not work for patients who do not have enough antibodies for there is a certain level required for the antibodies to be seen. This method of antibodies screening is not very effective as only few patients develop antibodies to the level needed for detection. It also has a disadvantage where the test only shows exposure and cannot tell if the patient has an ongoing infection. This therefore calls for more tests to determine the presence of an infection in the patient. When one tests negative and there are some other indications of Hepatitis C.

Blood tests do not give the best results compared to biopsy examinations that show the condition of the liver. The blood tests are however preferred due to less cost and non involvement in surgical measures. The blood tests carry several stages as shown by Jennkins (pp 9). The stages may be a pre-examination to biopsy tests or just a completion of the diagnosis of the disease. The first test to be done is the ALT test to determine the amount of enzyme alanine amino transfer in the liver. This is followed by the EIA (Enzyme immuno assay) that seeks to reveal the antibodies affiliated to the HCV. This test is always 90-95% accurate (Jennkins pp 9). RIBA (Recombinant immunoblot assay) test is then done to detect the specific antibodies and finally the PCR (Polymerase chain reaction) test for the viral load hence determine the severity of the infection. This is possible because the virus was observed to be a single stranded RNA (Hagedorn, C. H. and Rice, C. M pp 12). Other possible tests include; the transcription mediated amplification (TMA), the ELISA test and branched DNA (b-DNA) test (). These tests are advantageous because they detect the exposure of the patient to the virus, the presence of an infection and give the viral load of the virus (the quantity/population of the virus in the blood). The last test on Hepatitis C is the genotype testing. This needs some caution since the viral genotype and viral load are not a clear show of the liver damage.

To this point chronic Hepatitis C is more diagnosed through a combination of the above tests and extra hepatic manifestations seen in the presence of the Hepatitis C virus. Such manifestations include: thyroid inflammation and hyper or hypo thyrosis (disruption of the thyroid function). Porphyria cutanea tarda which is defined as low levels of enzyme that helps in heme formation thus one gets blister formation on contact with the sun rays is also an extra hepatic manifestation. Kidney inflammation, presence of large amounts of cryoglobulin proteins in the blood and diabetes mellitus can be associated with extra hepatic functioning of the body. Some individuals may encounter dryness of the mouth, eyes and the nose. A condition called sicca syndrome (Askari. K Fred &Danie. S Cutler pp 43).

When one has been diagnosed of Hepatitis C, then the next thing that follows is treatment. Seeking medication at an early stage is very vital as the very late stages can not be reversed even in the use of drugs. The acute phase can clear on its own and registers 90% success upon treatment as shown by (Health Canada pp 268). Caution should be taken to avoid spontaneous clearance without treatment as the symptoms may ease out yet living the virus still under multiplication at the liver. This later develops into the chronic form of the disease.

In cases of the chronic stages there are very small chances of self recovery. It therefore calls for administration of drugs. The most commonly used drugs are pegylated interferon alpha used in conjunction with an anti viral drug called ribavirin. They are given according to the genotype because some genotypes require much more dosage to clear than others. Genotype 1 which is more common in the US is given a dose that takes 12 months (NDDIC), while genotype 2 and 5 take 6 months. In genotype 6 the medicine is administered for a whole year. The treatment is much easier in cases of a low viral load. Since the number of viruses is small and their multiplication rate is also low then their clearance is faster. There are more drugs still under the experimental stages and we hope that they will be a great improvement to the current drugs in reducing the prevalence of the disease. Some of the drugs under study include: pyrimidine (to be used with interferons), protease inhibitors and polymerase inhibitors. There are also some developments on albuferon, zadaxin and DAPY for treatment of Hepatitis C (Fred MW et el pp 980). The current used drugs show some side effects like; flu syndrome, fatigue, muscle pains, nausea and vomiting, low grade fever, skin irritations and coughs. The adverse side effects include: temporary disabilities, anemia and diseases involving the heart and the circulatory system, bone marrow suppression, permanent hair loss as well as massive unrecoverable weight loss (Fred MW et el pp 982). Psychiatric problems may develop on the use of these drugs and due to the earlier faced psychological stress, result to suicidal ideation.

Prevention to any disease is always the best cure. Hepatitis C can be prevented by change of some behavioral aspects and been a little more careful with hygienic aspects. Hepatitis C patients should take precaution and get vaccinated against Hepatitis A and B to avoid infection that could worsen their liver conditions. People suspecting to have Hepatitis should keep off from alcohol consumption as it increases liver fibrosis and liver cirrhosis. Alcohol also increases the chances of contracting liver cancer. Smoking increases incidents of scars in the liver developing to liver fibrosis (Shiell, A. & Law, M. 22). Therefore smoking should also be a behavior to avoid. Sharing of needles and equipments used in drug administration should be unheard of. People should be advised to avoid some tattoo methods that seem to be unhygienic and the sharing of tattoo equipments that are not properly sterilized. Keep off unsanitary methods of piercing the body or even acupuncture (Askari. K Fred &.Danie. S Cutler p. 77-79). Be careful in case of helping in an accident event avoiding injury to yourself or direct contact with blood from the casualties. Do not share personal items like tooth brushes, razors, nail cutters or the manicure/pedicure set (Howard J. “The Hepatitis C” p 17). In case of sex with multiple partners ensure you use a condom.

Conclusion

To conclude, it is only reasonable to advocate for the preventive measure be put into great consideration. As much as, Hepatitis C would seem to be harmless it is killing quite a number of our youth so anti drug campaigns should be emphasized in schools. Medical practitioners should also exercise more caution in blood related practices. The government should enhance drug control measures to reduce the spread of this silent killer.

Work cited

Angus Reid Group. Hepatitis C: Final report. Report to Health Canada. (2000) pp 34-40.

Askari. K Fred &Danie. S Cutler. Hepatitis C, the silent epidemic: the authoritative guide. UK: perseus publishing. (1999) pp 25-90.

Branch, C.L. Hepatitis C: State of the art at the millennium. US: Thieme publishers (2000) pp 37-38.

Centers for Disease Control and Prevention. Recommendations for prevention and control of Hepatitis C virus (HCV) infection and HCV related chronic disease. Morbidity and Mortality weekly report 1998; 47: pp 1-39.

Clark J. M, and Diehl AM. Nonalcoholic fatty liver disease: an under recognized cause of cryptogenic cirrhosis. JAMA. (2003): pp 3000-4.

Feitelson Mark. Hepatitis C: From laboratory to clinic. USA: Cambridge University press. (2002) pp 5-113.

Fred MW, ML Shiffman, KR Reddy et al. Peginterferon alfa-2a plus ribavirin for chronic hepatitis C infection. New England Journal of Medicine. (2002) 347: pp 972-982.

Hagedorn, C. H. and Rice, C. M. The hepatitis C viruses. Berlin, Germany: Springer-Verlag. (2000). pp 8-29.

Health Canada. Mediums to reach injecting drug using populations. Ottawa: Health Canada. (2000) pp 268-290.

Henkel John. Hepatitis C: New cure helps some but cure remains elusive. US: Diane publishing Co. (1999) pp 5-10.

Howard J. Worman. The Hepatitis C: source book. USA: Mc Graw-hill professional publisher. (2002). pp 5-19.

Howard J. Worman. The liver disorders: source book. USA: Mc Graw-hill professional publisher. (1999). pp 9-32.

Jenkins Mark. Hepatitis C: Practical, medical & spiritual guidelines for daily living with HCV. Hazelden publishers. (2000). pp 9.

Kaplowits N &D. Laurie. Drug induced liver disease. New York: Marcel. (2003) pp 450-451.

Mast, E, E. and M, J. Alter. Hepatitis C: Semi pediatric infectious disease (1997). pp 6-28.

Remis, R. S. Estimating the number of people co-infected with hepatitis C virus and human immunodeficiency virus in Canada. Report to Health Canada. (2001). Pp 70-92.

Rowe, W., Rowe, J. and Malowaniec, L. (2000). Hepatitis C: Mental health issues.

Canadian Journal Of Public Health, 91. Supplement 1: (2000). pp 42-44.

Shiell, A. and Law, M. G. The cost of hepatitis C and the cost-effectiveness of its prevention. Health Policy. 58: (2001).pp 121-131.

Strader DB, T. Wright, DL. Thomas & LB Seef. Diagnosis, management and treatment of Hepatitis C: Hepatology (2004) 1147-1171.

National Center for Infectious Diseases: Arctic Investigations Program. (NCFID). 2008. Web.

National Digestive Information Clearinghouse (NDDIC). Web.

Introduction

A chronic illness and disability have a great impact on individual lives and wellbeing. Hepatitis C, a known virus-caused disease that attacks the liver and that is also a chronic infector, is also spread by such an intimate exchange of infected body fluids. Moreover, the researchers suggested, the promiscuous men would probably encounter that organism, whatever it was, repeatedly; as a result, their immune systems would be overwhelmed, leaving them vulnerable to all manner of infections (Falvo, 2005).

Signs and Symptoms of Chronic Form of Hepatize C

A chronic form, involves liver biopsy, which develops in the patients who become infected. The main problem is that chronic form has no symptoms (Worman 2006). There was a clue from the spread of the hepatitis virus; along with its ability to enter the body through mucous membranes, the virus also gained easy access via needles that were contaminated by infected blood and were shared among heroin users (a common practice). The symptoms of hepatitis C are go unnoticed. For this reason, it is difficult to estimate the total number of infections and the number of people who manage to eliminate the virus. This form of hepatitis does not directly destroy hepatic cells.

Diagnosis

The main problem is that the symptoms of hepatitis C are indistinguishable from the hepatotrophic virus. Also, antibodies against hepatitis C do not appear until about 8-10 weeks after onset of the disease, a doctor cannot diagnose a disease. Chronic hepatitis C is diagnosed when abnormal liver tests are found. In most cases, “the physical examination is completely normal, but in some, the liver may be moderately enlarged and slightly tender” (Worman 2006, p. 65). Also, if the secondary factors were known, some of them might be appropriate targets in any effort to block full-scale development of hepatitis C in those infected. The harm reduction model, retrospectively understood in terms of a health belief model, can be applied to understand hepatitis C risk behavior. It maintains that when individuals are threatened by logistic and legal barriers.

Hepatitis C is a classic, serious complication of blood transfusions, and even though an almost foolproof screening test for it has been widely used for more than fifteen years, new forms of hepatitis caused by yet-unidentified viruses have surfaced, and are believed to be infecting 7 percent to 10 percent of the 4 million Americans who receive transfusions every year. If true, this would be a far greater threat than transfusion-related AIDS (Rhodes and Hergenrather 2003, p. 347). A number of predisposing elements — things that work in tandem with the basic causative agent of hepatitis C — have been suggested, among them duration of infection, environmental agents, genetic influences, a previously compromised immune system, and coexistent infection with other viruses or bacteria. Although investigators have yet to come up with firm data to support any of these secondary causes, there is a continued keen interest in what role, if any, they may play in hepatitis C (Worman 2006).

Psycho-Social Factors

The main psycho-social aspects involve emotional reactions to chronic illness and disability such as grief, fear and anxiety, anger and depression, feelings of guilt and frustration. When the illness diagnosed, patients may feel frustration and emotional distress which influences their life style and relations with the environment. “Those with chronic illness or disability may have particularly strong feelings of anger or hostility about their diagnosis or the circumstances surrounding their condition” (Falvo 2005, p. 6). And so, many researchers say they have come up with evidence to prove that positive thinking, a healthy attitude, and mental imagery that focuses on actually battling a disease like, say, cancer can be used successfully to fight off the disease and improve survival (Falvo, 2005). They know, also, that grief can temporarily injure immune function, and there is mounting evidence that daily, garden-variety stresses, as well as heavier pressures, can alter the level of T-cells just enough to set off a wide range of disorders from allergies to genital herpes. Among patients with hepatitis C, depression seems to be more frequent than in other diseases (Habib, 2003).

Other symptoms are equally nonspecific and include loss of appetite, nausea with little or no vomiting, vague abdominal discomfort localized over the liver, and joint pains with no swelling. The weak immune response also accounts for the shortage of liver failure in hepatitis C (Worman 2006). A feeling of anxiety and anger is caused by the fact that some patients are infected by donor blood or needles (Habib, 2003). A feeling of anger and frustration may be cause by late diagnosis and progression of the disease. Identifying that role, determining whether it takes more than the hepatitis C virus alone to cause the disease, would give researchers a clue not only to what conditions and practices beyond those already known increase the risk of infection, but to what proportion of infected individuals will ultimately develop the disease — questions that are still high among those about hepatitis C yet to be resolved. many patients are well aware of possible disabilities caused by hepatitis C, which lead them to feeling of guilt and anxiety. in this case, “frustrated goals, loss of self-regard, or loss of the illusion of omnipotence and control can result in internalized anger, anxiety, and guilt. To a great degree, how individuals adjust will be related to how they conceptualize the losses” (Falvo 2005, p. 85).

Treatment

Treatment and rehabilitation processes require cooperation of different medical professional involving therapists and psychologists in order to help a patient maintain a healthy attitude towards life and overcome depression and desperation. Chronic illness has a great impact on life style changing behavior patterns and relations with people. A person with hepatitis C has to change its diet and limit sexual relations with partners. “Cognitive changes that inhibit or regulate emotional responses can result in disinhibition, impaired judgment, or impaired impulse control” (Falvo 2005, p. 53). Treatment also affects life style and behavior of a person. Treatment for hepatitis C involves interferon b and ribavirin. In some cases, interferon b cannot be used because it temporarily makes that disease worse. People with severe symptoms and abnormal liver tests with do not receive treatment because of the risk of making the disease process and causing the death (Habib, 2003; Lieber, 2001).

Prognosis

Prognoses for hepatitis C and its proliferation are not optimistic. Hepatitis C is fast becoming the world’s leading infectious killer, with conservative estimates indicating that there are more than a billion people infected throughout the world — 200 million as chronic carriers of the virus (which means they can pass it on to someone else) -50 million new infections every year, and more than 2 million deaths a year. Unlike AIDS, hepatitis C is highly endemic in places like the People’s Republic of China (500,000 to 1 million new cases every year) and Southeast Asia. Even Eastern Europe, the Soviet Union, and the Middle East, thus far spared from AIDS, are endemic areas for hepatitis C (Worman, 2006). The gap in time between identifying the cause of a disease like hepatitis C and finding a way to prevent, control, or eradicate it is often, unfortunately, a long one. When a disease breaks forth from concealment and manifests its power, it is farther on the road to being cured. But the fact remains that virtually all of the infective agents that have plagued humankind down through the centuries have been as persistent in maintaining their grip on their hosts as the scientists have been in trying to loosen it.

References

Falvo, D. (2005). Medical and Psychosocial Aspects of Chronic Illness and Disability-3rd Edition. Jones and Bartlett Publishers.

Habib, S. E. (2003). Understanding the Context of Risk Practices among Injecting Drug Users: Implications for Hepatitis C Prevention. Australian Journal of Social Issues, 38 (1), pp. 1-4.

Lieber, Ch. S. (2001). Alcohol and Hepatitis C. Alcohol Research & Health, 25 (4), pp. 245-250.

Rhodes, S. D., Hergenrather, K. C. (2003). Using an Integrated Approach to Understand Vaccination Behavior among Young Men Who Have Sex with Men: Stages of Change, the Health Belief Model, and Self-Efficacy. Journal of Community Health, 28 (5), 347.

Worman, H. J. (2006). The Liver Disorders and Hepatitis Sourcebook. McGraw-Hill; 2 edition.

Prominent aspects of the disease

Hepatitis is a group of infectious diseases involving liver inflammation with viruses. There are five types of them with A, B, and C being the most widespread. Hepatitis C is a viral disease caused by infection with the virus called HCV that makes hepatocyte cells inflamed and damaged. Hence liver cells lose the ability to filter the blood and absorb carbohydrates, fats, and proteins (Foung & Baumert, 2019). Viral hepatitis C can be found both in chronic and acute types. No medical service can provide an effective vaccine against HCV nowadays because of the rapid mutations processes and numerous genotypes swiftly adapting to the immune system. The modes of transmission include contacts with infected blood or contaminated instruments; the virus is often transmitted from a mother with HCV to a child (Ghany et al., 2019). HCV is a common reason for liver cancer, cirrhosis, and liver transplantation.

Current data and statistics related to the disease

Hepatitis C is supposed to be the most common disease caused by a virus and transmitted by blood in the United States. The prevailing genotype among US citizens is genotype G1 (75%) (Ghany et al., 2019). According to the Centre for Disease Control and Prevention (Ghany et al., 2019), about 3,700 cases were reported in 2018, with 3 million people infected in the U.S. More than 70 million people from all over the world are suffering from HCV. According to the most recent data, the total number of deaths in the U.S. officially approached 16,000 people in the year 2018 (Ghany et al., 2019). Approximately 500,000 people die from Hepatitis C annually.

Health disparities related to the disease

The incubation period usually lasts from two weeks to six months. The main danger of this form of Hepatitis lies in the difficulty of diagnosis at an early stage for a complete absence of symptoms or insignificant manifestation. Besides, such symptoms are “disguised” as signs of other diseases. Patients may experience fever, decreased appetite, fatigue, vomiting, nausea, abdominal pain, dark urine, and jaundice (Ghany et al., 2019). Some psychological symptoms as depression, anxiety can also be added here.

Prevention strategies including complementary and alternative health therapies

The World Health Organization elaborated a set of instructions on preventing Hepatitis C. The recommendations are as follows: providing safe injections in the provision of medical care, testing donated blood for HBV and HCV, drug addiction treatment (Ghany et al., 2019). The best prevention measure from HCV, according to ASSLD, is the patient with Hepatitis, totally aware of how to stop communicating the disease to others (Ghany et al., 2019). Hepatitis C can be prevented through treatment or behavioral changes, such as public projects on eliminating social stereotyping.

Health therapy involves DAA (direct-acting antivirals) that can cure the majority of detected HCV cases. Alternative therapies help patients afflicted by anxiety and depression to make them feel more hopeful or to eliminate some symptoms. For instance, it is believed that milk thistle and Vitamin D intake can help to supplement liver functioning during medical treatment (Llewellyn et al., 2019). What is more, such activities as yoga, massage, and acupuncture help diminish anxiety and some symptoms.

Contemporary research

During the last 20 years, a considerable breakthrough in treating and studying HCV has been made. The most contemporary research provided the world with direct-acting antiviral medication, which causes fewer side effects than before (Foung & Baumert, 2019). Screening programs and laboratory testing have been worked on to detect the disease at the early stages. Although there is no vaccine, progress has been made, and new possible molecular are being explored (Foung & Baumert, 2019). Besides, for the last period, new studies on neurophysiological and psychosocial aspects of the disease in HCV patients started to appear (Llewelin et al., 2019). However, there is a lot of research to do before humanity can eliminate a disease like this.

Pathophysiologic effects of stress-related Hepatitis

The identification of psychological and psychiatric symptoms is crucial during the treatment. People diagnosed with Hepatitis may be prone to panic, hopelessness, and guilt, thus being exposed to mental illnesses more than physically healthy people. Some researchers relate these symptoms to HCV neurotoxicity (Barreira et al., 2019). It means that the virus can intrude in CNS and contaminate microglial cells, affecting memory and cognitive processes, causing fatigue, and depriving the ability to concentrate. The mentioned characteristic of the virus may make the disease progress faster. Understanding the stress mechanisms in hepatitis patients can help to improve the medical treatment significantly.

Evidence-based stress management interventions that might help with prevention or cure

Learning about the disease more can help to prevent it and cure it successfully. Thus, some psychosocial studies conducted by Turkish researchers revealed that people taking DDA report being depressed and having problems with social functioning (Kesen et al., 2019). The researchers insist on providing psychotherapeutic services to the patients.

There is also the study by Llewellyn and others (2019) detecting that hepatitis A and B vaccination were less successful among the people who were stressed or felt a lack of social support. According to the research, antibody concentration also depends on the patient’s stress during the treatment (Llewellyn et al., 2019). Llewellyn (2019) also adds that people surrounded by healthy people have higher antibody responses while being treated. Therefore, psychological well-being and warm social relationships positively affect the immune system and its possibility to fight the disease.

References

Barreira, D. P., Marinho, R. T., Bicho, M., Fialho, R., & Ouakinin, S. R. S. (2019). Psychosocial and neurocognitive factors associated with hepatitis C–Implications for future health and well-being. Frontiers in psychology, 9, 2666. Web.

Foung, S. K., & Baumert, T. F. (2019). Current progress and challenges in the development of a hepatitis C virus vaccine. Frontiers Media SA.

Ghany, M. G., Marks, K. M., Morgan, T. R., Wyles, D. L., Aronsohn, A. I., Bhattacharya, D.,… & Heller, T. (2019). Hepatitis C guidance 2019 update: AASLD-IDSA recommendations for testing, managing, and treating hepatitis C virus infection. Hepatology, 71(2), 686-721. Web.

Kesen, O., Tarık Kani, H., Yanartaş, Emre Aykut, U., & Gök, B. (2019). Evaluation of depression, anxiety, and quality of life in hepatitis C patients who treated with direct acting antiviral agents. PubMed Central (PMC), 30(9), 801-806. Web.

Llewellyn, C., Ayers, S., McManus, C., Newman, S., Petrie, K. J., Revenson, T. A., & Weinman, J. (2019). Cambridge handbook of psychology, health and medicine. Cambridge University Press.

The Hepatitis C virus was discovered in 1989, and since this discovery, scientists have observed that HCV has a highly variable RNA genome (Chiaho 2012). So far, six major HCV genotypes have been identified and it has been noted that their prevalence in various geographical regions varies. Genotyping is a significant development since it helps to determine the treatment regiment to be offered to the patient.

There has been an increased understanding of HCV transmission over the years. It is now known that the virus is found in various body fluids. However, the threat of infection only occurs when the virus is concentrated enough. Developments have been made in the screening of the virus. Scientists have identified many recombinant HCV diagnostic antigens and developed tests for detecting HCV antibodies (Zhang 2015). Optimal tests for HCV infection have been developed, leading to the early diagnosis and treatment of infections.

The first major treatment development took place in 1999 when scientists discovered that the combination of ribavirin and interferon was efficient in treating HCV. This led to the development of a new general of antiviral agents, which were protease inhibitors that interrupted HCV replication (Acton 2013). Combining these drugs with the IFN and ribavirin led to improved cure rates among patients.

The second breakthrough was in 2010 when the connection between the virus and the brain was made (Batool 2015). Scientists also discovered how fat contributes to the virus replication process. This led to the introduction of Direct-Acting Antivirals, which not only had higher cure rates, but they are also safer for patients. The treatment duration using DAA was 12 weeks compared to the 48 weeks needed for the Interferon and Ribavirin therapy (Mullhaupt 2015). Advances in treatment methods made over the years have greatly improved cure rates.

Hepatitis C is a disease developed from infection with the hepatitis C virus. The disease affects the liver, and it can be acute or chronic. Acute HCV results in mild illnesses that typically clear up naturally after about 6 months. Chronic infections can lead to life-threatening disease and require treatment to cure or manage. HCV infection takes a chronic course in about 80% of those infected. HCV is found in all body fluids, but it is transmitted through blood. Common forms of transmission include needle sharing among drug users and through transfusion of unscreened blood.

A significant issue with Hepatitis C is that it does not cause symptoms after the initial infection. For this reason, the Hepatitis C Virus is known as a silent disease due to its symptomless clinical course. This virus can affect an individual without producing the symptoms for many years, and diagnosis only occurs when liver cirrhosis develops. It is important to diagnose HCV infection at the earliest time possible to prevent significant damage. Screening of at-risk groups is crucial to identify the virus. Through screening, infected people can be identified and an assessment of the degree of damage done by the virus carried out.

After a positive diagnosis, a person should consider treatment. The need for treatment depends on whether the HCV is acute or chronic. Acute HCV can clear up on its own, but chronic HCV will require treatment to cure it. The current treatment regiment makes use of direct antiviral agents, which are more effective and have fewer side effects. Vaccination against HCV would be a preferred option. However, genetic diversity has made the development of a preventive vaccine difficult. Without the availability of a fully effective vaccine, optimal treatment is the primary strategy for dealing with HCV.

References

Acton, A 2013, Hepatitis C Virus: New Insights for the Healthcare Professional, Cengage Learning, Boston.

Batool, S 2015, ‘Health Related Behaviors and Medication Adherence in Patients with Hepatitis C’, Journal of Behavioural Sciences, vol. 25, no.1, pp. 15.

Chiaho, S 2012, Chronic Hepatitis B and C: Basic Science to Clinical Applications, World Scientific, NY.

Mullhaupt, B 2015, ‘Modeling the Health and Economic Burden of Hepatitis C Virus in Switzerland’, PLoS ONE vol. 10, no.6, pp. 1-13

Zhang, S 2015, ‘Cost-effectiveness of sofosbuvir-based treatments for chronic hepatitis C in the US’, BMC Gastroenterology, vol. 15, no.1, pp. 1-9.