There are 3 viruses that cause hepatitis. Each hepatitis virus is named with a letter of the alphabet hepatitis A, hepatitis B and hepatitis C. Hepatitis C is usually spread through contact with blood products, like accidentally being stuck with a dirty (used) needle, using IV drugs and sharing needles, or getting a blood transfusion before 1992. Most people don't feel sick when they are first infected with hepatitis C. Instead, the virus stays in their liver and causes chronic liver inflammation.
Most people who are infected with hepatitis C don't have any symptoms for years. However, hepatitis C is a chronic illness (it doesn't go away). If you have hepatitis C, you need to be watched carefully by a doctor because it can lead to cirrhosis (a liver disease) and liver cancer.
An estimated 3 percent of the world's people carry a virus that silently attacks their livers. Most people infected with the hepatitis C virus (HCV) have no symptoms at all. In fact, most people don't know they have the disease until liver damage shows up, decades later, during routine medical tests.About 20 percent of people with hepatitis C develop cirrhosis, usually several decades after infection. Of those who have cirrhosis, about half progress to either liver failure or cancer.
Hepatitis C is one of six identified hepatitis viruses — the others are A, B, D, E and G. All cause the liver to become inflamed, which interferes with its ability to function. Hepatitis C is generally considered to be among the most serious of these viruses.Currently, it's estimated in the United States that a many as 10 to 20 thousand people each year are dying of hepatitis C-related liver disease. Hepatitis C accounts for nearly a third of all liver cancer cases in the United States, and it's the most common indication for liver transplantation as well.
Acute hepatitis C refers to the first 6 months after infection with HCV. Between 60% to 70% of people infected develop no symptoms during the acute phase. In the minority of patients who experience acute phase symptoms, they are generally mild and nonspecific, and rarely lead to a specific diagnosis of hepatitis C. Symptoms of acute hepatitis C infection include decreased appetite, fatigue, abdominal pain, jaundice, itching, and flu-like symptoms.
No vaccine is currently available to prevent hepatitis C and treatment for chronic hepatitis C is too costly for most persons in developing countries to afford. Thus, from a global perspective, the greatest impact on hepatitis C disease burden will likely be achieved by focusing efforts on reducing the risk of HCV transmission from nosocomial 3exposures (e.g. blood transfusions, unsafe injection practices) and high-risk behaviours (e.g. injection drug use).
Hepatitis C virus (HCV) infects an estimated 170 million persons worldwide and thus represents a viral pandemic, one that is five times as widespread as infection with the human immunodeficiency virus type 1 (HIV-1). The institution of blood-screening measures in developed countries has decreased the risk of transfusion-associated hepatitis to a negligible level, but new cases continue to occur mainly as a result of injection-drug use and, to a lesser degree, through other means of percutaneous or mucous-membrane exposure. Progression to chronic disease occurs in the majority of HCV-infected persons, and infection with the virus has become the main indication for liver transplantation. HCV infection also increases the number of complications in persons who are coinfected with HIV-1. Although research advances have been impeded by the inability to grow HCV easily in culture, there have been new insights into pathogenesis of the infection and improvements in treatment options.
Hepatitis C treatment presents a challenge because the medications often cause side effects that may be worse than the initial symptoms of infection. "The combination drug regimen, which clears the virus in up to 40 percent of patients, frequently makes them feel ill, prompting them to halt treatment early, before the virus has cleared. Side effects may include flu-like symptoms, depression, rashes and abnormal blood counts.
Despite the side effects, the sooner treatment can begin, the better the chances of preventing complications such as liver failure and liver cancer. But there is an additional treatment challenge.
An important feature of the virus is the relative mutability of its genome, which in turn is probably related to the high propensity (80%) of inducing chronic infection. HCV is clustered into several distinct genotypes which may be important in determining the severity of the disease and the response to treatment.
Donor hearts are given based on the donor's blood type and body weight, and the potential recipient's blood type, body weight, severity of illness and geographic location. Seriously ill patients at a nearby transplant center have priority.A heart can be disconnected from a person's circulation for about four hours and still work properly. Thus time is critical. When the heart is removed, the transplant team puts it in a special cold solution to keep it alive (even though it's not beating). Then it's rushed to the hospital where the recipient is located.
Laboratory diagnosis of infection with the Hepatitis C virus is characterised by the detection of antibodies to HCV. Positive test results are usually confirmed with line immunoassays. It is recommended that all blood donations are tested for HCV.he number of available HCV antibody tests, including simple/rapid tests has increased in recent years.Test kits are evaluated against the WHO HCV reference panel of characterised serum/plasma specimens.
You may be given interferon, a drug that boosts your immune system, or other antiviral drugs.Doctors are continuing to search for the best ways to treat hepatitis C. As new information becomes available, treatments change. You should discuss possible new treatments with your health care provider.
Researchers are reporting a potential "cure" for hepatitis C, a blood-borne viral infection that's the leading cause of cirrhosis, liver cancer and the need for liver transplants in the United States.
Use of the drug peginterferon, either alone or in combination with the drug ribavirin, reduced levels of the virus to undetectable levels for up to seven years, the researchers said.
"This paper strongly suggests, for the first time, that hepatitis C is a curable disease," said lead researcher Dr. Mitchell Shiffman, a professor at Virginia Commonwealth University School of Medicine and chief of hepatology and medical director of the school's Liver Transplant Program. "After treatment, 99.6 percent of the patients remained virus undetectable for over five years," he added.
In the study, 997 patients with hepatitis C or with both hepatitis C and HIV were treated with either Pegasys (peginterferon alfa-2a) alone or in tandem with ribavirin. Shiffman's team then monitored blood levels of hepatitis C once a year for an average of 4.1 years, and as long as seven years.
The researchers found that 99 percent of patients with hepatitis C who were treated successfully with peginterferon alone, or in combination with ribavirin, had no detectable virus up to seven years later.
"This is the first long-term study that confirms what we believed for many years that these individuals are truly cured of hepatitis C," Shiffman said.
The remaining eight patients tested positive for hepatitis C at an average of two years after treatment. There was no pattern to the patients as far as age, gender or hepatitis C genotype. It isn't known whether these patients had a relapse or were re-infected with the virus, the researchers noted.
The findings were to be presented Monday at the 38th annual Digestive Disease Week conference, in Washington, D.C.
Hepatitis C is a blood-borne infectious disease of the liver and is one of the most important causes of chronic liver disease in the United States. An estimated 4.1 million Americans have been infected with hepatitis C, and 3.2 million are chronically infected. The number of new infections each year declined from an average of 240,000 in the 1980s to about 26,000 in 2004, the latest year for which statistics are available. The number of hepatitis C-related deaths could increase to 38,000 a year by the year 2010, surpassing annual HIV/AIDS deaths, according to the U.S. Centers for Disease Control and Prevention.
The virus is usually spread through contact with infected blood and blood products. Blood transfusions and the use of shared, unsterilized, or poorly sterilized needles, syringes and injection equipment have been the main routes of transmission in the United States, according to the National Institutes of Health.
Most people who have hepatitis C don't know they have it, Shiffman said. "Of those who have been diagnosed, only about 25 percent have received treatment, because of the side effects of treatment," he said. "The reason why you should treat it is because you can cure hepatitis C, and we finally have the data to definitively document it."
Dr. Eugene Schiff, chief of the division of hepatology and professor of medicine at the University of Miami Miller School of Medicine, agrees that most cases of hepatitis C can be cured.
"In contrast to hepatitis B or HIV, this virus can be totally eradicated and cured," he said.
But, many patients find the side effects of treatment off-putting. Those side effects can include fever and chills, Shiff said. "You feel pretty lousy. After treatment starts, you feel worse the day after your shot, but it tapers off over the course of the week," he said. "Along with that anxiety, irritability and depression can develop. And we are quick to use antidepressants to allow these people to stay on the medication."
Additional side effects include a drop in the production of white blood cells and anemia. Often patients are giving additional drugs to combat these conditions, Shiff said.
Treatments can go on for as many as 72 weeks, depending on the reaction to therapy Shiff said. "Some people are reluctant to get treatment, because they heard that the treatment isn't so pleasant," he said. "But they should come out and get treatment."
Schiff noted that new antiviral drugs to treat hepatitis C are being tested. "It is hoped that these new antivirals will be more effective and have less severe side effects and may even be used without peginterferon alfa-2a or ribavirin," he said
The detection of HCV RNA is a reliable marker which is used to decide before treatment and it is a good tool in therapy evaluation. Now with pegylated interferon and ribavirin, we can treat up to 50-85% of patients, according to genotype. But many infected patients are now without treatment because the diagnostis is not done. That's why screening of patient with a high risk must be done. Education and information are a reliable tools to protect patients without infection.Recommendation for groups of people be tested for hepatitis C:
* Those who received blood products prior to 1992
* Anyone who has ever used IV drugs or illicit drugs
* The sexual partner of anyone with hepatitis C, including married couples
* Children of an infected mother
* Individuals with unexplained liver disease or hepatitis
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