Hepatitis C (HCV)

This research paper is going to review today’s silent killer, the Hepatitis C virus. This paper will talk about the description of the disease, the signs and symptoms, the etiology and risk factors, diagnostic studies, treatments and prognosis of this disease. I had lived with this disease for over ten years before diagnosed so it is important to understand the signs and symptoms so the disease can be identified and a treatment plan can be identified as the sooner it is treated the more likely it will eradicate the disease.

Hepatitis C virus (HCV) is from the virus family Flaviviridae with an RNA envelope serving as it's genetic material. The genetic material (RNA) is HCV's pathogenic structure. The genome is positive sense single stranded RNA, which is very similar to mRNA and can be translated quickly to the host cell (Bauman 2012). Hepatitis C is an enveloped virus, and the RNA also lacks a proofreading ability after replication, which results in mutations coding for many genotypes within the host. This genetic variability makes it difficult for the host immune system to clear all the HCV infections. As one infection clears, another strain is being produced (Bauman 2012). The HCV antibody detected by ELISA(Wilkinson

Hepatitis C is a prevalent health care problem. According to the Centers of Disease Control and Prevention (CDC, 2016), approximately 2.7-3.9 million of the adult population in the United States is infected with hepatitis C virus (HCV). Some groups of people are at risk for Hepatitis C infection, including current injection drug users, people who received the blood transfusion before 1992, organ recipients from a donor who tested positive for hepatitis C virus, hemodialysis patients, and children born to a hepatitis C mother (CDC, 2016). Hepatitis C causes embarrassment and isolation from the society. Self-esteem and understanding of the family, friend and community will motivate the patient to have a good quality life in society. This

There are a number of individuals who may be suffering from an illness and not even be aware they have an illness. One example of such illness is Hepatitis C (HCV). Hepatitis C is a severe disease of the liver. It is caused by the Hepatitis C virus (Centers for Disease Control and Prevention (CDC), 2015). As a result, Hepatitis C has been termed a silent epidemic (CDC, 2015). This is because a lot of individuals have Hepatitis C and don’t even realize they have the infection (CDC, 2015). As the infection begins to progress over time, it could cause acute issues to the liver (CDC, 2015). Those issues could be things like damage to the liver, the liver could fail to function, cirrhosis, or even cancer of the liver (CDC, 2015). However, screening for Hepatitis C will allow an individual to benefit from treatments that are available, hence eliminating the disease from the body and preventing the liver from undergoing any further damage (CDC, 2015).

     Did you know that over two hundred million people are infected with the Hepatitis C Virus (HCV)? Unfortunately it is true, and twenty five thousand more are infected each year. Out of these victims, three are acquaintances of mine. They are why I chose to research this Silent Epidemic. In this paper you will not only learn about the virus itself, but also ways to recognize and prevent it. The goal of this is to prevent the further spread of this disease, and furthermore to make you aware of your options if infected.

Hepatitis C viral (HCV) infection is one of the many chronic illnesses that disproportionately affect the 2 million persons currently incarcerated in US jails and prisons. (ACA, 2015). HCV is most frequently acquired through exposure to infected blood in persons who injected drugs any time in their lifetime. Offenders are statistically at increased risk for bloodborne pathogen infections such as HCV because of the strong association of chronic addiction and criminal behavior. Correctional health care systems have more patients with HCV infection, on a percentage basis, than any other major health care system in the United States.

HCV is an enveloped single stranded RNA virus and belongs to the genus Hepacivirus of the family Flaviviridae (Irshad el al., 2013). Analysis has identified 6 different types of HCV genotypes numbered 1 to 6 (Pawlotsky, 2003). Genotype 1 is the common type of HCV currently in the United States (Irshad el al., 2013). Differentiating between the genotypes when determining the which antiviral regimen to treat the patient with. Humans are the only known natural host for HCV (Pawlotsky, 2003). HCV is a non-cytopathic virus that enters the liver cell and replicates causing hepatocytes necrosis by several mechanisms by immune mediated cytolysis and metabolic changes including hepatic steatosis, oxidative stress and insulin resistance

Hepatitis C has been referred to as a "Silent Epidemic," since it usually progresses slowly over many years. Most people who are infected with hepatitis C are not aware of any noticeable symptoms for as long as one to two decades after they are infected. In fact, by the time symptoms appear, the virus has probably already begun to damage the liver. If the liver is injured and stops functioning, death will always be the outcome (Lieber). Liver failure from chronic hepatitis C is one of the most common causes of liver transplants in the United States.

It has been observed that drug users are at great threat for HCV infections. HCV (Hepatitis C Virus) is more easily spread than HIV (Human Immunodefiency Virus), because its prevalence is greater than HIV. According to Macias et.al (2008), it has been observed that non-injection drug users have higher rates of hepatitis C infection in comparison to overall population. They attributed this to following reasons; sexual behaviors, tattoo or piercing materials, nail or hair clippers, and razors. Some studies have established that non-injector drug users do not inject due to fear of overdose, family problem, decline in income and health issues such as collapsed veins, scars from abscesses, fear of needles and overdosing (Sotheran et al., 1999).

Globally, an estimated 150 million people have been infected with hepatitis C virus (HCV). HCV is the major cause of cirrhosis and liver cancer and one of the most common indications for liver transplantation (Simmonds, 2004).There is serious concern about the growing problem of the HIV and HCV prevalence in Africa, where the major route of transmission of HIV is through the sexual route. Co-infection with HCV and HIV is common due to shared routes of transmission – via blood and blood products and sharing of needles for injecting drugs. About 40 million people are estimated to be infected with HIV worldwide of which approximately 4-5 million are co-infected with HCV (Alter, 2006). Co-infection with HIV and HCV are common due to shared routes of transmission, however, there are differences in the ways that these viruses are transmitted in the developed and developing countries (Ocama and Seremba, 2011).

The purpose of this case study on Hepatitis C (HCV) is to come up with a process improvement plan of getting patients screened, approved, educated, and started on treatment within a 20 day period. In order to make this happen, everyone in the clinic needs to be educated on the required clinical screenings and documentation. The case study is designed for: medical assistants, pre, post, tumor, and organ management nurses, and nurse practitioners. The case study will be reviewed over the next two weeks in the liver clinic and the reason is to improve the knowledge of everyone on HCV and to know what is needed in the screening and approval process of treatment.

The site of the primary infection is in the alimentary tract, a short prodromal or pre-icteric phase, varying from two to seven days, usually precedes the onset of jaundice. The most prominent symptoms in this phase are fever, headache, muscular and abdominal pain, anorexia, nausea, vomiting and sometimes arthralgia. Hepatomegaly and leukopenia are often present during this period. In typical cases the urine becomes dark, and the stools pale before appearance of yellow discoloration of the mucous membranes and appearance of jaundice about ten days after onset of the general symptoms. Fever and most of the general symptoms usually subside within a few days of jaundice, but in severe cases both general and abdominal symptoms may become further aggravated at this phase. Jaundice is often accompanied by itching and sometimes by urticarial or papular rashes. Liver is usually enlarged and liver function tests are abnormal with highly elevated levels of serum alanine aminotransaminase (ALT) and serum aspartate aminotransaminase (AST).

Hepatitis C is a liver disease that is spread from one person to another by the contact of uninfected blood with that of someone who is infected. After having the disease for a number of years, someone who is infected with Hepatitis C is likely to have liver problems in the future, which could lead to cirrhosis and liver cancer within twenty years of being infected. Over the years, many infectious disease specialists have found treatments that manage the disease, but, in 2013, Gilead Sciences created the medicine by the name of Sofosbuvir (Sovaldi). The difference between Sovaldi and other hepatitis C treatments that have been used over the years is that Sovaldi is the only treatment that cures the disease rather than managing its symptoms in order to decrease the severity like the other treatments do. For this reason many physicians desire to prescribe Sovaldi to suffering patients, but often times cannot do so because the drug is not covered by all State Medicaid policies; therefore, many of these patients are left to suffer with the disease as they do not have the means to find the curing specialty drug. State Medicaid covers many health plans, but some states neglect to cover the specialty drug, Sovaldi; although the addition of coverage for this treatment will have short term negative impacts, the long term effects will overshadow the initial issues.

Hepatitis C Virus, HCV, means inflammation of the liver. Worldwide, this blood-borne pathogen newly infects over 3 million people each year and can seem endemic in some parts of the world. Yet, we have come a remarkable way since HCV was only identified in 1989. The extent in our understanding has brought several people at ease, but we still have much more to learn. Today, 4 million people in the United States are living with HCV and 170 million around the globe. There is only a small portion of people who are infected that develop serious complications, the bigger portion who are afflicted with this disease is giving us many challenges in the medical field. Newly

Any inflammation which can affect the function of the liver is named Hepatitis. Affected by virus, alcoholism, some medications which are toxin to liver also, certain medical condition can lead to hepatitis. Hepatitis C is one of the common viral forms caused by Hepatitis C virus a small (55–65 nm), enveloped, single-stranded RNA of the Flaviviridea family(HEPATITIS C). After infection the first several months are called acute phase which is mostly asymptomatic but sometimes shows some symptoms like “fever, feeling tired, not wanting to eat, upset stomach, throwing up, dark urine, grey- colored stool, joint pain, and yellow skin and eyes”(HEPATITIS C). If infection with the virus is not detected in this phase the illness can become chronic or lifelong infection. But, some research results shows without known causes” around 20% of patients are able to clear, the virus without treatment in the first 6 months”(HEPATITIS C). For those 80% uncured by their own natural body defense the illness becomes chronic which can lead to deadly conditions such as liver failure and even liver cancer. There are limited treatments for chronic state of hepatitis C and there is not been vaccine discovery for disease. Hepatitis C is blood borne pathogen. Also, “having a sexually transmitted disease or HIV, sex with multiple partners, or rough sex appears to increase a person’s risk for Hepatitis