Hepatitis C Is A Significant Public Health Problem

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

Many people don’t understand how dangerous Hepatitis C is because it is not commonly known about as much as Hepatitis A or B. This disease is however very serious. Although frequently asymptomatic in time the virus can lead to cirrhosis, liver cancer and liver failure. Symptoms of HCV are jaundice (yellowing of the eyes), stomach pain, nausea and fatigue. Treatment options for the disease, if caught early enough is a combination of medications or depending on the degree of damage, a liver transplant. ”For some people, hepatitis C is a short-term illness but for 70%-85% of people who become infected with

The strain of genotypes is not differentiated by the severity of the disease. However, there will make a distinction in the regimen and the duration of the treatment (CDC, 2016). Treatment for chronic HCV is based on guidelines from the Infectious Diseases Society of America (IDSA) and the American Associations for the Study of Liver Diseases (AASLD). The criteria of who should receive the treatment include how much the virus in the body, the strain of hepatitis C, the degree of liver inflammation or damage, comorbidity, and response to previous treatment (Infectious Diseases Society of America [IDSA], 2016). The highest priority for treatment should give to a patient with advanced fibrosis and compensated cirrhosis (IDSA, 2016). Moreover, treatment priority should provide to the patient who has a high risk of transmitting the disease from and to others, such as individuals who are active injection drug users and hemodialysis patients (IDSA, 2016).

According to Baily, et al. (2009) lack of treatment to cure the disease will lead to a patient’s uncertainty on how the illness will present itself in the future. Thus, patients must face the unknown factors of their disease progression and manage life with their chronic illness. In Chronic Hepatitis C, tracking of outcomes and progressions are difficult, and disease trajectory varies from person to person (Baily, et al 2009). In addition, uncertainty stems from lack of knowledge of the disease, loss of control, and expectations of possible relapse of symptoms in the future.

If someone is getting tested for Hepatitis C, they will first take an antibody test. This test will detect if antibodies are present in the blood, which will tell if the person has ever had Hepatitis C, not if they currently possess it (“Who Should”). If the antibody test comes back positive, a qualitative test will then be run. This test declares tells if someone is currently infected with Hepatitis C. A quantitative test can also be run, which shows the amount of Hepatitis C that is in the blood (“Who Should”). There are two main medications that are used to treat Hepatitis C. The first being Pegylated Interferon and another being Ribavirin. Both medications are used for the treatment of adult patients with chronic liver disease (FDA). These medications are used in place of the vaccine that has not been created for Hepatitis C. Therefore, Hepatitis C can be detected easily and is treatable.

Hepatitis C is a blood transmitted virus that has been know for substandard therapies/ drug treatments. When Mr. Parish commented that currently, there is no absolute cure to HCV, my mind immediately shifted to “cancer”. People often think of cancer as the most severe illness someone can get, because there is no cure. However, we forget that in actuality, there are numerous

Guedj, Jeremie et al. " Modeling shows that the NS5A inhibitor daclatasvir has two modes of action and yields a shorter estimate of the hepatitis C virus half-life ." Proceedings of the National Academy of Sciences of the United States of America. Vol.

Initial curative treatment in the early 1990’s used interferon and the antiviral ribavirin with a cure rate of 50% (Watson, n.d., p. 1). 2011 saw the invention of two antiviral medications, telaprivir and boceprevir, that increased cure rates to 70%. In 2013 newer drugs, simeprevir and sofosbuvir, were introduced with the later creating 90% cure rates in patients (Watson, n.d., p.gs. 1-2). Simeprevir (Sovaldi) was created for administration once per day over a minimum of a year (Gilead, 2014). Eradication of the disease in patients is effective in patients co-infected with HIV with low rates of side effects (Sulkowski, et al., 2014), highlighting its efficacy in complex patient populations. The cost of such treatment is $1,000 per day with an average cost for curative course exceeding $94,000 (Venteicher, 2014). The medication is FDA approved and prescribed readily, but patients are not receiving access to the medication through their insurers.

Regina is a 62-year-old female diagnosed with chronic viral Hepatitis C (B18.2) and is genotype 1a. She is treatment naïve. Her most recent lab results indicate HCV RNA 4,005,368 IU/mL, ALT 63, and AST 83. Regina’s CT scan shows a cirrhotic appearance of the liver.

Vaccine is available to protect against HBV infection, but not for HCV. Even though vaccines exist, it can only protect against infections if they are administered before the person is exposed to the cancer-promoting virus [13]. Recent advances in screening have helped in early detection of cirrhosis. In recent times, quantitative assays for HBsAg and HBeAg are also being used in identifying patients likely to respond to anti-HBV treatments, although more work is needed to standardize these new assays [14]. When early detection is successful, treatments include surgery to remove part of the liver (partial hepatectomy) or liver transplant [6]. Other treatments include cryosurgery and radiation therapy for cases where cancer has not metastasized. For patients where cancer has metastasized, targeted therapy, chemotherapy or clinical

When a doctor uses the term Hepatitis C or HCV, what comes to mind? Many people have little to no knowledge of what it is. Is it deadly? Is there a cure? Is it a virus or disease? There are many questions that enter the mind because there are many concerns associated with an unknown illness. Several people wonder if the virus is similar to hepatitis A or B because there has been education throughout the years that provides more awareness surrounding the two known viruses, but it is discovered there are vast differences. Until recently, the general population was unaware that another hepatitis virus acted as a silent killer. Unlike hepatitis A or B, hepatitis C is a relatively new disease that can go unnoticed until it is too late. The virus

Quantitative HCV RNA (viral load testing) is needed in clinical practice to decide whether to continue or stop therapy treatment for patients with chronic hepatitis C. In other words, to determine the long-term biochemical, virologic, and histologic outcomes in patients with chronic hepatitis C who have a sustained response to interferon-α therapy, which is a 12-week treatment plan.

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.

In recent years, there has been a progressive improvement in the sensitivity and specificity of both immunological and molecular assays used for the diagnosis of hepatitis C. Furthermore, advances in molecular technologies allowed the development of new tests that facilitate early diagnosis of people at increased risk and screening of blood donors. Thus, treatment can be instituted earlier, minimising the potential of infection dissemination and reducing costs to the health system. Hence, high