Research Study on the Interaction Among Platelets and Lymphocyte Function in Patients with Liver Disease

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.

Describe the clinical presentation (signs and symptoms) of viral hepatitis. List the different underlying causes of this condition.

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

A recombinant-based assay for the hepatitis C virus HCV has been developed, using RNA isolate from the hepatitis C virus.

Chronic hepatitis C virus (HCV) causes inflammation of the liver, eventually leading to tissue damage. Cirrhosis is the result of extensive scarring of the liver. The Centers for Disease Control and Prevention state that HCV typically causes cirrhosis in 5 to 20 percent of infected people over a period of 20 to 30 years. Overall, cirrhosis develops 20 to 30 percent of the time. Progression to cirrhosis may be accelerated in people who are older, obese, drink alcohol, or are immune-suppressed (such as people who are coinfected with HIV).

The majority of children with NAFLD are asymptomatic. Occasionally patients may complain of vague abdominal pain, fatigue, or malaise, however, liver disease is usually found incidentally on physical exam or routine lab work1. Children may have mild to moderate hepatomegaly; however, the majority of these children are overweight or obese, making liver palpation a challenge. In addition to obesity and visceral adiposity, children with NAFLD often present with acanthosis nigricans on the back of their neck or intertrigenous areas, which is suggestive of insulin

HCV is the major cause of liver transplantation in Western countries (Roels and Rahmel, 2011).

The body views the platelets as a foreign body and causes a response that produces antibodies that marks the spleen to destroy and remove the platelets. The platelet count is affected by antibodies produced by individuals with ITP. The antibody produced covers the surface of the platelets making them easily destructible by macrophages. Once the macrophages destroy the platelets faster than they are produced, the number of platelets are greatly reduced causing a decrease in blood clotting.

This chronic myeloproliferative disorder (MPD) is associated with mass quantity of platelets that are put out by megakaryocytes

Hepatitis A virus, HAV is a nonenveloped, RNA virus. The virus is resistant to bile lysis due to lack of a lipid envelope. The virus is resistant to freezing, detergents, and acids. It is inactivated by formalin and chlorine. The virus survives on human hands and fomites and requires temperatures higher than 185°F (85°C) for inactivation. HAV survives for extended periods in seawater, fresh water, wastewater, and soil. The virus is transmitted by close contact with an infected person or by contact with contaminated food or water products.”

     The next tests that would be performed is known as a Qualitative HCV Test. This is also a blood test. This test checks for Polymerase Chain Reactions, which is a specific way of looking for Hepatitis C Viral RNA. This tests shows whether, or not you actually have HCV infecting your system. If you do in fact, have HCV present in your body, it is necessary to properly identify the type.

Markers of HCV infection are found in 80 to 90% of patients with hepatocellular carcinoma in Japan, 44 to 66% in Italy, and 30 to 50% in the United States (El-Serag and Rudolph,2007). It has been projected that cases of HCV-related hepatocellular carcinoma will continue to increase over the next two to three decades (El-Serag

The excellent marker for the resolution of HCV infection is sustained virological response (SVR), defined as undetectable HCV RNA in blood 24 weeks after finishing the treatment (Desmond et al., 2006). SVR is accompanied by reduction in hepatic inflammation and regression of fibrosis in patients without cirrhosis; but in patients with cirrhosis remain at risk of life-threatening complications as hepatic failure and portal hypertension (Younossi et al., 2007). The risk of HCC is reduced but not eliminated in patients who achieve SVR, and therefore screening for HCC must continue (Bruno et al., 2007).

Flow cytometry analyses were used to monocytes characterization and confirmation through evaluating the expression of monocytes-macrophages surface markers (BD FACSCaliburTM Flow Cytometer, USA). The surface marker which used for monocytes characterization was CD14 phycoerythrin (PE)-conjugated human monoclonal antibody (BD Biosciences, San Jose, CA, USA). For all experiments, an unstained group as a control was considered. Data from 10-20,000 gating monocytes population in the FSC/SSC window was obtained. Data analyses were used through CellQuest Pro software version 5.1 (Tree Star; BD Biosciences).

The symptoms start appearing after two to five weeks of infection. The main symptoms are nausea, vomiting, diarrhea, low fever, rashes, loss of appetite and yellowing of skin (jaundice), abdominal pain. Diarrhea occurs in case of children. No specific treatment is there. Patients need adequate rest and proper nutrition. If skin becomes yellow then the patient needs a blood test or a liver panel test. If a person vomits for a long period amount of time, they get dehydrated; then, only then, hospitalization is needed. Patients should drink a plenty amount of water, or fluids. He or she should take food, which does not cause any harm to the liver. Patients should avoid tea, coffee or any alcoholic beverages, which causes harm to liver. He or she takes adequate rest. He should not take any medicine which causes harm to liver. If patient is confused about taking medicine then he or she should consult a doctor. Techniques for growing HAV in cell culture have made it possible to generate sufficient amounts of virus for vaccine production. Several inactivated or live attenuated vaccines against hepatitis A have been developed, but only four inactivated hepatitis A vaccines are currently available internationally. All four vaccines are similar in terms of efficacy and side-effect profile. The vaccines are given parenterally, as a two-dose series, 6-18 months apart. The dose of vaccine,