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Hepatitis C is an infectious disease affecting the liver, caused by the hepatitis C virus (HCV). The infection is often asymptomatic, but once established, chronic infection can progress to scarring of the liver fibrosis, and advanced scarring cirrhosis which generally appears after many years. In some cases, those with cirrhosis will go in to liver failure or other complications of cirrhosis, which is including liver cancer. It is a life threatening disease that kills so many people all around the world. This disease can be easily prevented if people avoid its causes such taking precautions of direct contact with infected blood or body fluids. Furthermore, practicing safe sex will decrease the chances of being infected with this type of hepatitis. However, hepatitis has many devastating consequences and effects that may disturb the client physically and socially. Unfortunately, when hepatitis virus invades the liver, it will cause a massive disruption on its metabolic functions. Also, the client will be isolated from the people because of the stigma of the disease.
The word "hepatitis" means inflammation of the liver and also refers to a group of viral infections that affect the liver. The most common types are Hepatitis A, Hepatitis B, and Hepatitis C.
Although science has discovered a lot of therapies that cures most of the infectious diseases which affect our body, but there is still no perfect cure for hepatitis B and C. "Hepatitis B virus infection is a global public health problem, with approximately 400 million people chronically infected, each year it causes more than 500 000 deaths worldwide" ( Aggarwal & Ranjan, 2004, p. 1080).
The use of serological and virological tests has become essential in the management of hepatitis C virus (HCV) infection in order to diagnose infection, guide treatment decisions and assess the virological response to antiviral therapy.
Generally, hepatitis B and C are transmitted through homosexual practices and by direct contact with infected blood, which result in many physical and social effects of their carriers. Many people do not know that they have hepatitis C until they already have some liver damage as its appearance takes many years. There are two types of hepatitis C. The first type which is called acute hepatitis C happens in a short period and cured soon after its discovery. The second type which is most common is called chronic hepatitis C, this type is developed in long period as in most cases the diagnosis for this disease was late. A group of viruses known as the hepatitis viruses cause most cases of liver damage worldwide. Although hepatitis C can be very serious, most people can manage the disease and live active, full lives.
Despite, the great efforts of health organizations to educate the public regarding the danger of sexually transmitted diseases and drug addiction, the number of people getting infected with hepatitis through unsafe sex and sharing contaminated needles is increasing yearly.
Causes of Hepatitis:
The Hepatitis C virus is caused by the Hepatitis C virus (HCV) and it is the most serious type of hepatitis. It is a blood-borne disease, which means that it is transmitted by contact with the blood of an infected person. This can be through open wounds and sores, blood transfusions, pregnancy in which the diseased mother will transmit this disease to her child during delivery, and sharing cutting equipments and syringes with an infected person. It may occasionally be passed through unprotected sex where there's an exchange of bodily fluids such as semen and vaginal fluid" (Asian centre for liver disease and transplantation, Hepatitis C, para.1).
Significant numbers of those positive HCV people have never had blood transfusion or any exposure via sexual contact; nor do they use illicit drugs. Obviously, they pick up the virus in some way, but it is difficult to establish the source. Many such cases are never satisfactorily explained.
Anyone can get hepatitis C, but some people are at higher risk. Usually, the people get infected with hepatitis through homosexual practices. Moreover, studies have shown that homosexuals will have a higher rate of sexually transmitted diseases especially hepatitis. Also when got a tattoo or a piercing with a needle that has infected blood on it can lead to hepatitis. In rare cases, a mother with hepatitis C spreads the virus to her baby at birth, or a health care worker is accidentally exposed to blood that is infected with hepatitis C. In addition, hepatitis can be transmitted through direct contact with blood that has been infected with the hepatitis virus especially, among drug addicts due to the sharing of contaminated needles. Also, blood transfusions can lead to hepatitis due to inappropriate laboratory screening for the donated blood because the hepatitis virus can remain inactive in the blood stream for a certain period called the incubation period and shows false negative readings. The person who received hemodialysis treatments for a long period of time will be at high risk to get the hepatitis C disease. Many people find out that they have the virus by accident, when their blood is tested before a blood donation or as part of a regular checkup. Often, people with hepatitis C will have high levels of liver enzyme in their blood.
Effect of Hepatitis:
About half of those infected HCV people have an uneventful recovery, but other half suffers slow progressive symptoms (chronic hepatitis).
However, hepatitis has fatal consequences on the person's physical wellbeing and serious social repercussions. "Hepatitis C has a profound effect on the physical and psychological function of patients, in addition, social stigma and concerns about being infectious impair the psychological status of patients and their families" (Cormier, 2005, p. 58). Initially, the most serious consequence of hepatitis is liver dysfunction due to the virus invasion of the liver resulting in disruption of its metabolic function. Furthermore, the liver carries out the process of eliminating metabolic waste products and any liver dysfunction may lead to accumulation of these products in the body resulting in decreased body immunity and eventually death ."Hepatitis produce massive liver necrosis, most hepatic functioning is disrupted and prognosis is poor, with mortality rate exceeding 70%, hepatic encephalopathy commonly accompanies massive liver necrosis" (Nowak & Handford, 2004, p. 378). A small number of people with hepatitis C infection may develop liver cancer. Moreover, being infected with hepatitis results in social discrimination because the person may have a history of drug addiction or homosexuality which is forbidden or unaccepted in most cultures and religions. Also, the infected persons will be stigmatized for having an infectious disease, and the people will not interact with him as they may be scared of catching the infection and as a result of this, the person will thus be excluded from most social activities in the community. "To some, the isolation is worse than virus" (Porter, 2005, p. 3).
Symptoms of hepatitis:
Most infected people won't develop symptoms until the virus causes liver damage, which can take 10 years or more to happen. This makes it common for people to develop chronic hepatitis C for 15 years or longer with out symptoms and before its diagnosis. In addition, others have one or more of the following symptoms:
Yellowish discoloration of eyes and skin which is called jaundice.
A longer than usual amount of time for bleeding to stop.
Upset stomach, loss of appetite and nausea.
Swelling of ankles.
Muscles and joint pain.
Easy bruising, tenderness at liver site and fever,
Diarrhoea, light-colour stools and dark yellow urine.
Itching of skin and sore muscles.
Diagnosis of Hepatitis:
The diagnosis of "hepatitis C" is rarely made during the acute phase of the disease because the majority of infected people are not experiencing symptoms during this phase of the disease. Those who do experience acute phase symptoms are rarely ill enough to seek medical attention. In other hand, the diagnosis of chronic phase of hepatitis C is challenging due to the absence or lack of specificity of symptoms, until advanced liver disease develops, which may not occur until decades into the disease. Chronic hepatitis C may be suspected on the basis of the medical history (particularly if there is any history of IV drug abuse or inhaled substance usage such as cocaine), also if there is a history of piercings or tattoos, unexplained symptoms, or abnormal liver enzymes or liver function tests are found during routine blood testing. Occasionally, hepatitis C is diagnosed as a result of targeted screening such as contact tracing or blood donation (blood donors are screened for numerous blood-borne diseases including HCV). Hepatitis C testing begins with serological blood test which is used to detect antibodies to HCV. Anti-HCV antibodies can be detected in 80% of patients within 15 weeks after exposure, in >90% within 5 months after exposure, and in >97% by 6 months after exposure. http://en.wikipedia.org/ ( retrieved on 10th December, 2009)
Overall, HCV antibody tests have a strong positive predictive value for exposure to the hepatitis C virus, but may miss patients who have not yet developed antibodies, or have an insufficient level of antibodies to detect. Virological testing has become essential in the management of hepatitis C virus (HCV) infection in order to diagnose infection, and most importantly guide treatment decisions and assess the virological response to antiviral therapy. In patients who have no indication for therapy or have a contra-indication to the use of antiviral drugs, virological tests have no prognostic value. Indeed, neither anti-HCV antibodies nor the ( HCV- RNA) load correlate with the severity of liver inflammation or fibrosis nor with their progression. Thus, they cannot be used to predict the natural course of infection or the onset of extra hepatic manifestations. In untreated patients, the severity of liver inflammation and fibrosis must be evaluated every three to five years by means of a liver biopsy or non-invasive serological or ultrasound-based testing. The most recommended test is liver biopsy which is a procedure to remove a small sample of liver tissue for laboratory test that can help to determine the severity of the disease and guide treatment decisions. (Int J Med Sci. 2006; 3(2): 35-40.)
Treatment of Hepatitis:
Hepatitis C infection is treated with antiviral medications intended to clear the virus from body. The doctor may recommend a combination of medications taken over several weeks. Once completed a course of treatment, the doctor will test patient's blood for HCV. If HCV is still present, the doctor may recommend a second round of treatment. However Antiviral medications can cause depression and flu-like signs and symptoms, such as fatigue, fever and headache. Some side effects can be serious enough that treatment must be delayed or stopped in certain cases.
If the liver has been severely damaged, a liver transplant may be an option. During a liver transplant, the surgeon removes the damaged liver and replaces it with a healthy liver. Most transplanted livers come from deceased donors, though a small number come from living donors. In addition, for people with hepatitis C infection, a liver transplant is not a cure. Treatment with antiviral medications usually continues after a liver transplant, since hepatitis C infection is likely to recur.
The doctor will likely recommend receiving vaccines against the hepatitis A and B viruses. These are separate viruses that also can cause liver damage and complicate treatment of hepatitis C.
To form a committee to determine ways to reduce hepatitis C virus (HCV) in order to minimize the morbidity and mortality rates related to chronic viral hepatitis. The committee is assessing current preventive and control activities and identifying priorities for research, policy, and action. The committee will highlight issues that warrant further investigations and opportunities for collaboration between private and public sectors. In conducting its work, the committee will consider several points such as:
Improving vaccine coverage among vulnerable populations to reach national transmission elimination goals.
Increasing the proportion of persons aware of their chronic infection status.
Identifying barriers to the identification, counseling, and testing of persons at risk for chronic hepatitis, and ways they can be reduced and eliminated.
Promoting prevention among adolescents and adults who engage in risky behaviors, particularity those known to have screened positive for HCV.
Assess the role of laboratory testing strategies for the identification of markers for acute HCV infection.
Assess laboratory testing strategies for identification of antiviral resistance for HCV.
Participants of infected person in clinical trials can play a more active role in their own health care, gain access to new research treatments before they are widely available, and help others by contributing to medical research.
However, certain of lifestyles need to be changed, such as:
Stop drinking alcohol because it speeds the progression of liver disease.
Avoid medications that may cause liver damage
Keep body healthy by maintaining healthy lifestyle practices each day. For example, choose a diet full of fruits and vegetables, do physical exercises at least three times per week, and get enough sleep.
Take preventive measures when coming in contact with infected blood. Cover any opened wounds and do not share razors or toothbrushes. Avoid infected people from donating blood by full screening before donation; avoid contact body organs or semen.
In conclusion, hepatitis can be caused by any direct contact with infected agents such as sharing needles, blood transfusions with unscreened blood and sexual contact which may lead to fatal physical effects as well as social consequences. In my opinion, health authorities should focus on educating people about practicing safe sex. Also, the dangerous effects of abusing drugs must be reinforced to the public. Although, this serious disease is transmitted mainly through homosexual practices or sharing of contaminated needles among drug addicts, I think we don't have to judge people that they are immoral because they may got the disease from other sources such as, drug addict husband who transferred the disease to his innocent wife through legal sexual contact.
Electron microscopy of hepatitis C virus (HCV)
Transferred from http://en.wikipedia.org/ 2009-12-12 (1pm)