Hepatitis C: An Overview By Jose Poulose, M.D. - PowerPoint PPT Presentation

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Hepatitis C: An Overview By Jose Poulose, M.D.

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An estimated 2.7-3.9 million people in the United States have chronic hepatitis C. HCV infection becomes chronic in approximately 75%–85% of cases. The overall incidence rate for 2014 was 0.7 cases per 100,000 population, an increase from 2010–2012 – PowerPoint PPT presentation

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Title: Hepatitis C: An Overview By Jose Poulose, M.D.


1
Hepatitis C An Overview
  • Jose Poulose, M.D

2
Some facts
  • An estimated 2.7-3.9 million people in the United
    States have chronic hepatitis C.
  •  An estimated 30,500 acute hepatitis C cases
    occurred in 2014.
  • HCV infection becomes chronic in approximately
    7585 of cases.
  • In 2014, a total of 2,194 cases of acute
    hepatitis C were reported to CDC from 40 states.
  • The overall incidence rate for 2014 was 0.7 cases
    per 100,000 population, an increase from
    20102012
  • Source CDC.GOV

3
Who is at risk?
  • Current or former injection drug users, including
    those who injected only once many years ago
  • Recipients of clotting factor concentrates made
    before 1987, when more advanced methods for
    manufacturing those products were developed
  • Recipients of blood transfusions or solid organ
    transplants before July 1992, when better testing
    of blood donors became available
  • Chronic hemodialysis patients
  • Persons with known exposures to HCV, such as
  • health care workers after needlesticks involving
    HCV-positive blood
  • recipients of blood or organs from a donor who
    tested HCV-positive
  • Persons with HIV infection
  • Children born to HCV-positive mothers

4
Some more facts
  • Of every 100 persons infected with HCV,
    approximately
  • 7585 will go on to develop chronic infection
  • 6070 will go on to develop chronic liver disease
  • 520 will go on to develop cirrhosis over a
    period of 2030 years
  • 15 will die from the consequences of chronic
    infection (liver cancer or cirrhosis)
  • Most patients are unaware of the disease.

5
How is it transmitted?
  • Injection drug use (currently the most common
    means of HCV transmission in the United States)
  • Receipt of donated blood, blood products, and
    organs (once a common means of transmission but
    now rare in the United States since blood
    screening became available in 1992)
  • Needle stick injuries in health care settings
  • Birth to an HCV-infected mother
  • ex with an HCV-infected person (Less frequent)
  • Sharing personal items contaminated with
    infectious blood, such as razors or
    toothbrushes-Very unusual
  • (Other health care procedures that involve
    invasive procedures, such as injections

6
Who should be screened?
  • Currently injecting drugs
  • Ever injected drugs, including those who injected
    once or a few times many years ago
  • Have certain medical conditions, including
    persons
  • who received clotting factor concentrates
    produced before 1987
  • who were ever on long-term hemodialysis
  • with persistently abnormal alanine
    aminotransferase levels (ALT)
  • who have HIV infection
  • Were prior recipients of transfusions or organ
    transplants, including persons who
  • were notified that they received blood from a
    donor who later tested positive for HCV infection
  • received a transfusion of blood, blood
    components, or an organ transplant before July
    1992
  • HCV- testing based on a recognized exposure is
    recommended for
  • Healthcare, emergency medical, and public safety
    workers after needle sticks, sharps, or mucosal
    exposures to HCV-positive blood
  • Children born to HCV-positive women

7
Baby Boomers and Hepatitis C screening
  • Almost exactly nine months after World War II
    ended, the cry of the baby was heard across the
    land, as historian Landon Jones later described
    the trend. More babies were born in 1946 than
    ever before 3.4 million, 20 percent more than in
    1945. This was the beginning of the so-called
    baby boom. In 1947, another 3.8 million babies
    were born 3.9 million were born in 1952 and
    more than 4 million were born every year from
    1954 until 1964, when the boom finally tapered
    off. By then, there were 76.4 million baby
    boomers in the United States. They made up
    almost 40 percent of the nations population.
  • Those born between 1945 and 1965 should be
    screened once.

8
Testing
  • AntiHCV antibody testing followed by polymerase
    chain reaction testing for viremia is accurate
    for identifying patients with chronic HCV
    infection. Various noninvasive tests with good
    diagnostic accuracy are possible alternatives to
    liver biopsy for diagnosing fibrosis or
    cirrhosis.
  • Early detection has shown to be effective in
    altering the natural course of the disease.
  • Screening should be done voluntarily and with the
    patient clearly understanding that they are being
    screened.

9
Symptoms
  • Most people have no symptoms. Those who do
    develop symptoms may have fatigue, nausea, loss
    of appetite, and yellowing of the eyes and skin.
  • but people may experience Pain areas in the
    abdomen Gastrointestinal bleeding, bloating,
    fluid in the abdomen, or nausea
  • Whole body fatigue, fever, or loss of appetite
    Skin web of swollen blood vessels in the skin or
    yellow skin and eyes
  • Also common depression or weight loss

10
Medications
  • Antiviral drug Reduces viruses' ability to
    replicate.
  • Interferon alfa-2b (Pegintron)
  • Pegylated interferon alfa
  • Sofosbuvir (Sovaldi)
  • Ribavirin (Rebetol, Copegus, Virazole, and
    Ribasphere)
  • Simeprevir (Olysio)
  • Ledipasvir
  • Always remember Prevention is better than cure!
    Say goodbye to those shared needles! Get yourself
    checked!
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