Transcript Hepititis C - Amber Rhodes, RN

What Is Hep C?
Hepatitis C (HCV) is one of several viruses that causes hepatitis
(inflammation of the liver).
HCV is spread most efficiently through exposure to infected blood.
The presence of HCV in the liver triggers the human immune system,
which leads to inflammation.
It is difficult for the human immune system to eliminate HCV from the
body.
Up to 85% of people who are acutely (symptomatic) infected with HCV
will fail to eliminate the virus and will become chronically infected.
Over time (usually decades), prolonged inflammation may cause
scarring.
Extensive scarring in the liver is called cirrhosis.
Cirrhosis leads to extensive scaring that leaves the liver unable to
function
HCV is the most common reason for liver transplantation in the U.S.
Causes, incidence, and risk factors
Hepatitis C infection is caused by the hepatitis C virus
(HCV). People who may be at risk for hepatitis C are those
who:
Have been on long-term kidney dialysis
Have unprotected sexual contact with a person who has
hepatitis C (this risk is much less common than hepatitis B,
but the risk is higher for those who have many sex partners,
already have a sexually transmitted disease, or are infected
with HIV)
Causes, incidence, and risk factors (continued)
Inject street drugs or share a needle with someone who has
hepatitis C
Received a blood transfusion before July 1992
Received a tattoo or acupuncture with contaminated
instruments (the risk is very low with licensed, commercial
tattoo facilities)
Received blood, blood products, or solid organs from a
donor who has hepatitis C
Share personal items such as toothbrushes and razors with
someone who has hepatitis C (less common)
Were born to a hepatitis C-infected mother (1/20 babies
born to mothers with HCV)
Symptoms
 Usually show no symptoms if recently infected with HCV
 About 1 in 10 have yellowing of the skin (jaundice) that gets better
 Most people develop a long-term (chronic) infection (usually no symptoms )
If the infection has been present for many years, the liver may be permanently
scarred.
Causes Cirrhosis- Often, there may be no symptoms until cirrhosis has
developed.
The following symptoms could occur with hepatitis C infection:
 Abdominal pain (right upper
abdomen)
 Abdominal swelling (due to
fluid called ascites)
 Clay-colored or pale stools
 Dark urine
 Fatigue
 Fever
 Itching
 Jaundice
 Loss of appetite
 Nausea
 Vomiting
Signs and tests
Blood tests are done to check for hepatitis C:
 EIA assay to detect hepatitis C antibody
 Hepatitis C RNA assays to measure virus levels (viral load)
 Genetic testing is done to check for the hepatitis C genotype. Six
genotypes exist. Test results can help your doctor better choose your
treatment.
 Most Americans have genotype 1 infection, which is the hardest to
treat.
 Genotypes 2 and 3 are also common, and respond better to
treatment.
 The following tests are done to identify and monitor liver damage
from hepatitis C:
 Albumin level, Liver function tests, Prothrombin time
 Liver biopsy can show how much damage has been done to the
liver.
Treatment
 The goals of HCV treatment are to remove the virus from the blood
and reduce the risk of cirrhosis and liver cancer that can result from
long-term HCV infection.
 Many patients with hepatitis C benefit from treatment with
medications. The most common medications are a combination of
pegylated interferon alfa and ribavirin, an antiviral medication.
 Most patients receive weekly injections of pegylated interferon alfa.
Ribavirin is a capsule taken twice daily. Ribavirin can cause birth
defects. Women should avoid getting pregnant during, and for 6 months
after treatment.
 Treatment is given for 24 - 48 weeks.
 Telaprevir and boceprevir are newer drugs which may be used for
patients with genotype 1.
Treatment (continued)
Patients who develop cirrhosis or liver cancer may be
candidates for a liver transplant.
People with hepatitis C should also:
Avoid taking vitamins, nutritional supplements, or new
over-the-counter medications without first discussing it with
their health care provider.
Avoid any substances that are toxic to the liver, including
alcohol. Even moderate amounts of alcohol speed up the
progression of hepatitis C, and alcohol reduces the
effectiveness of treatment.
Get vaccinated against hepatitis A and B.
Local Needle Exchanges
The agencies listed below are the main providers of clean syringes and injection
equipment in San Francisco. They also provide collection services of used
syringes. All services are free. As well, many pharmacies in San Francisco will collect
used syringes for no cost.
API Wellness Center- TransTHRIVE (API), 730 Polk Street, 415-292-3420
Homeless Youth Alliance (HYA), 584 Cole St.
Mission Neighborhood Resource Center (MNRC), 165 Capp Street, 415-869-7977
San Francisco HIV Prevention Project (HPP), 117 Sixth Street, near Mission, 415241-5100
St. James Infirmary (SJI), 1372 Mission Street @10th St.
Tenderloin Health(TH), 187 Golden Gate Ave @ Leavenworth, 415-437-2900
 http://stjamesinfirmary.org/?page_id=731
Prevention
Avoid contact with blood or blood products whenever possible
Do not inject illicit drugs, and especially do not share needles
with anyone. Be careful when getting tattoos and body
piercings
Sexual transmission is very low among stable, monogamous
couples.
People who have sex outside of a monogamous relationship
should practice safer sex behaviors to avoid hepatitis C, as well
as sexually transmitted diseases, including HIV and hepatitis B.
Currently there is no vaccine for hepatitis C
 http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001329/
Question and Answer
Name one thing can you do to prevent getting
Hepatitis C?
True/False
It is ok to share a razor with a room-mate who
has Hep C?
Is there a vaccine for Hep C?