Hepatitis C

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Hepatitis C Virus
Hepatitis is an inflammation of the liver, which can be caused by several different viruses. It can also be acute or chronic, depending on the particular virus and stage of the disease. The different types of hepatitis are hepatitis A (HAV), hepatitis B (HBV), hepatitis B- associated delta (HDV), hepatitis C (HCV) (Porth 2005). These viruses are capable of being transmitted in many different ways but each one will instigate a viral response and inflammation within the liver itself. HAV presents as an acute infection and does not become chronic (CDC 2011). HBV and HCV may begin as acute infections, but can remain in the body and result in a long-term chronic illness (CDC). Hepatitis C Virus (HCV), which is the chronic form of the disease, is one of the most common causes of chronic hepatitis, cirrhosis and hepatocellular carcinoma in the world (Porth 2005). There are 3.9 million people in the Unites States, who are infected with HCV (Falvo 2009). The hepatitis C virus is a result of infection from the flavivirus but is unrelated to the HAV or HBV virus; it is also from the same family of viruses as the yellow fever virus (OHDS 2011). Unlike HAV and HBV, there is no immunization available for HCV. Of those that are infected, 75% to 85% will develop chronic infections, which can lead to the development of chronic liver disease (ODHS). Who is at risk for HCV? The CDC (2011) discusses that injectable drug users (IDU), past and present. Statistically, IDU have been shown to account for approximately 60% of current HCV infections (CDC). Others at risk include persons who have received blood or blood products before the implementation of screening practices in 1992; hemodialysis patients; persons who have participated in non-sterile tattooing and body piercing practices; HIV patients; and children born to mothers that carry the hepatitis C virus. For members of the health care community, this can be a potential hazard due to accidental contact with human body fluids, such as blood. Those infected with this disease can face challenges both personally and socially due to the obvious physical affects as well as the social stigma associated with the disease. The main route of transmission is contact with infected human body fluids. This can be by different methods such as blood transfusion, shared intravenous needles or accidental needle sticks. Other routes of transmission that are of concern are tattooing, acupuncture, body piercing, from mother to infant or during sexual contact. HCV has an incubation period that can last from 15 to 150 days (Porth 2005). Its signs and symptoms are significantly less severe in comparison to the other viral hepatitis infections. They may include fever, fatigue, weight-loss, nausea, vomiting, dark urine, clay-colored bowel movements, joint paint, muscle aches and possibly tenderness in the area of the liver (Mayo Clinic). The Mayo Clinic (2009) says that approximately 70% to 80% of people with acute HCV do not display any noticeable symptoms at all. Testing and diagnosis for HCV can be relatively simple, for example a blood test; however, depending on circumstances some tests can be as invasive as a liver biopsy. Hepatic function tests and confirmatory testing such as viral markers can be used to detect the presence of infection. The anti-HCV test qualitatively detects the overall presence of the virus. When a positive test result is obtained, confirmatory testing will be performed. This test is termed HCV recombinant immunoblot assay. However, these tests cannot determine past or current infections as they can only indicate the presence of a current infection. An HCV RNA test is still qualitative, but it is done to determine the presence of a current infection. Quantification of the infection is then processed by way of HCV viral load testing, which is capable of measuring the overall amount of RNA in the blood system, giving direct measurement of...
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