Hcv Case Studies
Choice “E” is the best answer. Although the factors involved in the development and progression of chronic infection are incompletely not completely understood, a number of studies have identified variables that contribute to progressive liver disease. The rate of progression to fibrosis and cirrhosis after initial infection with HCV appears to be higher in men and lower in women, particularly younger women. Evidence for this comes mostly from retrospective analyses of two large outbreaks of hepatitis C that occurred among pregnant women who received Rh immune globulin that had been contaminated with HCV. In a 17-year follow-up study of 704 Irish women with anti-HCV after receipt of contaminated immune globulin, the chronicity rate was 55%.
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In prospective surveys among inner city Baltimore injection drug users, the prevalence of chronic HCV infection in African American men was 95%. The NHANES study also revealed a higher rate of chronic infection among African Americans (86%), compared to Caucasians (68%) (p=0.02)[5]. In addition, African Americans had a lower rate of sustained viral response (SVR) to interferon and ribavirin treatment for HCV infection. Interestingly, African Americans and Asians with HCV have a 2-fold and 4-fold increased risk, respectively, of developing HCC when compared to Caucasians with HCV[5]. No host or viral genetic differences have yet been identified to explain the racial disparities in the incidence of chronic HCV, response to treatment, or development of HCC. Cirrhosis develops in approximately 10% to 15% of individuals with chronic HCV infection. In addition, the rate of chronicity in HCV infection appears to be lower in women, particularly younger women. Evidence for this comes mostly from retrospective analyses of two large outbreaks of hepatitis C that occurred among pregnant women who received Rh immune globulin that had been contaminated with …show more content…
The mean time for progression to cirrhosis in patients who drink less that 50 grams of alcohol per day and are older then than 40 years is 30 years. Among males over 40 years old who consumed more than 50 grams of alcohol per day, the mean time for progression to cirrhosis was 13 years. In addition, among HCV-positive women less than 40 years old who consumed no alcohol, the mean time to cirrhosis was 42 years. It is hypothesized that more severe liver injury among alcohol users is due to alcohol-induced enhancement of viral replication or increased susceptibility of cells to viral
In prospective surveys among inner city Baltimore injection drug users, the prevalence of chronic HCV infection in African American men was 95%. The NHANES study also revealed a higher rate of chronic infection among African Americans (86%), compared to Caucasians (68%) (p=0.02)[5]. In addition, African Americans had a lower rate of sustained viral response (SVR) to interferon and ribavirin treatment for HCV infection. Interestingly, African Americans and Asians with HCV have a 2-fold and 4-fold increased risk, respectively, of developing HCC when compared to Caucasians with HCV[5]. No host or viral genetic differences have yet been identified to explain the racial disparities in the incidence of chronic HCV, response to treatment, or development of HCC. Cirrhosis develops in approximately 10% to 15% of individuals with chronic HCV infection. In addition, the rate of chronicity in HCV infection appears to be lower in women, particularly younger women. Evidence for this comes mostly from retrospective analyses of two large outbreaks of hepatitis C that occurred among pregnant women who received Rh immune globulin that had been contaminated with …show more content…
The mean time for progression to cirrhosis in patients who drink less that 50 grams of alcohol per day and are older then than 40 years is 30 years. Among males over 40 years old who consumed more than 50 grams of alcohol per day, the mean time for progression to cirrhosis was 13 years. In addition, among HCV-positive women less than 40 years old who consumed no alcohol, the mean time to cirrhosis was 42 years. It is hypothesized that more severe liver injury among alcohol users is due to alcohol-induced enhancement of viral replication or increased susceptibility of cells to viral