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Follow WhmSoft's board vlrFilter, Multifunction Audio Filter with Remote Control on Pinterest. Hepatitis CHepatitis C is an infectious disease caused by the hepatitis C virus (HCV) that primarily affects the liver. ENGERIX-B: A vaccine against hepatitis B (hep B) to stimulate the body's immune system to produce antibodies against the hep B virus.
Neither pregnancy nor lactation should be considered a contraindication to vaccination or treatment with HBIG.
Persons who have previously been infected with HBV are immune to re-infection and do not require PEP. The option of giving one dose of HBIG and reinitiating the vaccine series is preferred for non-responders who have not completed a second 3-dose vaccine series.
HCV is not transmitted efficiently through exposures to blood in the occupational setting, and the incidence of anti-HCV seroconversion after accidental occupational exposure is 1.8% (0%-7%). The Body is a service of Remedy Health Media, LLC, 750 3rd Avenue, 6th Floor, New York, NY 10017. MNT – Hourly Medical News Since 2003 Sign in Your MNT Email address Password Remember me ?
Post-traumatic stress disorder occurs after a person is exposed to a traumatic event, though not everyone that experiences or witnesses such an event is affected by the condition. Researchers from the University of California in Los Angeles (UCLA) have identified two gene variants that could influence the risk of post-traumatic stress disorder (PTSD).
According to the National Institute of Mental Health (NIMH), 6.8% of the adult population of the US experience PTSD at some point in their lifetime. Symptoms can vary in intensity over time and can be triggered by reminders of the traumatic event that caused the disorder to occur in the first place. Previous research in 2012 involving these samples led to the discovery that survivors carrying two gene variants associated withdepression were more likely to have PTSD than those that did not carry the variants. For the study, published in the Journal of Affective Disorders, the team assessed the roles of two genes in the DNA samples, taken from 200 individuals. Anyone can be exposed to a traumatic event and be affected by PTSD, regardless of age and gender.
Recently, Medical News Today reported on a study finding that women experiencing large numbers of PTSD symptoms could have almost two times the risk of developing type 2 diabetes compared with women who have not been exposed to trauma.
Hepatitis C virus: A single-stranded RNA virus in the Flaviviridae family that causes hepatitis C.
Hepatitis C - Wikipedia, the free encyclopediaHepatitis C is an infectious disease affecting the liver, caused by the hepatitis C virus (HCV).
For persons who previously completed a second vaccine series but failed to respond, 2 doses of HBG are preferred. Unlike HBV, data indicate that HCV does not survive well in the environment, suggesting that environmental contamination with blood is not a significant risk for HCV transmission in the health care setting (the only exception may be in the hemodialysis setting). The Body and its logos are trademarks of Remedy Health Media, LLC, and its subsidiaries, which owns the copyright of The Body's homepage, topic pages, page designs and HTML code.
New genetic research may now explain why some people develop the condition while others do not.
This discovery could lead to improvements in the diagnosis and treatment of PTSD in the future. Goenjian traveled to Armenia in 1988 after a 6.8 magnitude earthquake hit the country, destroying many cities and killing more than 25,000 Armenians.
The genes were COMT, an enzyme that degrades the mood regulator dopamine, and TPH-2, a controller of the production of serotonin.
Goenjian says the team hopes that the study’s findings will lead to molecular methods for screening people at risk for PTSD and identify new forms of drug therapy to prevent and treat the disorder.
Detailed drug information for the consumer, includes dosage, Engerix-B side effects and more.Engerix-B - U S Food and Drug Administration Home PageEngerix-B. In addition, there are no data supporting the use of IG (anti-HCV antibody) as PEP to prevent HCV transmission. General Disclaimer: The Body is designed for educational purposes only and is not engaged in rendering medical advice or professional services. During this time, many families agreed to have blood samples sent to UCLA so that the team could analyze their DNA for information pertaining to psychiatric vulnerability. He recommends that research into this area continues in a bid to uncover more of the genes involved. The HCV genome contains some 10,000 nucleotides and encodes a single polyprotein of 3,000 amino acids.
None of the antivirals currently available to treat HCV infection are FDA approved for use in PEP, nor have any clinical trials been done to assess the effect of antivirals (ie interferon with or without ribavirin) as postexposure prophylaxis.
The information provided through The Body should not be used for diagnosing or treating a health problem or a disease. Hepatitis B Vaccine (rby) Information for the Medical, Nursing and Pharmaceutical Professions.
Recommendations for postexposure management of HCV are to achieve early detection of chronic disease and, if present, refer to an expert for treatment options.
There are data from studies done outside the US to suggest that a short course of interferon (IFN) alfa-2b therapy in the acute stage of HCV is associated with higher rates of resolved infection than when therapy is begun once chronic disease has been established (Jaeckel E., et al. Genes and inherited traits may play a role determining an individual’s risk of developing PTSD. Researchers from the University of California in Los Angeles (UCLA) have identified two gene variants that could influence the risk of post-traumatic stress disorder (PTSD). In some cases, those with cirrhosis will develop complications such as liver failure, liver cancer, or esophageal and gastric varices. The theoretical argument exists, then, that antiviral treatment at the first signs of detectable HCV RNA may prevent the development of chronic infection.
HCV is spread primarily by blood-to-blood contact associated with intravenous drug use, poorly sterilized medical equipment, needlestick injuries in healthcare, and transfusions.
Prevention includes harm reduction efforts among people who use intravenous drugs and testing donated blood. Chronic infection can be cured about 90% of the time with treatments that include the medications sofosbuvir or simeprevir. Previous to this a combination of peginterferon and ribavirin was used which had a cure rate around 50% and greater side effects.
About 343,000 deaths due to liver cancer and 358,000 deaths due to cirrhosis occurred in 2013 due to hepatitis C.
The existence of hepatitis C – originally identifiable only as a type of non-A non-B hepatitis – was suggested in the 1970s and proven in 1989. Symptoms are generally mild and vague, including a decreased appetite, fatigue, nausea, muscle or joint pains, and weight loss and rarely does acute liver failure result.
The infection resolves spontaneously in 10–50% of cases, which occurs more frequently in individuals who are young and female. Late relapses after apparent cure have been reported, but these can be difficult to distinguish from reinfection.
Fatty changes to the liver occur in about half of those infected and are usually present before cirrhosis develops. Worldwide hepatitis C is the cause of 27% of cirrhosis cases and 25% of hepatocellular carcinoma. Cirrhosis is more common in those also infected with hepatitis B, schistosoma, or HIV, in alcoholics and in those of male gender. In those with hepatitis C, excess alcohol increases the risk of developing cirrhosis 100-fold. Liver cirrhosis may lead to portal hypertension, ascites (accumulation of fluid in the abdomen), easy bruising or bleeding, varices (enlarged veins, especially in the stomach and esophagus), jaundice, and a syndrome of cognitive impairment known as hepatic encephalopathy.


Extrahepatic complications The most common problem due to hepatitis C but not involving the liver is mixed cryoglobulinemia (usually the type II form) — an inflammation of small and medium-sized blood vessels. Hepatitis C is also associated with the autoimmune disorder Sjogren's syndrome, a low platelet count, lichen planus, porphyria cutanea tarda, necrolytic acral erythema, insulin resistance, diabetes mellitus, diabetic nephropathy, autoimmune thyroiditis, and B-cell lymphoproliferative disorders. Possible associations include Hyde's prurigo nodularis and membranoproliferative glomerulonephritis. This site complies with the HONcode standard for trustworthy health information: verify here.
Occult infection Persons who have been infected with hepatitis C may appear to clear the virus but remain infected. The virus is not detectable with conventional testing but can be found with ultra-sensitive tests. The original method of detection was by demonstrating the viral genome within liver biopsies, but newer methods include an antibody test for the virus' core protein and the detection of the viral genome after first concentrating the viral particles by ultracentrifugation. A form of infection with persistently moderately elevated serum liver enzymes but without antibodies to hepatitis C has also been reported. The consequences of occult infection appear to be less severe than with chronic infection but can vary from minimal to hepatocellular carcinoma. The rate of occult infection in those apparently cured is controversial but appears to be low. 40% of those with hepatitis but with both negative hepatitis C serology and the absence of detectable viral genome in the serum have hepatitis C virus in the liver on biopsy. Virology Main article: Hepatitis C virus The hepatitis C virus (HCV) is a small, enveloped, single-stranded, positive-sense RNA virus. The genotypes are divided into several subtypes with the number of subtypes depending on the genotype. In the United States, about 70% of cases are caused by genotype 1, 20% by genotype 2 and about 1% by each of the other genotypes.
The half life of the virus particles in the serum is around 3 hours and may be as short as 45 minutes.
Transmission Hepatitis C infection in the United States by source The primary route of transmission in the developed world is intravenous drug use (IDU), while in the developing world the main methods are blood transfusions and unsafe medical procedures.
The cause of transmission remains unknown in 20% of cases; however, many of these are believed to be accounted for by IDU. Drug use Intravenous drug use (IDU) is a major risk factor for hepatitis C in many parts of the world. Of 77 countries reviewed, 25 (including the United States) were found to have prevalences of hepatitis C in the intravenous drug user population of between 60% and 80%. Occurrence of hepatitis C among prison inmates in the United States is 10 to 20 times that of the occurrence observed in the general population; this has been attributed to high-risk behavior in prisons such as IDU and tattooing with nonsterile equipment.
Healthcare exposure Blood transfusion, transfusion of blood products, or organ transplants without HCV screening carry significant risks of infection. The United States instituted universal screening in 1992 and Canada instituted universal screening in 1990. This decreased the risk from one in 200 units to between one in 10,000 to one in 10,000,000 per unit of blood. This low risk remains as there is a period of about 11–70 days between the potential blood donor's acquiring hepatitis C and the blood's testing positive depending on the method.
Those who have experienced a needle stick injury from someone who was HCV positive have about a 1.8% chance of subsequently contracting the disease themselves. There is a risk from mucosal exposures to blood; but this risk is low, and there is no risk if blood exposure occurs on intact skin.
Limitations in the implementation and enforcement of stringent standard precautions in public and private medical and dental facilities are known to be the primary cause of the spread of HCV in Egypt, the country with highest rate of infection in the world.
Sexual intercourse Whether hepatitis C can be transmitted through sexual activity is controversial.
While there is an association between high-risk sexual activity and hepatitis C, and multiple sexual partners are a risk factor for hepatitis C, there is no conclusive evidence that hepatitis C can be transmitted by sexual activity, since people who report transmission with sex as their only risk factor may actually have used drugs but denied it.
The majority of evidence supports there being no risk for heterosexual couples with only one sexual partner. Sexual practices that involve higher levels of trauma to the anogenital mucosa, such as anal penetrative sex, or that occur when there is a concurrent sexually transmitted infection, including HIV or genital ulceration, do present a risk.
The United States Department of Veterans Affairs recommends condom use to prevent hepatitis C transmission in those with multiple partners, but not those in relationships that involve only a single partner.
Body modification Tattooing is associated with two to threefold increased risk of hepatitis C.
This can be due to either improperly sterilized equipment or contamination of the dyes being used.
Tattoos or piercings performed either before the mid-1980s, "underground," or nonprofessionally are of particular concern, since sterile techniques in such settings may be lacking. It is rare for tattoos in a licensed facility to be directly associated with HCV infection. Shared personal items Personal-care items such as razors, toothbrushes, and manicuring or pedicuring equipment can be contaminated with blood. Appropriate caution should be taken regarding any medical condition that results in bleeding, such as cuts and sores.
HCV is not spread through casual contact, such as hugging, kissing, or sharing eating or cooking utensils.
Vertical transmission Vertical transmission of hepatitis C from an infected mother to her child occurs in less than 10% of pregnancies.
It is not clear when transmission occurs during pregnancy, but it may occur both during gestation and at delivery.
There is no evidence that breast-feeding spreads HCV; however, to be cautious, an infected mother is advised to avoid breastfeeding if her nipples are cracked and bleeding, or if her viral loads are high. Diagnosis Serologic profile of Hepatitis C infection There are a number of diagnostic tests for hepatitis C, including HCV antibody enzyme immunoassay or ELISA, recombinant immunoblot assay, and quantitative HCV RNA polymerase chain reaction (PCR). HCV RNA can be detected by PCR typically one to two weeks after infection, while antibodies can take substantially longer to form and thus be detected. Chronic hepatitis C is defined as infection with the hepatitis C virus persisting for more than six months based on the presence of its RNA.
Chronic infections are typically asymptomatic during the first few decades, and thus are most commonly discovered following the investigation of elevated liver enzyme levels or during a routine screening of high-risk individuals. Diagnosis in the infant is difficult as maternal antibodies may persist for up to 18 months. Serology Hepatitis C testing typically begins with blood testing to detect the presence of antibodies to the HCV, using an enzyme immunoassay. If this test is positive, a confirmatory test is then performed to verify the immunoassay and to determine the viral load.
A recombinant immunoblot assay is used to verify the immunoassay and the viral load is determined by a HCV RNA polymerase chain reaction. If there is no RNA and the immunoblot is positive, it means that the person tested had a previous infection but cleared it either with treatment or spontaneously; if the immunoblot is negative, it means that the immunoassay was wrong. A number of tests are available as point of care testing which means that results are available within 30 minutes. Liver enzymes are variable during the initial part of the infection and on average begin to rise at seven weeks after infection. Biopsy Liver biopsies are used to determine the degree of liver damage present; however, there are risks from the procedure. The typical changes seen are lymphocytes within the parenchyma, lymphoid follicles in portal triad, and changes to the bile ducts. There are a number of blood tests available that try to determine the degree of hepatic fibrosis and alleviate the need for biopsy.


Screening It is believed that only 5–50% of those infected in the United States and Canada are aware of their status. Testing is recommended for those at high risk, which includes injection drug users, those who have received blood transfusions before 1992, those who have been in jail, those on long term hemodialysis, and those with tattoos. Screening is also recommended in those with elevated liver enzymes, as this is frequently the only sign of chronic hepatitis.
Centers for Disease Control and Prevention (CDC) added a recommendation for a single screening test for those born between 1945 and 1965. Prevention See also: Hepatitis C vaccine As of 2016, no approved vaccine protects against contracting hepatitis C.
However, there are a number of vaccines under development and some have shown encouraging results. A combination of harm reduction strategies, such as the provision of new needles and syringes and treatment of substance use, decreases the risk of hepatitis C in intravenous drug users by about 75%.
The screening of blood donors is important at a national level, as is adhering to universal precautions within healthcare facilities.
In countries where there is an insufficient supply of sterile syringes, medications should be given orally rather than via injection (when possible). Those with chronic hepatitis C are advised to avoid alcohol and medications toxic to the liver, and to be vaccinated for hepatitis A and hepatitis B. Ultrasound surveillance for hepatocellular carcinoma is recommended in those with accompanying cirrhosis.
Medications Treatment with antiviral medication is recommended in all people with proven chronic hepatitis C who are not at high risk of dying from other causes.
People with the highest complication risk should be treated first, with the risk of complications based on the degree of liver scarring.
The initial recommended treatment depends on the type of hepatitis C virus with which a person is infected.
Once cirrhosis is established, the rate of developing hepatocellular carcinoma is ~1–4% per year. Rates of new infections have decreased in the Western world since the 1990s due to improved screening of blood before transfusion. In the United States, about 2% of people have hepatitis C, with the number of new cases per year stabilized at 17,000 since 2007. This mortality rate is expected to increase, as those infected by transfusion before HCV testing become apparent. The total number of people with this infection is higher in some countries in Africa and Asia.
It is believed that the high prevalence in Egypt is linked to a now-discontinued mass-treatment campaign for schistosomiasis, using improperly sterilized glass syringes. Alter, Chief of the Infectious Disease Section in the Department of Transfusion Medicine at the National Institutes of Health, and his research team demonstrated how most post-transfusion hepatitis cases were not due to hepatitis A or B viruses. Despite this discovery, international research efforts to identify the virus, initially called non-A, non-B hepatitis (NANBH), failed for the next decade. In 1987, Michael Houghton, Qui-Lim Choo, and George Kuo at Chiron Corporation, collaborating with Dr.
Bradley at the Centers for Disease Control and Prevention, used a novel molecular cloning approach to identify the unknown organism and develop a diagnostic test. In 1988, Alter confirmed the virus by verifying its presence in a panel of NANBH specimens. The discovery led to significant improvements in diagnosis and improved antiviral treatment. Alter and Houghton were honored with the Lasker Award for Clinical Medical Research for "pioneering work leading to the discovery of the virus that causes hepatitis C and the development of screening methods that reduced the risk of blood transfusion-associated hepatitis in the U.S. In 1994, Bradley sued Chiron, seeking to invalidate the patent, have himself included as a coinventor, and receive damages and royalty income. Society and culture See also: List of people with hepatitis C World Hepatitis Day, held on July 28, is coordinated by the World Hepatitis Alliance. In Canada the cost of a course of antiviral treatment is as high as 30,000 CAD in 2003, while the United States costs are between 9,200 and 17,600 in 1998 USD. In many areas of the world, people are unable to afford treatment with antivirals as they either lack insurance coverage or the insurance they have will not pay for antivirals. In the English National Health Service treatment rates for hepatitis C are higher among wealthier groups per 2010-2012 data.
Research As of 2011, there are about one hundred medications in development for hepatitis C. These include vaccines to treat hepatitis, immunomodulators, and cyclophilin inhibitors, among others. These potential new treatments have come about due to a better understanding of the hepatitis C virus.
Animal models One barrier to finding treatments for hepatitis C is the lack of a suitable animal model. Despite moderate success, current research highlights the need for pre-clinical testing in mammalian systems such as mouse, particularly for the development of vaccines in poorer communities.
Currently, chimpanzees remain the available living system to study, yet their use has ethical concerns and regulatory restrictions.
While scientists have made use of human cell culture systems such as hepatocytes, questions have been raised about their accuracy in reflecting the body's response to infection. A strategy is to introduce liver tissues from humans into mice, a technique known as xenotransplantation.
This engineering process is known to create humanized mice, and provide opportunities to study hepatitis C within the 3D architectural design of the liver and evaluating antiviral compounds. Alternatively, generating inbred mice with susceptibility to HCV would simplify the process of studying mouse models.
Special populations Children and pregnancy Main article: HCV in children and pregnancy Compared with adults, infection in children is much less well understood.
Worldwide the prevalence of hepatitis C virus infection in pregnant women and children has been estimated to 1–8% and 0.05–5% respectively. The vertical transmission rate has been estimated to be 3–5% and there is a high rate of spontaneous clearance (25–50%) in the children.
In developed countries transmission around the time of birth is now the leading cause of HCV infection. Factors associated with an increased rate of infection include membrane rupture of longer than 6 hours before delivery and procedures exposing the infant to maternal blood. Infection around the time of birth in one child does not increase the risk in a subsequent pregnancy. HCV infection is frequently found in children who have previously been presumed to have non-A, non-B hepatitis and cryptogenic liver disease.
While infection is commonly asymptomatic both cirrhosis with liver failure and hepatocellular carcinoma may occur in childhood. Immunosuppressed See also: Hepatitis C and HIV coinfection The rate of hepatitis C in immunosuppressed people is higher than the normal population. This is particularly true in those with human immunodeficiency virus infection, recipients of organ transplants and those with hypogammaglobulinemia. Novel and Combination Therapies for Hepatitis C Virus, An Issue of Clinics in Liver Disease,.



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