Hepatitis 202
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Transcript of Hepatitis 202
![Page 1: Hepatitis 202](https://reader033.fdocuments.us/reader033/viewer/2022061209/548e158bb479598e6a8b48a5/html5/thumbnails/1.jpg)
Hep 202Just when you thought you
knew everything.
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Today We Will
• Review Hepatitis 101• Take a more in-depth look at
Hepatitis C• Look at hepatitis C tests, nutrition,
HIV co-infection, extra hepatic effects and treatment
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Case Study Jane and Julia
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What Would You Tell Jane and Julia if You Were Bob?
Discuss in your groups:
1. What does hepatitis and viral hepatitis mean and what do you know about the five major types of viral hepatitis?
2. What are the signs and symptoms of hepatitis C?
3. What are the risk factors for hepatitis C and how can one prevent getting it?
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Hep 101 Overview
• Hepatitis C– Name signs/symptoms, risk factors
and prevention
•Hepatitis =
•Viral Hepatitis =
•Name 5 identified types of viral hepatitis
Liver inflammationVirus that causes liver inflammation
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How Does Hep C Damage The Liver?
BC Hepatitis Services, 2003
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Hepatocellular Carcinoma
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Viral Hepatitis5 Major Identified Types:A: oral-fecal transmission
B: sexual fluids & blood to blood
C: blood to blood
D: travels with B
E: oral-fecal transmission
VaccinePreventable
Adapted from Corneil, 2003
There are also other less common strains
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Other Types are Being Discovered!
• Hepatitis G (HGV or HGBV-C)– Similar transmission to Hep C – Appears to cause chronic infection– Long term effects of virus on the liver
still to be determined
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Hepatitis C
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More on Hepatitis C
• RNA Virus (Flaviviridae Family)6 major variations maybe up to 11
+
50 to 90 subtypes (e.g. Hepatitis C genotype 1 subtype B)
•Type 1 is most common type found in North America
Unfortunately it is also the most difficult to treat
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More Info (con’t)
• Other routes of transmission–Mother-to-child, breastfeeding, dialysis
• Certain locations also increase risk– E.g. prisons because more individuals
already have the virus than in general population
Highly Debatable
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Health Canada, Hepatitis C Prevention, Support and Research Program, 2002
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Health Canada, Hepatitis C Prevention, Support and Research Program, 2002
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Health Canada, Hepatitis C Prevention, Support and Research Program, 2002
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Health Canada, Hepatitis C Prevention, Support and Research Program, 2002
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Health Canada, Hepatitis C Prevention, Support and Research Program, 2002
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Tests Screening:
Detects if the body has produce antibodies to Hepatitis C (anti-HCV)
•Usually need a minimum of six weeks to detect antibodies. After 6 months 95% will have detectable antibodies
1st test that is done when someone gets tested
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Tests
• Other tests are required to confirm the screening test and whether someone still has the virus• They look for the specific genotype and the amount of virus in the blood stream.
Looks for virus RNA
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Tests• Other tests are used to monitor
liver function and damage• They include:
Liver Enzymes(ALT, AST, GGT, LDH)
Checks for amount of liver cell inflammation
Liver Function(Bilirubin, Albumin, INR)
Checks to see if liver is clearing toxins and producing proteins
Liver Biopsy Microscopic look at how badly the liver is scarred
Liver Ultrasound Liver cancer screen
Corneil, 2003
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Hepatitis C Nutrition/Health Tips
• Eat frequent smaller meals• Avoid Alcohol• May need to decrease iron intake• Protein intake may need to increase
– 1-1.5g/kg/Day is generally recommended
Dieticians of Canada, Hepatitis C Nutrition Care, 2003
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More Tips• Salt restrictions may need to be
implemented depending on fluid retention
• Consult with dietician or health care professional to best tailor needs
Dieticians of Canada, Hepatitis C Nutrition Care, 2003
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Complimentary & Alternative Therapies
• For the most part, are considered experimental due to lack of research
• Some herbs have shown to have some benefit – E.g. Milk Thistle (Silymarin)
•Just because herbs are natural does not mean they are all safe some can harm the liver!
Dieticians of Canada, Hepatitis C Nutrition Care, 2003
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Milk Thistle Example
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Other HCV-related conditions
These may occur when the immune system tries to fight off the virus
Dead antibodies deposit in the body causingBlood & Kidney Disorders
Toxins in the blood maydeposit in the body causing:Skin DisordersMental Disorders
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HIV Co-infection
Seems tospeed upthe rate ofviralreplication
Appears to increase rate of liver scarring and long-term complications such as cirrhosis
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Treatment
Goal is to achieve a sustained virological response (SVR)
• Means that virus RNA is no longer detectable after treatment over a sustained period of time (will still have antibodies)
More likely to achieve a SVR if:• Treating genotype other than genotype 1• Low viral levels and liver damage at
treatment onset• Low body weight or surface area
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Treatment• Best treatment currently available is
a combination of two antiviral drugs:
Pegylated Interferon
+Ribavirin
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Treatment• Side effects can include:
– Depression– Flu-like symptoms
• Some cannot complete treatment due to side effects
• Others may not qualify because – Liver is too damaged– Addicted to drugs and/or alcohol
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Questions?