Hepatitis C is a liver disease caused by the hepatitis C virus. It is transmitted through exposure to infected blood, most commonly through sharing needles or other drug use equipment. Only about one-third of people show symptoms during initial infection, which may include fatigue, abdominal pain, and jaundice. Most people go on to develop chronic hepatitis C infection without symptoms for many years. Advanced liver disease from hepatitis C may lead to complications like jaundice, ascites, bleeding, and liver cancer. Co-infection with HIV increases the challenges of diagnosing and treating hepatitis C.
- The document discusses dental management considerations for patients infected with HIV and/or HCV, including common oral manifestations such as candidiasis, periodontal diseases, and viral diseases.
- Treatment planning requires assessing a patient's medical history, disease progression, ability to withstand treatment, and risk of bleeding or infection based on lab results.
- Invasive dental procedures for patients with HIV/HCV may require modifications like antibiotic pre-medication, and extra precautions are needed for those with advanced liver disease or bleeding problems.
HCV- Hepatitis and Hepatitis C InfectionBishwashPdl
Hepatitis C Virus and Infection. History, Source and Mode of Infection, Types of infection, Factors promoting severity, Laboratory Diagnosis of Hepatitis C, ELISA, References.
Hepatitis C virus (HCV) infection is the most common chronic bloodborne infection in the United States, with approximately 3.2 million people chronically infected. HCV accounts for 40% of chronic liver disease and is the most common cause of liver transplant in the country. Genotype 1 is the most prevalent worldwide, accounting for 70% of HCV cases in the United States. HCV transmission occurs primarily through blood exposures like transfusions, injection drug use, and medical equipment reuse. The average incubation period is 6-7 weeks, though 90% of infected individuals test antibody positive within 5 months.
HIV stands for human immunodeficiency virus and causes AIDS (acquired immunodeficiency syndrome). HIV weakens a person's immune system by destroying important immune cells called CD4 cells. AIDS is the final stage of HIV infection where the immune system is severely damaged, leaving a person vulnerable to opportunistic infections. HIV is transmitted through certain body fluids like blood, semen, vaginal fluids, and breast milk. Common ways of transmission include unprotected sex, contaminated needles, and from mother to child during pregnancy, childbirth, or breastfeeding. There is no cure for HIV/AIDS, but treatment with antiretroviral drugs can control the virus and prevent transmission.
Hepatitis C is a viral infection of the liver caused by the hepatitis C virus (HCV). HCV is a positive-sense single-stranded RNA virus of the Flaviviridae family with 6 major genotypes. It was discovered in 1989 and infects approximately 3% of the world's population, resulting in 54,000 deaths and 955,000 disabilities annually. HCV can cause both acute and chronic liver disease, with chronic infection potentially leading to cirrhosis and liver cancer. Diagnosis involves blood tests to detect HCV antibodies or RNA. While there is no vaccine, treatment options include combinations of ribavirin with other antiviral drugs like Daklinza or Epclusam, which cure the infection in 12 weeks
Hepatitis is an inflammation of the liver that can be caused by viruses or other factors. There are five main hepatitis viruses: Hepatitis A, B, C, D, and E. Hepatitis B and C cause chronic liver disease and put people at high risk for cirrhosis and liver cancer. Hepatitis B is diagnosed through blood tests detecting antigens and antibodies. Treatment involves antiviral medication lasting 6 months to a year. Hepatitis C is diagnosed through blood tests detecting antibodies and RNA. New antiviral drugs can cure most cases of Hepatitis C infection within 12 weeks of treatment. There are vaccines to prevent Hepatitis A and B but currently no vaccine for Hepatitis C.
Hepatitis B is a major public health problem worldwide that can cause both acute and chronic infection. It is a DNA virus that is highly infectious and transmitted through bodily fluids. Chronic infection puts people at risk of serious liver conditions like cirrhosis and cancer. While most acute infections resolve, 10% of cases become chronic carriers with active liver disease risk. Prevention focuses on vaccination, screening blood products, and safe needle practices.
Here are three more potential causes of paralysis in patients with AIDS:
- Cryptococcal meningitis: The most common fungal infection of the CNS in AIDS patients. Can cause increased intracranial pressure, cranial neuropathies, and spinal cord compression.
- Progressive multifocal leukoencephalopathy (PML): Caused by JC virus reactivation in AIDS patients. Presents with cognitive impairment, visual changes, and sometimes motor deficits. MRI often shows multifocal white matter lesions.
- Vacuolar myelopathy: Caused by HIV itself. Presents with spastic paraparesis. MRI may show T2 hyperintensities in the lateral and posterior columns of the spinal cord. Treat
- The document discusses dental management considerations for patients infected with HIV and/or HCV, including common oral manifestations such as candidiasis, periodontal diseases, and viral diseases.
- Treatment planning requires assessing a patient's medical history, disease progression, ability to withstand treatment, and risk of bleeding or infection based on lab results.
- Invasive dental procedures for patients with HIV/HCV may require modifications like antibiotic pre-medication, and extra precautions are needed for those with advanced liver disease or bleeding problems.
HCV- Hepatitis and Hepatitis C InfectionBishwashPdl
Hepatitis C Virus and Infection. History, Source and Mode of Infection, Types of infection, Factors promoting severity, Laboratory Diagnosis of Hepatitis C, ELISA, References.
Hepatitis C virus (HCV) infection is the most common chronic bloodborne infection in the United States, with approximately 3.2 million people chronically infected. HCV accounts for 40% of chronic liver disease and is the most common cause of liver transplant in the country. Genotype 1 is the most prevalent worldwide, accounting for 70% of HCV cases in the United States. HCV transmission occurs primarily through blood exposures like transfusions, injection drug use, and medical equipment reuse. The average incubation period is 6-7 weeks, though 90% of infected individuals test antibody positive within 5 months.
HIV stands for human immunodeficiency virus and causes AIDS (acquired immunodeficiency syndrome). HIV weakens a person's immune system by destroying important immune cells called CD4 cells. AIDS is the final stage of HIV infection where the immune system is severely damaged, leaving a person vulnerable to opportunistic infections. HIV is transmitted through certain body fluids like blood, semen, vaginal fluids, and breast milk. Common ways of transmission include unprotected sex, contaminated needles, and from mother to child during pregnancy, childbirth, or breastfeeding. There is no cure for HIV/AIDS, but treatment with antiretroviral drugs can control the virus and prevent transmission.
Hepatitis C is a viral infection of the liver caused by the hepatitis C virus (HCV). HCV is a positive-sense single-stranded RNA virus of the Flaviviridae family with 6 major genotypes. It was discovered in 1989 and infects approximately 3% of the world's population, resulting in 54,000 deaths and 955,000 disabilities annually. HCV can cause both acute and chronic liver disease, with chronic infection potentially leading to cirrhosis and liver cancer. Diagnosis involves blood tests to detect HCV antibodies or RNA. While there is no vaccine, treatment options include combinations of ribavirin with other antiviral drugs like Daklinza or Epclusam, which cure the infection in 12 weeks
Hepatitis is an inflammation of the liver that can be caused by viruses or other factors. There are five main hepatitis viruses: Hepatitis A, B, C, D, and E. Hepatitis B and C cause chronic liver disease and put people at high risk for cirrhosis and liver cancer. Hepatitis B is diagnosed through blood tests detecting antigens and antibodies. Treatment involves antiviral medication lasting 6 months to a year. Hepatitis C is diagnosed through blood tests detecting antibodies and RNA. New antiviral drugs can cure most cases of Hepatitis C infection within 12 weeks of treatment. There are vaccines to prevent Hepatitis A and B but currently no vaccine for Hepatitis C.
Hepatitis B is a major public health problem worldwide that can cause both acute and chronic infection. It is a DNA virus that is highly infectious and transmitted through bodily fluids. Chronic infection puts people at risk of serious liver conditions like cirrhosis and cancer. While most acute infections resolve, 10% of cases become chronic carriers with active liver disease risk. Prevention focuses on vaccination, screening blood products, and safe needle practices.
Here are three more potential causes of paralysis in patients with AIDS:
- Cryptococcal meningitis: The most common fungal infection of the CNS in AIDS patients. Can cause increased intracranial pressure, cranial neuropathies, and spinal cord compression.
- Progressive multifocal leukoencephalopathy (PML): Caused by JC virus reactivation in AIDS patients. Presents with cognitive impairment, visual changes, and sometimes motor deficits. MRI often shows multifocal white matter lesions.
- Vacuolar myelopathy: Caused by HIV itself. Presents with spastic paraparesis. MRI may show T2 hyperintensities in the lateral and posterior columns of the spinal cord. Treat
The document discusses immunity and infection, including:
1) The chain of infection involves a pathogen, reservoir, transmission, entry and establishment in a new host. Breaking the chain prevents spread of disease.
2) The immune system defends against pathogens through physical and chemical barriers, and cells and antibodies that fight infection.
3) Pathogens like bacteria, viruses, fungi and parasites can cause infectious diseases. Emerging diseases are on the rise due to factors like drug resistance, travel and human behavior.
4) Maintaining a healthy immune system involves good nutrition, exercise, rest and controlling stress. Sexually transmitted diseases pose major health risks and can be prevented through education and safe practices.
Hepatitis C
Hepatitis C is a liver disease caused by the hepatitis C virus (HCV): the virus can cause both acute and chronic hepatitis, ranging in severity from a mild illness lasting a few weeks to a serious, lifelong illness.
The document discusses pathology associated with HIV and AIDS, including:
1. It provides an overview of the global HIV/AIDS epidemic and prevalence rates over time in South Africa.
2. It describes the clinic-pathologic presentations of different stages of HIV infection, including common infections and conditions associated with different CD4 count ranges.
3. It discusses anatomical and clinical presentations of various opportunistic infections and cancers associated with advanced HIV, including tables outlining cardiovascular, dermatological, neurological, and other manifestations.
4. It presents several images of pathologic findings from HIV-infected patients, such as lesions from toxoplasmosis, Kaposi's sarcoma, lymphoma, and other conditions.
This seminar presentation summarizes key information about Hepatitis E virus (HEV) infection, including its characteristics, pathogenesis, clinical manifestations, epidemiology, diagnosis, prevention and control. HEV is an RNA virus that causes acute hepatitis and has four genotypes that infect humans and animals. It is transmitted fecal-orally and causes inflammation of the liver. Pregnant women are particularly susceptible and have a high mortality rate from HEV infection. Diagnosis involves microscopy, serological techniques like ELISA, and molecular techniques like PCR. Prevention focuses on proper sanitation, vaccination, and screening of animals that can transmit HEV like swine.
Blood Group system & Hemolytic Disease of New bornPraveen Kumar
The document discusses Karl Landsteiner's 1901 discovery of the ABO blood group system and the three main blood types: A, B, and O. It explains how his findings allowed for the first successful blood transfusion in 1907. The document also outlines several other blood group systems, such as Rh, Lewis, MNS, and Duffy. For Rh system, it notes the D antigen is most antigenic in humans. The document concludes by discussing hemolytic disease of the newborn, which can occur when an Rh-negative mother has an Rh-positive baby, and treatments like anti-D antibodies and exchange transfusions.
This document discusses primary health care and the Alma-Ata Declaration of 1978. It provides the following key points:
- The Alma-Ata Declaration established "Health for All" as a goal and endorsed primary health care as the key approach. It defined primary health care as including health education, disease prevention and control, immunizations, maternal and child care, nutrition, treatment, and more.
- The Declaration recognized health as a fundamental human right and reducing inequality in health status between developed and developing nations. It emphasized social and economic development alongside health.
- Students will conduct community assessments, interviewing families using an assessment tool and reporting their findings. Their work aims to support primary health care goals
This research project aims to examine the family burden of people living with AIDS receiving treatment at BPKIHS. It will use an exploratory research design and survey 30 primary caregiver family members using interviews and assessments of family burden. The study hypothesizes that there will be no association between family burden and caregiver characteristics or social stigma. It seeks to understand the demographic profiles of PLWAs and their families, problems faced by caregivers, and the relationship between family burden and demographics. The results could help develop strategies to better support patients and reduce caregiver burden through education and policy changes.
The document provides information about the roles and responsibilities of phlebotomists in a biochemistry laboratory. It discusses key duties like ensuring proper patient identification, sample handling and transport procedures. It also outlines various preanalytical and analytical considerations for sample collection and testing, including different anticoagulants, test types, quality standards and transport methods. The document emphasizes the importance of adherence to protocols and informing the laboratory of any issues that could impact test results.
This document provides information about hepatitis C virus (HCV) including its structure, genome, genotypes, epidemiology, transmission, pathogenesis, diagnosis, and management. It discusses:
- HCV has a single-stranded RNA genome within the Flaviviridae family. It exists as different genotypes that determine treatment response.
- HCV is a major cause of liver disease worldwide, with transmission primarily through blood exposure. Diagnosis involves antibody and RNA testing.
- Treatment aims to eradicate HCV and involves pegylated interferon and ribavirin combinations. Response is monitored via viral load decline. Adverse effects require monitoring and management. New direct-acting antivirals are improving treatment outcomes.
Viral hepatitis can be caused by five main viruses - hepatitis A, B, C, D, and E. While the clinical symptoms are often similar, the viruses differ in their modes of transmission and tendencies to cause acute or chronic infection. Hepatitis A and E typically cause acute infection transmitted through the fecal-oral route, while hepatitis B, C, and D can establish chronic infections transmitted through blood or other bodily fluids. Understanding the differences between the hepatitis viruses is important for preventing and treating viral hepatitis.
This document provides an overview of the history of phlebotomy and bloodletting. It discusses how the practice began in ancient Egypt and Greece and was used as a medical treatment through the 18th century, often resulting in patient harm. The development of the microscope in the 17th century allowed for examination of blood cells and helped transition bloodletting to diagnostic blood collection. The document also covers universal precautions for safe handling of blood and body fluids to prevent disease transmission.
The document provides an overview of India's healthcare system, including its various components and the roles of the public and private sectors. Some key points:
- The healthcare system comprises sectors like hospitals, insurance, pharmaceuticals, medical tourism, diagnostics, and equipment/supplies.
- The private sector accounts for around 80% of healthcare delivery and has grown significantly due to various factors like reduced government funding and policies encouraging privatization.
- Medical tourism in India is a growing market valued at $3 billion in 2012 due to lower costs compared to other countries.
- The diagnostics sector is highly fragmented but growing at 20% annually with increased healthcare spending and insurance penetration.
- Foreign direct investment
This slide contains information regarding HIV, ARV. This can be helpful for proficiency level and bachelor level nursing students. Your feedback is highly appreciated. Thank you!
ABO blood group system was decover by Karal landsteine
which contain A, B, and o antigen on the surface of BC, WBC,s platatelet and other body tissue cells except brain cell, and anti A, antiB and Anti Ab natural occuring antibodies in plasma of B,A, and O blood group individual respectively
THIS PPT IS ABOUT THE HEALTH CARE SYSTEM IN CHINA MOSTLY STUDIED IN ECONOMICS.
THIS ALSO SHOWS YOU ABOUT THE INSURANCE POLICY AND GDP RATE AND MANY MORE
HIV attacks and destroys CD4 cells, weakening the immune system and leading to AIDS. It is transmitted through bodily fluids like blood, breastmilk, semen and vaginal secretions. The infection progresses from HIV infection to AIDS in stages - first, the window period when antibodies are not detectable. It is then followed by asymptomatic phase that can last 10-15 years before HIV-related illnesses and infections emerge. Untreated, it culminates in AIDS when the immune system is severely compromised. Risk groups include those with multiple sexual partners and intravenous drug users. Testing involves pre- and post-test counseling and uses ELISA or Western Blot confirmatory tests.
HIV (Human Immunodeficiency Virus) infects cells of the immune system and destroys or impairs their function.
Infection progressive deterioration of the immune system breaking down the body's ability to fight out infections & diseases by opportunistic bacteria, viruses and fungi.
AIDS (Acquired Immune Deficiency Syndrome) refers to the most advanced stages of HIV infection and a collection of signs and symptoms caused by more than 20 opportunistic infections or related cancers.
Evolution and Revolution: Current Issues in HIV and HCV Co-infection
Chapter 1 – HIV-Hepatitis C Virus Co-infection: An evolving epidemic
Chapter 2 - Management of HIV infection in HIV/HCV co-infected patients
Chapter 3 - Management of HCV in co-infected patients
Chapter 4 - HCV Therapy: Direct acting antiviral agents in co-infected individuals
Chapter 5 - Drug interactions with directly acting antivirals for HCV: Overview & challenges in HIV/HCV Co-infection
Chapter 6 - Complicated cases
Chapter 7 - Future trials of Hepatitis C therapy in the HIV co-infected
Chapter 8 - HCV infection in marginalized populations
Chapter 9 - HIV/HCV Co-infection: Through the eyes of a co-infected hemophiliac
Dr. aabha nagral management and prevention of hepatitis cSanjeev Kumar
Hepatitis C remains a significant problem, infecting an estimated 12 million people in India. Rates of infection were historically higher in thalassemia patients due to multiple transfusions but have reduced since mandatory testing was implemented in 2001. However, ongoing transmission still occurs. Only a small proportion of infected thalassemia patients receive treatment due to challenges with side effects and cost. More effective and affordable oral treatments are urgently needed to improve outcomes for those with chronic Hepatitis C infection.
The document discusses immunity and infection, including:
1) The chain of infection involves a pathogen, reservoir, transmission, entry and establishment in a new host. Breaking the chain prevents spread of disease.
2) The immune system defends against pathogens through physical and chemical barriers, and cells and antibodies that fight infection.
3) Pathogens like bacteria, viruses, fungi and parasites can cause infectious diseases. Emerging diseases are on the rise due to factors like drug resistance, travel and human behavior.
4) Maintaining a healthy immune system involves good nutrition, exercise, rest and controlling stress. Sexually transmitted diseases pose major health risks and can be prevented through education and safe practices.
Hepatitis C
Hepatitis C is a liver disease caused by the hepatitis C virus (HCV): the virus can cause both acute and chronic hepatitis, ranging in severity from a mild illness lasting a few weeks to a serious, lifelong illness.
The document discusses pathology associated with HIV and AIDS, including:
1. It provides an overview of the global HIV/AIDS epidemic and prevalence rates over time in South Africa.
2. It describes the clinic-pathologic presentations of different stages of HIV infection, including common infections and conditions associated with different CD4 count ranges.
3. It discusses anatomical and clinical presentations of various opportunistic infections and cancers associated with advanced HIV, including tables outlining cardiovascular, dermatological, neurological, and other manifestations.
4. It presents several images of pathologic findings from HIV-infected patients, such as lesions from toxoplasmosis, Kaposi's sarcoma, lymphoma, and other conditions.
This seminar presentation summarizes key information about Hepatitis E virus (HEV) infection, including its characteristics, pathogenesis, clinical manifestations, epidemiology, diagnosis, prevention and control. HEV is an RNA virus that causes acute hepatitis and has four genotypes that infect humans and animals. It is transmitted fecal-orally and causes inflammation of the liver. Pregnant women are particularly susceptible and have a high mortality rate from HEV infection. Diagnosis involves microscopy, serological techniques like ELISA, and molecular techniques like PCR. Prevention focuses on proper sanitation, vaccination, and screening of animals that can transmit HEV like swine.
Blood Group system & Hemolytic Disease of New bornPraveen Kumar
The document discusses Karl Landsteiner's 1901 discovery of the ABO blood group system and the three main blood types: A, B, and O. It explains how his findings allowed for the first successful blood transfusion in 1907. The document also outlines several other blood group systems, such as Rh, Lewis, MNS, and Duffy. For Rh system, it notes the D antigen is most antigenic in humans. The document concludes by discussing hemolytic disease of the newborn, which can occur when an Rh-negative mother has an Rh-positive baby, and treatments like anti-D antibodies and exchange transfusions.
This document discusses primary health care and the Alma-Ata Declaration of 1978. It provides the following key points:
- The Alma-Ata Declaration established "Health for All" as a goal and endorsed primary health care as the key approach. It defined primary health care as including health education, disease prevention and control, immunizations, maternal and child care, nutrition, treatment, and more.
- The Declaration recognized health as a fundamental human right and reducing inequality in health status between developed and developing nations. It emphasized social and economic development alongside health.
- Students will conduct community assessments, interviewing families using an assessment tool and reporting their findings. Their work aims to support primary health care goals
This research project aims to examine the family burden of people living with AIDS receiving treatment at BPKIHS. It will use an exploratory research design and survey 30 primary caregiver family members using interviews and assessments of family burden. The study hypothesizes that there will be no association between family burden and caregiver characteristics or social stigma. It seeks to understand the demographic profiles of PLWAs and their families, problems faced by caregivers, and the relationship between family burden and demographics. The results could help develop strategies to better support patients and reduce caregiver burden through education and policy changes.
The document provides information about the roles and responsibilities of phlebotomists in a biochemistry laboratory. It discusses key duties like ensuring proper patient identification, sample handling and transport procedures. It also outlines various preanalytical and analytical considerations for sample collection and testing, including different anticoagulants, test types, quality standards and transport methods. The document emphasizes the importance of adherence to protocols and informing the laboratory of any issues that could impact test results.
This document provides information about hepatitis C virus (HCV) including its structure, genome, genotypes, epidemiology, transmission, pathogenesis, diagnosis, and management. It discusses:
- HCV has a single-stranded RNA genome within the Flaviviridae family. It exists as different genotypes that determine treatment response.
- HCV is a major cause of liver disease worldwide, with transmission primarily through blood exposure. Diagnosis involves antibody and RNA testing.
- Treatment aims to eradicate HCV and involves pegylated interferon and ribavirin combinations. Response is monitored via viral load decline. Adverse effects require monitoring and management. New direct-acting antivirals are improving treatment outcomes.
Viral hepatitis can be caused by five main viruses - hepatitis A, B, C, D, and E. While the clinical symptoms are often similar, the viruses differ in their modes of transmission and tendencies to cause acute or chronic infection. Hepatitis A and E typically cause acute infection transmitted through the fecal-oral route, while hepatitis B, C, and D can establish chronic infections transmitted through blood or other bodily fluids. Understanding the differences between the hepatitis viruses is important for preventing and treating viral hepatitis.
This document provides an overview of the history of phlebotomy and bloodletting. It discusses how the practice began in ancient Egypt and Greece and was used as a medical treatment through the 18th century, often resulting in patient harm. The development of the microscope in the 17th century allowed for examination of blood cells and helped transition bloodletting to diagnostic blood collection. The document also covers universal precautions for safe handling of blood and body fluids to prevent disease transmission.
The document provides an overview of India's healthcare system, including its various components and the roles of the public and private sectors. Some key points:
- The healthcare system comprises sectors like hospitals, insurance, pharmaceuticals, medical tourism, diagnostics, and equipment/supplies.
- The private sector accounts for around 80% of healthcare delivery and has grown significantly due to various factors like reduced government funding and policies encouraging privatization.
- Medical tourism in India is a growing market valued at $3 billion in 2012 due to lower costs compared to other countries.
- The diagnostics sector is highly fragmented but growing at 20% annually with increased healthcare spending and insurance penetration.
- Foreign direct investment
This slide contains information regarding HIV, ARV. This can be helpful for proficiency level and bachelor level nursing students. Your feedback is highly appreciated. Thank you!
ABO blood group system was decover by Karal landsteine
which contain A, B, and o antigen on the surface of BC, WBC,s platatelet and other body tissue cells except brain cell, and anti A, antiB and Anti Ab natural occuring antibodies in plasma of B,A, and O blood group individual respectively
THIS PPT IS ABOUT THE HEALTH CARE SYSTEM IN CHINA MOSTLY STUDIED IN ECONOMICS.
THIS ALSO SHOWS YOU ABOUT THE INSURANCE POLICY AND GDP RATE AND MANY MORE
HIV attacks and destroys CD4 cells, weakening the immune system and leading to AIDS. It is transmitted through bodily fluids like blood, breastmilk, semen and vaginal secretions. The infection progresses from HIV infection to AIDS in stages - first, the window period when antibodies are not detectable. It is then followed by asymptomatic phase that can last 10-15 years before HIV-related illnesses and infections emerge. Untreated, it culminates in AIDS when the immune system is severely compromised. Risk groups include those with multiple sexual partners and intravenous drug users. Testing involves pre- and post-test counseling and uses ELISA or Western Blot confirmatory tests.
HIV (Human Immunodeficiency Virus) infects cells of the immune system and destroys or impairs their function.
Infection progressive deterioration of the immune system breaking down the body's ability to fight out infections & diseases by opportunistic bacteria, viruses and fungi.
AIDS (Acquired Immune Deficiency Syndrome) refers to the most advanced stages of HIV infection and a collection of signs and symptoms caused by more than 20 opportunistic infections or related cancers.
Evolution and Revolution: Current Issues in HIV and HCV Co-infection
Chapter 1 – HIV-Hepatitis C Virus Co-infection: An evolving epidemic
Chapter 2 - Management of HIV infection in HIV/HCV co-infected patients
Chapter 3 - Management of HCV in co-infected patients
Chapter 4 - HCV Therapy: Direct acting antiviral agents in co-infected individuals
Chapter 5 - Drug interactions with directly acting antivirals for HCV: Overview & challenges in HIV/HCV Co-infection
Chapter 6 - Complicated cases
Chapter 7 - Future trials of Hepatitis C therapy in the HIV co-infected
Chapter 8 - HCV infection in marginalized populations
Chapter 9 - HIV/HCV Co-infection: Through the eyes of a co-infected hemophiliac
Dr. aabha nagral management and prevention of hepatitis cSanjeev Kumar
Hepatitis C remains a significant problem, infecting an estimated 12 million people in India. Rates of infection were historically higher in thalassemia patients due to multiple transfusions but have reduced since mandatory testing was implemented in 2001. However, ongoing transmission still occurs. Only a small proportion of infected thalassemia patients receive treatment due to challenges with side effects and cost. More effective and affordable oral treatments are urgently needed to improve outcomes for those with chronic Hepatitis C infection.
This document provides information about the Ontario HIV and Substance Use Training Program (OHSUTP). It summarizes the vision, mission, and mandate of OHSUTP, which is to provide training to substance use and mental health service providers to increase knowledge of HIV/AIDS and promote skills development. It also provides an overview of Fife House, the supportive housing organization that OHSUTP operates out of. Key information includes descriptions of Fife House's supportive housing programs and services for people living with HIV/AIDS.
- HIV and hepatitis C (HCV) are known as the "killer twins" as they have many similarities. Both are blood-borne viruses that can silently damage the body for a long time before symptoms appear.
- There are no cures for either HIV or HCV, and treatments can only help patients live longer but are very expensive. According to WHO, HCV infects more people worldwide than HIV.
- A major issue is that many people in India are unaware that they are infected with HIV or HCV since there is often a "window period" before infections can be detected by tests. This means infected people can unknowingly spread the viruses.
La hepatitis B es una enfermedad del hígado causada por el virus de la hepatitis B que puede causar procesos agudos o crónicos, incluso cirrosis, cáncer de hígado o muerte. Se transmite a través del contacto con sangre o fluidos corporales infectados. Su diagnóstico se realiza mediante análisis de sangre y biopsia hepática. Su tratamiento incluye medicamentos como el interferón o trasplante de hígado en casos graves, y su prevención mediante vacunación de bebés y grupos de
El documento describe la hepatitis B, un virus que causa inflamación del hígado y puede provocar enfermedad aguda o crónica. Se transmite a través de la sangre y fluidos corporales. Actualmente causa entre 250.000 y 500.000 muertes al año. Existe vacuna que previene la infección y debe administrarse a recién nacidos de madres infectadas.
This document discusses hepatitis B, including its history, prevalence, transmission, clinical features, outcomes, and diagnosis. Key points include:
- Hepatitis B is a serious viral infection that affects the liver and can become chronic, increasing risk of cirrhosis and liver cancer. It is transmitted through bodily fluids and from mother to child.
- Globally, over 350 million people have chronic hepatitis B infections, with prevalence highest in Asia and Africa.
- The virus replicates in liver cells and can cause acute or chronic infection. Chronic carriers have a high risk of long-term liver damage.
- Symptoms of acute hepatitis B include jaundice and fatigue. Chronic infection often has no symptoms but increases cirrh
Hepatitis B is a viral infection that affects the liver and can cause both acute and chronic disease. It is transmitted through bodily fluids and is preventable through vaccination. Acute hepatitis B usually clears up on its own within 6 months, while chronic hepatitis B can last a lifetime if left untreated. Complications of chronic hepatitis B include cirrhosis, liver cancer, and liver failure. Hepatitis B is a major global health problem and vaccination is the most effective way to prevent its spread.
This document provides information about HIV/AIDS, including:
- It defines endemic, epidemic, and pandemic, with AIDS classified as a pandemic.
- As of 2003, it was estimated that 40 million people worldwide were living with HIV/AIDS, with 25-28.2 million in Sub-Saharan Africa.
- HIV attacks and destroys CD4 cells, weakening the immune system and leaving the body vulnerable to opportunistic infections over time without treatment.
- HIV is transmitted through direct contact with infected bodily fluids like blood, semen, vaginal fluids. It cannot be transmitted by casual contact.
- Prevention strategies include blood screening, education on safer sex practices, STI treatment, and preventing mother
The document discusses hepatitis C, including its virology, transmission, symptoms, screening, treatment and prevention. It provides epidemiological data on chronic hepatitis C in Georgia from 2009-2014. Specifically, it finds that 50% of reported viral hepatitis cases in Georgia during this period were chronic hepatitis C. It also analyzes the age distribution and geographic distribution of chronic hepatitis C cases.
A 90 minute presentation to Addiction and Mental Health workers in Ontario, Canada.
Contains many links to useful resources and information.
To provide a background and overview of some of the newer substances we are seeing and people may be consuming.
A focus on:
- MDMA / Ecstasy / Molly
- Drug Checking
- Bath Salts / Cathinones
- Synthetic Cannabinoids
**Unfortunately the speaker notes are not uploading. Please contact us if you would like a copy of these: http://www.ohsutp.ca/contact
E, K, G, BZP, 2CB, 5MeO-DIPT...
“Party Drugs” such as Ecstasy, Ketamine and GHB have not gone away. However, there have been significant changes to purity and associated risks. As well, a proliferation of new substances are quickly appearing.
What are some of the current substances being used and the risk reduction messages we should be sharing, particularly with today’s youth?
We will look at:
Street Drugs --> Party Drugs --> NPS
Specific substances:
- What they are
- How they work
- Immediate risks
- Longer-term concerns
- Risk reduction strategies
HIV is a virus that causes AIDS by depleting the immune system. It originated from chimpanzees in West Africa and was likely transmitted to humans in the early 20th century. There are two types of HIV, with Type 1 being more prevalent and virulent worldwide. HIV is transmitted through unprotected sex, blood transfusions, needle sharing, and from mother to child. Untreated, it progresses from initial infection to AIDS in stages. People with AIDS experience opportunistic infections like oral thrush, pneumonia, and cancers like Kaposi's sarcoma due to a weakened immune system. Treatment involves antiretroviral drugs which can cause side effects.
This document discusses stigma, discrimination, disclosure, and legal issues related to HIV. It begins by defining stigma and its impacts. It then discusses the roots of HIV stigma, including fear of contagion and negative assumptions about those infected. Multiple stigmas can compound issues for those living with HIV. Legal duties around disclosure are complex, with unclear guidelines around what constitutes significant risk of transmission. Non-disclosure can result in criminal charges but disclosure may not fully protect against prosecution. Community organizations have duties around confidentiality but not mandatory reporting.
* Watch the video at the end of the presentation
Viral infections remain among the most important challenges in the management of the transplant recipient. This observation reflects both a predisposition to viral infection by immunosuppression that targets T-cell function, the diverse population of viruses, and the impact of viruses including infection, graft rejection, and malignancies. Traditionally, the manifestations of cytomegalovirus (CMV) infection have been termed “direct” (organ-specific) and “indirect” (immune) effects. More accurate terms might be “viral cytopathic” effects and “cellular and systemic immunologic” effects. The clinical manifestations of viral CMV infections are the result of suppression of multiple host defense mechanisms, predisposing to secondary invasion by such pathogens as P. jiroveci, Candida and Aspergillus species and increasing the risk for graft loss and death. As the biology of viral infection is explored, many of these manifestations of viral infection appear to be mediated not only by T-cells but also by the innate immune system.
Hepatitis C is a liver disease that can range from mild to severe, leading to cirrhosis or liver cancer. About 150 million people are chronically infected worldwide each year. Egypt has one of the highest rates globally, with 14.7% of its population infected, mostly through unsafe medical practices. Common routes of transmission include injections, medical procedures, dental work, and birth from an infected mother. While the disease can be treated, there is no vaccine. Egypt faces a public health emergency due to hepatitis C, and reducing transmission requires improved infection control and safe practices in healthcare settings.
- What it is.
- How & Why people use it.
- Effects: (Physiological; Psychological; Behavioural).
- Short-term risks.
- Long-term consequences.
- Risk Reduction: (Strategies; Behaviours).
- Working with intoxication.
- Why now? Again!
- Community responses.
- Supports & Resources.
Hepatitis B is a viral infection that affects the liver and can become chronic. It is transmitted through bodily fluids and can range from asymptomatic to life-threatening. Around 1 million people die each year from hepatitis B complications like cirrhosis and liver cancer. While there is no cure for chronic hepatitis B, antiviral treatments can suppress the virus and prevent further liver damage. Vaccination provides highly effective protection against the disease.
This document discusses tumors and cancers that are more common in HIV/AIDS patients. It states that those with HIV/AIDS have a higher risk of developing Kaposi sarcoma, non-Hodgkin lymphoma, and cervical cancer. It provides details on the symptoms, risk factors, and treatments for these types of cancers associated with HIV/AIDS. The survival rates for Kaposi sarcoma and outcomes for non-Hodgkin lymphoma have improved with newer HIV treatments.
HIV can increase the risk of developing lymphomas through sustained B-cell activation and high cytokine levels. AIDS-related lymphomas are categorized based on location into systemic, primary central nervous system, and body cavity-based types. The two major histological groups are immunoblastic lymphoma and small non-cleaved cell lymphoma (Burkitt lymphoma). Human herpes viruses have been linked to some forms of AIDS-related lymphomas.
This document provides information on communicable diseases, focusing on HIV/AIDS, hepatitis B, hepatitis C, and hepatitis D. It defines each disease and describes their causes, transmission methods, symptoms, stages of infection, treatment options, and prevention methods. Some key points include:
- HIV damages the immune system, potentially leading to AIDS if untreated. Antiretroviral therapy can control HIV and prolong lives.
- Hepatitis B, C and D are transmitted through contact with infectious bodily fluids and can cause acute or chronic liver infection/disease.
- Prevention strategies include vaccination, safe sex practices, sterile medical equipment, and avoiding needle sharing.
- Testing and treatment are important for controlling diseases and monitoring liver
Hepatitis C continues to infect individuals in Saskatchewan. While Hep-C may be treatable, untreated Hep-C is a significant health threat. Transmission routes include shared drug equipment, dry blood contact, exposure during vacations, tattoos or piercing, and exposure through personal items such as razors and toothbrushes.
Hepatitis B is a viral infection that attacks the liver and can cause both acute and chronic disease. It is transmitted through contact with infected blood or bodily fluids and the most common modes of transmission are sexual contact, sharing needles, and from mother to baby during childbirth. Symptoms can include fatigue, fever, abdominal pain and jaundice. While there is no treatment for the acute form, chronic infection is treated with antiviral medications. Prevention includes vaccination, safe sex practices, and avoiding sharing personal items that may transmit blood or bodily fluids.
HEPATITIS_B_presentation disease control and management.pptnikhilgendre1
Hepatitis B is a viral infection that causes inflammation of the liver. It is spread through contact with infected blood or bodily fluids. The virus can cause both acute and chronic infections. Acute infections may cause symptoms but often resolve on their own, while chronic infections can lead to long-term liver damage. Hepatitis B can be prevented through vaccination. Those at high risk should be screened and infected individuals can be treated to reduce the risk of cirrhosis and liver cancer.
To create awareness about Generics treatment and make it available worldwide. My Aim is to raise awareness about hepatitis c treatment and generic. Visit here: http://anandmedicos.com/
Neuropsychiatric aspects of hiv infection and aidsNilesh Kucha
This document provides an overview of HIV/AIDS, including transmission, pathogenesis, diagnosis, treatment, and psychiatric aspects. Key points include:
- HIV is transmitted through bodily fluids and infects CD4 cells. Over time it can cause AIDS through opportunistic infections.
- Testing detects HIV antibodies. Positive results mean infection but not immunity. Counseling addresses testing, results, and confidentiality.
- A wide range of neurological and psychiatric syndromes can occur due to HIV, including dementia.
- Treatment involves prevention, antiretroviral drugs, and psychotherapy to address issues like guilt, relationships, and end-of-life decisions. Partner notification is also discussed.
Epidemiologic characteristics of Hemocontact Infections. Viral hepatitis B. V...Aniuta Sydorchuk
This document discusses hemocontact infections, which are blood-borne infections transmitted via contact with blood or other body fluids. It focuses on viral hepatitis B, viral hepatitis C, and Ebola hemorrhagic fever. For each disease, it covers the etiology, epidemiology, pathogenesis, clinical presentation, diagnosis, treatment and prevention. It compares the key differences between hepatitis B and C, such as transmission routes, incubation periods, likelihood of chronic infection, and serological tests used for diagnosis. For Ebola, it describes the disease progression, symptoms, laboratory diagnostics and supportive care approach, as there are currently no approved vaccines or treatments.
The document provides information about the liver and Hepatitis C virus. It discusses the anatomy and function of the liver, as well as the causes, symptoms, diagnosis, and treatment of Hepatitis C. Regarding Hepatitis C specifically, it notes that there are over 150 million chronic cases globally, it is transmitted through blood and bodily fluids, and while there is no vaccine, many new highly effective drug regimens have been developed to cure over 95% of cases. The document provides a comprehensive overview of Hepatitis C for medical students and healthcare professionals.
1. Four inmates have presented with upper abdominal pain and diarrhea, symptoms consistent with hepatitis A.
2. The latest patient reports eating raw seashells from home, indicating potential fecal-oral transmission of hepatitis A through contaminated food.
3. Outbreaks of hepatitis A can occur in closed settings like prisons where hygiene and sanitation may be challenges, allowing the virus to spread among susceptible individuals. Testing is needed to confirm hepatitis A as the cause.
This document provides information about HIV/AIDS and tuberculosis (TB) in South Africa to enhance nursing students' experience at service sites. It discusses transmission, symptoms, diagnosis and treatment of HIV/AIDS and TB. South Africa has the most HIV infections worldwide, especially among young women. TB is highly associated with HIV and a leading cause of death for those infected. The document recommends precautions to prevent transmission and encourages interaction with communities while dismissing stigmas.
This document provides information about Hepatitis C, including how it is transmitted, symptoms, diagnosis, treatment, and prevention. Some key points:
- Hepatitis C is a contagious liver disease caused by the hepatitis C virus that can range from mild to serious and lifelong.
- It is mostly transmitted through exposure to infectious blood, such as through contaminated medical equipment or injecting drug use.
- Most infected people do not show symptoms, though some may experience fatigue, abdominal pain, and jaundice. Chronic infection can lead to cirrhosis or liver cancer.
- Diagnosis involves antibody and RNA testing to confirm. People at high risk should be screened.
- Treatment involves antiviral therapy with
Communicable diseases can be transmitted between people directly or indirectly through infectious agents. They are categorized as either contagious diseases, which spread through direct contact, or infectious diseases, which spread indirectly through vehicles like food, water, or air. Every communicable disease has an incubation period where symptoms do not appear but the disease can still spread. Common symptoms include fever, diarrhea, fatigue, and coughing. Diseases are transmitted through various routes like contact with infected bodily fluids, inhaling droplets, bites, or ingesting contaminated substances.
This file contains the informational about hepatitis. templates used in this are self made. This is an educational and medical oriented ppt made for the school project. dark vibrant color combination add a glimpse of flavour in it.
Hepatitis A, B, and C are viral infections that cause inflammation of the liver. Hepatitis A spreads through ingestion of contaminated food or water. Hepatitis B spreads through bodily fluids and can be sexually transmitted or spread by sharing needles. Hepatitis C primarily spreads through exposure to infected blood, such as sharing needles. While symptoms are usually mild and resolve on their own for Hepatitis A, Hepatitis B and C can become chronic infections requiring treatment to prevent further liver damage. Testing identifies exposure and active infections, and immunizations protect against Hepatitis A and B.
Hepatitis C is a liver disease caused by the hepatitis C virus. It is usually spread when someone comes into contact with infected blood, such as through sharing needles or from an infected mother during birth. Many people with hepatitis C do not show any symptoms, so the only way to know if someone is infected is to get tested. Left untreated, chronic hepatitis C can lead to serious health problems like liver damage, liver failure, and liver cancer. However, treatments are now available that can cure most people with hepatitis C within 8 to 12 weeks.
This document provides information about universal precautions and bloodborne pathogens. It discusses:
- Bloodborne pathogens are infectious microorganisms found in human blood that can cause disease in humans, including HIV, HBV, and HCV.
- Standard precautions should be followed, including proper hand washing, use of personal protective equipment like gloves and gowns, safe disposal of sharps, and treating all human blood and body fluids as potentially infectious.
- Hepatitis B vaccination is required for healthcare workers and recommended for preventing infection. Other ways to prevent infection include safe work practices, good hygiene, and use of protective barriers.
- Proper disposal of sharps like needles and lancets in punct
Hepatitis is inflammation of the liver that can be caused by viruses, drugs, toxins, and other infections. The main viral causes are hepatitis A, B, C, D, and E. Hepatitis A is transmitted through contaminated food or water while hepatitis B and C are transmitted through blood and body fluids. Hepatitis B and C can become chronic infections while hepatitis A usually resolves on its own. Vaccines exist for hepatitis A and B but not for C. People at highest risk include injection drug users and those who have sex with multiple partners.
HIV/AIDS is a growing concern in Pakistan. While prevalence is currently low, it is a high risk country. HIV attacks the immune system, eventually leading to AIDS if untreated. There is no cure for HIV/AIDS, but treatment can suppress the virus. Common transmission methods include unprotected sex and needle sharing. Prevention focuses on abstinence, monogamy, condoms and clean needles. Symptoms vary from flu-like illness to opportunistic infections as immunity declines. Testing and treatment are important to manage the disease. Research continues on vaccines and treatments to control the HIV/AIDS epidemic.
Worlds AIDS Day 2016 (Peurto Rican Cultural Center & Vida SIDA) Tahseen Siddiqui
This document provides information about the HIV epidemic in the United States, with a focus on its impact and statistics regarding the Hispanic/Latino community. It discusses that Hispanics/Latinos account for a disproportionate number of HIV diagnoses compared to their population percentage. Specifically, it notes that in 2014 Hispanics/Latinos accounted for 24% of new HIV diagnoses while only representing 17% of the US population. It also summarizes some of the challenges facing the Hispanic/Latino community in terms of HIV, such as lower rates of retention in HIV care and higher rates of other sexually transmitted diseases.
How to Add Chatter in the odoo 17 ERP ModuleCeline George
In Odoo, the chatter is like a chat tool that helps you work together on records. You can leave notes and track things, making it easier to talk with your team and partners. Inside chatter, all communication history, activity, and changes will be displayed.
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Let’s explore the intersection of technology and equity in the final session of our DEI series. Discover how AI tools, like ChatGPT, can be used to support and enhance your nonprofit's DEI initiatives. Participants will gain insights into practical AI applications and get tips for leveraging technology to advance their DEI goals.
How to Build a Module in Odoo 17 Using the Scaffold MethodCeline George
Odoo provides an option for creating a module by using a single line command. By using this command the user can make a whole structure of a module. It is very easy for a beginner to make a module. There is no need to make each file manually. This slide will show how to create a module using the scaffold method.
How to Manage Your Lost Opportunities in Odoo 17 CRMCeline George
Odoo 17 CRM allows us to track why we lose sales opportunities with "Lost Reasons." This helps analyze our sales process and identify areas for improvement. Here's how to configure lost reasons in Odoo 17 CRM
This slide is special for master students (MIBS & MIFB) in UUM. Also useful for readers who are interested in the topic of contemporary Islamic banking.
This presentation was provided by Steph Pollock of The American Psychological Association’s Journals Program, and Damita Snow, of The American Society of Civil Engineers (ASCE), for the initial session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session One: 'Setting Expectations: a DEIA Primer,' was held June 6, 2024.
বাংলাদেশের অর্থনৈতিক সমীক্ষা ২০২৪ [Bangladesh Economic Review 2024 Bangla.pdf] কম্পিউটার , ট্যাব ও স্মার্ট ফোন ভার্সন সহ সম্পূর্ণ বাংলা ই-বুক বা pdf বই " সুচিপত্র ...বুকমার্ক মেনু 🔖 ও হাইপার লিংক মেনু 📝👆 যুক্ত ..
আমাদের সবার জন্য খুব খুব গুরুত্বপূর্ণ একটি বই ..বিসিএস, ব্যাংক, ইউনিভার্সিটি ভর্তি ও যে কোন প্রতিযোগিতা মূলক পরীক্ষার জন্য এর খুব ইম্পরট্যান্ট একটি বিষয় ...তাছাড়া বাংলাদেশের সাম্প্রতিক যে কোন ডাটা বা তথ্য এই বইতে পাবেন ...
তাই একজন নাগরিক হিসাবে এই তথ্য গুলো আপনার জানা প্রয়োজন ...।
বিসিএস ও ব্যাংক এর লিখিত পরীক্ষা ...+এছাড়া মাধ্যমিক ও উচ্চমাধ্যমিকের স্টুডেন্টদের জন্য অনেক কাজে আসবে ...
How to Setup Warehouse & Location in Odoo 17 InventoryCeline George
In this slide, we'll explore how to set up warehouses and locations in Odoo 17 Inventory. This will help us manage our stock effectively, track inventory levels, and streamline warehouse operations.
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2. Paul
Paul is a 44 year old gay man
who’s long term relationship
ended about six months ago. At
that time, neither of them were
HIV positive. Paul’s behaviour
has changed, he’s hooking up
with guys online and is drinking
and using party drugs and
Viagra. He tested HIV positive a
month ago. He now is looking to
hook up with other Poz guys.
2
3. Hepatitis C & HIV Co-infection
Goal:
• To increase participants’ knowledge of Hepatitis C and how it
impacts people co-infected with HIV.
Objectives:
• To provide participants with:
• An overview of the virology of Hepatitis C, including an
understanding of the impact on the liver.
• Accurate information about Hepatitis C transmission and
prevention.
• An understanding of their role in encouraging accurate and
complete testing for Hepatitis C.
• An understanding of the challenges and complexities of treatment.
• An understanding of the impact of Hepatitis C locally, provincially,
nationally and internationally.
3
4. Outline
• The Liver & Hepatitis A, B & C
• Epidemiology & How Hep C Works
• Transmission & Prevention
• Testing
• Treatment
• Co-infection with HIV
4
6. What does the liver do?
6
Makes &
regulates
hormones
(including sex
hormones!)
Makes &
regulates
hormones
(including sex
hormones!)
Gets rid of
waste
Gets rid of
waste
Processes
drugs
Processes
drugs
Makes proteins
to repair
damaged tissue
Makes proteins
to repair
damaged tissue
Stores
vitamins and
minerals
Stores
vitamins and
minerals
Food to energyFood to energy
If the liver is damaged, it can’t do these
important jobs properly, so people with
liver damage may start to feel ill.
7. Hepatitis
hepa = liver
itis = inflammation
7
Increasing
health concerns
5 Main Types (A,B,C,D,E)
Hepatitis A
Hepatitis B
Hepatitis C
• All effect the liver to varying degrees
• A, E - usually by food / water contamination
• B, C, D - usually by bodily fluids
• B, C - chronic
• Vaccines for hepatitis A, B
8. Hepatitis A
• Vaccine
– Often 2 step
• Fecal Oral transmission
• Diagnosed with a blood test
• Acute (not chronic)
• No treatment
– People recover within a few weeks
8
9. Hepatitis A
You could get hepatitis A from:
• Eating food made by an infected person who didn’t wash
his or her hands after using the bathroom
• Drinking untreated water or eating food washed in
untreated water
• Placing a finger or object in your mouth that came into
contact with an infected person’s stool
• Having close personal contact with an infected person,
such as through sex (esp., rimming) or caring for
someone who is ill
You cannot get hepatitis A from:
• Someone sneezing or coughing on you
• Sitting next to a person who has hepatitis A
• Hugging an infected person 9
10. Hepatitis B
• Vaccine
– Commonly 3 step (Twinrix for A&B)
• Bodily fluid transmission
– Blood, semen, & other bodily fluids
– Sexual; Injection Drug Use; etc.
• Many people experience no symptoms
– Diagnosed with a blood test
• No treatment for acute Hep B
– Most healthy adults clear the virus within 6 months
– Treatment maybe initiated for chronic Hep B
10
11. Hepatitis B
Hepatitis B is transmitted through blood and infected
bodily fluids. This can occur through:
• Direct blood-to-blood contact
• Unprotected sex
• Unsterile needles
• From an infected woman to her newborn during delivery.
Other possible routes of infection include sharing sharp instruments
such as razors, toothbrushes or earrings. Body piercing, tattooing and
acupuncture are also possible routes of infection unless sterile needles
and equipment are used.
Hepatitis B is NOT transmitted casually. It cannot be
spread through sneezing, coughing, hugging or eating food
prepared by someone who is infected with hepatitis B.
11
12. Hepatitis C (Hep C / HCV)
• A specific liver disease caused by the hepatitis C
virus (HCV)
• Hep C may lead to chronic infection of the liver
• Inflammation (swelling) of the liver may lead to
fibrosis and cirrhosis impacting liver function
12
13. Hepatitis C
• 6 major genotypes types
– Possible to be infected by different genotypes
• Type 1 is most common in North America
• The particular genotype a person has will
affect treatment decisions
13
14. Hepatitis C
• Hep C is classified into six major genotypes, many subtypes
(designated a, b, c, etc.), and about 100 different strains (numbered
1,2,3, etc.) based on the genomic sequence heterogeneity.
• Genotypes 1-3 have a worldwide distribution.
– Types 1a and 1b are the most common, accounting for about 60% of
global infections. They predominate in Northern Europe and North
America, and in Southern and Eastern Europe and Japan, respectively.
– Type 2 is less frequently represented than type 1.
– Type 3 is endemic in south-east Asia and is variably distributed in
different countries.
• Genotype 4 is principally found in the Middle East, Egypt, and central
Africa.
• Genotype 5 is almost exclusively found in South Africa.
• Genotypes 6-11 are distributed in Asia.
14
15. Hepatitis C Global Prevalance
130–150 million people have chronic hepatitis C infection
15http://www.amfar.org/treat-asia-launches-a-new-hepatitis-c-educati
23. 6 months
20-30 years
If 100 people
are infected…
~20 people
~80 people
40-60 people
Cirrhosis: 20 people
Cancer: 1-4 people
Acute
Only 1/3 of people
show symptoms
Symptoms
Over 50% of
people never show
symptoms
24. Hep C Symptoms
• Over half of people who are infected are asymptomatic
(show no symptoms) in the beginning and may carry the
virus for many years before other symptoms develop
• Only about one-third of people show symptoms during
the acute infection stage
• If the disease progresses to chronic infection, it can take
years before symptoms develop
• Relying on symptoms is not a
reliable way to diagnose
24
Hepatitis C …
Isn’t that the one I’ve
been vaccinated for?
25. Acute (Early) Infection Symptoms
• Fatigue
• Tenderness or an aching feeling on the right side of the
abdomen
• Decreased appetite perhaps with weight loss
• Flu-like symptoms
• Nausea
• Tendency to bruise or bleed easily
• Jaundice (yellowing of the skin and whites of the eyes)
• Rash
• Dark-coloured urine and light or clay-coloured stools
• These symptoms often go away after a short time.
25
26. Hep C Symptoms of
Advanced Liver Disease
• Jaundice
• Ascites (swelling in the abdomen)
• Blood in stool or vomit
• Sleep disturbances, depression, weight loss, dry
or itchy skin, and “brain fog” are also found in
people with chronic Hep C but the cause of
these symptoms remains uncertain.
26
27. How is Hep C transmitted?
27
Prim
arily
blood
to
blood
contact…
even
if you
can’t
see
th
blood!
Hepatitis C
is 10 times more
transmissible than HIV through blood contact.
28. Transmission Risk
• Sharing Drug Use
Equipment
• Sharing Tattoo /
Body Piercing
Equipment
• Unsterilized medical
equipment
• Blood or Cutting
Rituals
• Blood Transfusions
before 1992
• Sharing Personal
Hygiene
Equipment
• Unprotected Sex
• Child Birth
• Needle Stick
Injuries
28
• Sharing
space
• Hugging,
kissing
• Sharing
dishes
High Risk Some Risk NO Risk
29. How many times are you more likely to
have HCV if you’ve been in prison?
A. 5x
B. 20x
C. 29x
D. 39x
29
5x
20x
29x
39x
0% 0%0%0%
30. High Risk
• Sharing drug-use equipment: The equipment used for preparing and
injecting drugs, including steroids, can have microscopic amounts of blood
on it and transmit Hep C. Even a single event of sharing equipment
(including syringes, cookers, water, filters, tourniquets, and alcohol swabs)
is cause for testing to be considered.
• Sharing other drug-use equipment, like crack pipes, or bumpers, bills or
straws for snorting cocaine and other powdered drugs, can be risky
because small amounts of blood from cracked lips or tiny nosebleeds can
also be found on these items.
• Sharing tattoo or body-piercing equipment: The needles, equipment and
ink can be contaminated with blood and transmit Hep C, usually in places
and situations where proper sterilization techniques or single-use equipment
are not available or cannot be used.
- CATIE
30
31. High Risk
• Blood transfusions prior to 1992: In 1992, routine blood
screening began and the risk for Hep C from the blood system is
now very rare, but transfusions before 1992 are considered high risk
• Unsterilized medical equipment: Shared medical or surgical
equipment can transmit Hep C if it is not sterilized between patients
• Blood or cutting rituals: Rituals that involve cutting with shared
tools or the exchange of infected blood can transmit Hep C
- CATIE
31
32. Some Risk
• Sharing personal hygiene and grooming supplies: Shared razors,
toothbrushes, nail clippers and other household items that might have
infected blood on them can transmit Hep C
• Unprotected sexual intercourse: Hep C can be transmitted sexually,
especially when there is a chance that infected blood could be present (like
during menstruation or certain sex practices, such as sex that involves
fisting) or when other sexually transmitted infections are present
• Vertical transmission during childbirth
• Needlestick injuries-possibility of exposure to Hep C-infected blood
- CATIE
32
33. No Risk
• Casual contact with a person living with Hep C, including
sharing toilets, drinking glasses and eating utensils
• Hugging, kissing or touching a person living with Hep C
• Using new or sterilized medical equipment during
medical procedures
- CATIE
33
34. Sexual Hep C Transmission
• Evidence that Hep C can be present in some
people’s semen or vaginal secretions.
• In men co-infected with HIV and HCV, HCV is
more often found in the semen compared with
HCV positive men without HIV.
– The presence of HCV in the semen combined with a
weakened immune system may partially explain the
enhanced risk that HIV positive men have for HCV
infection when they engage in unprotected sex.
34
35. Risk Factors…
• Increasingly, in Canada, people infected with hepatitis C are disproportionately
affected by poverty, substance use, racism and limited access to healthcare.
• People living on the streets often do not have access to sanitary environments
• Prison populations do not have access to needle exchange programs or sterile
tattooing equipment and they may share personal hygiene items.
• Medical practices in some countries 20 or 30 years ago exposed numerous people to
Hep C, some of whom have immigrated to Canada.
• Aboriginal people face the challenges of racism and its impacts, including isolation,
poverty and the erosion of culture, which can lead some people to engage in risk
activities.
35
36. Hep C Outside the Body
• The virus itself is quite resilient
• Some evidence that Hep C may survive
outside of the body for four days or more
• Anecdotal evidence suggests up to two
weeks
• The longest recorded amount HCV has
survived in a syringe is 68 days
36
37. Preventing Transmission
• Avoid sharing…
– Needles, syringes, cookers, tourniquets,
water… any injecting equipment
– Crack pipes
– Snorting equipment
– Razors, nail clippers, toothbrushes
– Piercing/tattooing/branding equipment
• Have protected sex…
– Especially if blood might be involved
• Longer duration and rougher sex acts
37
40. Hep C Testing
• Informed consent
• The earlier people are tested and diagnosed the better
• Places to go for testing include:
– Public Health Units
– Community Health Centres
– Doctors’ offices
– Walk-in clinics
• Although the testing for Hep C is not anonymous, the results are confidential
• Hepatitis C is a reportable disease across Canada
– Case definitions for reporting differ from province to province
– Currently, testing positive for Hep C antibodies is the case definition for
reporting of Hep C in Ontario
– Contact tracing (some Health Units)
40
41. Hep C Testing
• Once infected with Hep C the body produces antibodies
– Window Period is usually 10 weeks (up to 6 months)
– Testing is recommend 3-6 months post exposure
• The antibody test is a screening test:
– If NEGATIVE, either…
• The person is not infected, OR
• They may be infected but their body hasn’t produced antibodies yet
(window period)
– If POSITIVE, then…
• RNA testing needed to see if the person still has Hep C in their body
(some people clear the virus)
41
42. Hep C Testing
• Diagnostic Tests:
– Hep C Antibody test: If positive
– RNA Testing
• Generally used when a person has tested positive for Hep C
antibodies
• Some people are able to clear the Hep C from their body without
treatment and thus will have no detectable Hep C RNA in their
blood
• To be certain the virus has cleared, repeat testing is required
• Determines the genotype (important for treatment)
• Important to encourage people to return for their test
results at all stages of testing
42
43. Why get tested?
• Empowers people by giving them information
they can use to stay healthy
• Individuals who find out they are living with Hep
C can make decisions about how to prevent
transmission, how to stay healthy, and whether
or not to access treatment
• People whose test results show they are not
infected can identify risk factors and learn to
keep themselves safe from infection
43
47. Treatment
48
Interferon (IFN)
Pegylated Interferon (PEG
IFN)
Ribavirin
Direct Acting Antivirals
(DAA)
From HepCHope.com
New:
•Fewer side effects
•Fewer pills
Exciting and Hopeful
time for treatment!
Interferon Free Treatment
48. Hep C Treatment
• There is treatment for Hep C. Treatment today is the
best it’s ever been and it’s helping more and more
people get rid of the virus.
• You might hear lots of bad things about Hep C
treatment, but many people choose to take treatment
and are able to get rid of the virus.
• With new treatment option comes higher success rates
in clinical trials and fewer side effects.
• A healthcare worker can help you decide if treatment is
right for you and help you get ready to start.
- CATIE
49
49. Hep C Treatment Medications
• Hep C treatment is:
– PEG-interferon, injected subcutaneously
(under the skin) once a week
– Pegasys (interferon-alfa-2a) — made by
Hoffman-La Roche
– PEG-Intron (interferon-alfa-2b) — made by
Schering-Plough
– Combination therapy — PEG-interferon and
ribavirin — may be used to try and wipe out
Hep C infection. If this is not possible, it may
also be given in an attempt to reduce the
liver damage caused by Hep C infection.
Ribavirin is a pill taken twice daily, with food.
– Hep C treatment may be problematic for
former users because the medication must
be injected.
50
50. Even Newer HCV Treatment!
• New Drugs have just been approved to
treat HCV without the use of peg-
interferon
• Awaiting approval for cost and access
51
51. Treatment Depends on Genotype
• Treatment time depends on what genotype a
person has
• Older treatment times could be up to a year but
with newer treatments it might be as short as 12
weeks
• It either works, or it doesn’t. When it works it’s
called SVR (Sustained Virological Response)
• SVR is: undetectable Hep C viral load, 6 months
after treatment ends
52
52. Hep C Treatment Tips
• If you drink alcohol, stopping, or cutting back on drinking,
can be one of the best things you do to make sure
treatment works.
• If you’re using drugs, Hep C treatment can still work.
More and more drug users are taking treatment and
getting rid of the virus. If you’re having trouble getting
treatment, talk to a healthcare worker you trust.
• Often there can be side effects from treatment, but your
healthcare worker can offer help and support if you have
problems.
• Getting through treatment can save your liver. And your
life.
- CATIE
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53. Factors that Reduce Treatment Success
• Cirrhosis (more advanced liver damage)
• Having genotypes 1 or 4 rather than 2
• Having a higher Hep C viral load (>400,000
IU/ml)
• Being of African/Caribbean origin (black)
• Being older than 40
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54. Factors that Reduce Treatment Success
• Drinking alcohol during treatment
• Having fatty liver
• Greater body weight (>75 kg or 165 lbs)
• Poor adherence
• Not managing side effects
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55. HCV Support Teams
• These teams exist throughout the province
and consist of:
– Nurse
– Social Worker
– Outreach Worker
– Peer Support
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56. HCV Support Teams
• These teams can help their clients with:
– Treatment adherence
– Managing side effects
– Continuity of care
– Navigating the health care/insurance systems
– Getting educated about the virus
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59. Bob
Bob is a regular client who just
tested positive for Hep C. He has
been injecting for two years and had
tried very hard not to share or use
any of his equipment. He’s upset and
confused about how he got Hep C
and what the long term
consequences will be. He thinks
someone might have used his
needle and not told him. Bob is
anxious to know what he can do and
when he might start getting sick. 60
60. Questions to consider…
• What other concerns might Bob have around his Hep C?
• Does how he got Hep C matter?
• What other harm reduction or prevention tools might
Bob need?
• What are the potential risks and opportunities for Bob?
• What resources and referrals might you suggest to Bob?
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62. Co-infection with HIV
• Why is co-infection important?
• Liver disease is the leading cause of death in
people co-infected with Hep C and HIV
• Co-infected individuals are 3x more likely to
develop chirosis
• There is an important overlap in terms of the
populations affected by these diseases
• 20-25% of PHAs in Canada also have Hep C
• Up to 80% of HIV+ IDU also have Hep C
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63. Co-infection with HIV - Transmission
• HIV increases the risk of getting Hep C
– Risk of vertical transmission of hepatitis C
increases from 5-10% to up to 20%
• In men co-infected with HIV and HCV,
HCV is more often found in the semen
compared with HCV positive men without
HIV.
– The presence of HCV in the semen combined
with a weakened immune system may partially
explain the enhanced risk that HIV positive
men have for HCV infection when they engage
in unprotected sex.
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64. In a person who is HIV positive the health of
their immune system can impact an HCV
test result.
A. True
B. False
C. I am not sure
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True
False
Iam
notsure
0%0%0%
65. Co-infection with HIV - Testing
• HIV increases the risk of a false negative
Hep C antibody test (someone is really
positive but the test comes back negative)
– Especially if CD4 count is less than 200
– The immune system is too weak to produce
antibodies
– Hep C RNA (viral load) test may be possible
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66. Co-infection with HIV
• Does Hep C make HIV progress faster?
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It doesn’t look like it. Studies show different results.
• Does HIV make Hep C progress faster?
Yes. HIV reduces the chance that Hep C will clear
on its own
HIV increases the risk of progressing to fibrosis,
cirrhosis and end-stage liver disease
67. Co-infection with HIV - Treatment
• Hep C complicates HIV treatment
– The liver may have a harder time processing
anti-HIV drugs
– Liver-toxic anti-HIV drugs may limit options
– There are drug combinations you want to
avoid
• AZT + ribavirin increases risk of anemia
• ddI or d4T + ribavirin increases risk of lactic
acidosis and pancreatitis
• Abacavir may reduce ribavirin levels
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68. Co-infection with HIV - Treatment
• With the older treatment, HIV had an impact on Hep
C treatment
– Treatment may have to start earlier
– Treatment time maybe extended
• From 24 weeks to 48 weeks in genotypes 2/3
– Treatment had a significantly lower success rate
• Clinical trials have proven that newer treatment for
HCV is just as effective for co-infected individuals as
with mono-infected people
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69. Co-infection with HIV - Treatment
• Which should be treated first, Hep C or HIV?
70
It depends on…
CD4 count
Stage of liver disease
Individual’s ability to take treatment
If CD4 is below 350, treating HIV is a priority
If CD4 has never been below 350, may choose to treat
Hep C only
It is possible to treat both at the same time
71. Jane
Jane is a 30 year old female who
has been coming to counselling for
the last few weeks for cocaine use.
In conversations with her you
know she is sexually active; in the
past couple of months she has
slept with 3 different men and had
unprotected intercourse with one
of them. She tells you that she
found out one of the men is Hep C
positive and is “freaking out
because what if I have Hep C now
or HIV?”
72
72. Questions to consider…
• How comfortable are you talking about her sexual
activity?
• To what services/programs would you refer Jane?
• What other concerns might Jane have as a result of her
substance use and sexual risks?
• How might you help Jane prepare for the results of her
tests, positive or negative?
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73. Carol
Carol is a 37 year old mother of
two children. She has just been
released from prison where she
served 18 months for trafficking.
She tested positive for HIV and
Hep C in jail. Carol is still in
shock from this and is in great
distress. She cries a lot,
apologizes a lot and is in the
office daily seeking help. Her
family has cut her off from any
support and her kids are in care.
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74. Questions to consider…
• Is she on methadone?
• What support does she have?
• Is she receiving OW or ODSP?
• Does she have medical care and is she on HIV
meds?
• What are the immediate concerns you have for
her?
• Is she stably housed?
• Any other medical issues?
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75. Recap
• Types of Hepatitis
• HCV
– Context
– How it works
– Symptoms
– Transmission
– Risk factors
– Testing
– Treatment
– Co-Infection
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76. Contact Us
Nick Boyce, Provincial Director, nboyce@ohsutp.ca
CC Sapp, Acting Director, ccsapp@ohsutp.ca
490 Sherbourne St., 2nd
Floor
Toronto, ON M4X 1K9
1-866-591-0347 (toll free)
416-703-7348 (t)
416-703-3542 (f)
www.ohsutp.ca
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