hepatitis a, b, c & hiv presentation (2011)
DESCRIPTION
General information about hepatitis A, hepatitis B and hepatitis C.TRANSCRIPT
Hepatitis A, B, C and HIV
The Hepatitis Education Project
Seattle, Washington
Topics of Discussion
What is hepatitis?
How are the hepatitis viruses different?
How is HIV/AIDS similar to the hepatitis viruses?
Goals
Increase awareness and understanding Prevent transmission Educate patients about care and treatment
Ground Rules
Open and interactive Educational focus Respectful and attentive No medical diagnosis
Liver Function
“Hepa” means liver; “itis” means inflammation
2nd largest organ Performs over 500
different functions Lacks nerve
endings Able to regenerate
Hepatitis - caused by many different agents:
Viruses Alcohol Drugs/prescriptions Herbs Genetic disorders Obesity
Hepatitis Viruses
Hep A Fecal-oral transmission Contaminated food & water
Hep B Blood & bodily fluids
Hep C: Blood
Some Similarities:HIV and Hep B
Transmitted via contaminated blood & bodily fluids
Risk of sexual transmission is high More easily transmitted through sex than
hep C
There is no cure for HIV or hepatitis B
Hepatitis B
Vaccine preventable In the U.S. most adults get over this infection on
their own (90-95%) People infected for a long time have a higher risk
of getting liver cancer Liver cancer possible before cirrhosis (unlike HCV) Liver cancer screening is important
Protect Yourself
Get immunized against Hep A and Hep B
Practice good hygiene Wash your hands with soap
& water
Practice safer sex with any new partner Use condoms
Hepatitis C
Hepatitis C is a virus transmitted via contaminated blood
There is NO VACCINE It is very common U.S. and Worldwide
About 4-5 million Hep C+ people in the U.S. About 200 million Hep C+ people in the World
How do people get infected with hepatitis C?
Injection drug use Tattoos (especially in jail or
prison, street tattoos) Blood transfusions (pre-1992) Intranasal drug use
Lower Risks of Exposure
Sexual transmission Mother-to-child at birth (3-5%) Sharing personal hygiene tools
Toothbrushes, razors, nail clippers Occupational exposure
Firefighters, healthcare workers Fighting
Drug Use is #1
Sharing any drug equipment can pass Hep C and Hep B “works” – needles, syringes, cottons, cookers,
pipes, straws, rinse water, etc.
Cleaning with bleach is preferred, but isn’t reliable against hepatitis viruses
Tattoos
Tattoos done in prison or jail are the most risky
Best protection: get tattoos at licensed shops (autoclave, disposable inks and needles)
How will I know if I have Hep C?
Get tested First blood test looks for exposure. This is called
an Antibody test. Second blood test looks for virus. This is called a
PCR or confirmatory test.
100 People
25% Resolve 75% Chronic
Natural History of Hep C
100 People
Resolve (25) Chronic (75)
Stable (34) Cirrhosis (41)
Mortality (25)
Liver Cancer (10)
Natural History of Hep C
Long-term effects of viral hepatitis Healthy livers are
plump and smooth Cirrhotic livers are
nodular; bumpy and shrunken
HCV is the leading cause of liver transplant in the U.S.
Dangerous Combinations
Alcohol + Hep C
HIV + Hep C
Hep B + Hep C
These can cause much worse & much faster liver damage
Symptoms of Hep C
Most people have no symptoms.
Symptoms can include: Fatigue (frequently tired) Memory or concentration problems (brain fog) Joint pains Insomnia (can’t sleep) Depression
Liver Biopsy
Gives you a scar stage, a rating of the amount of scarring
Stages of scarring: Stage 0: No scarring Stage 1: Mild Stage 2: Moderate scarring, Treatment maybe Stage 3: Bridging fibrosis, Treatment yes! Stage 4: Cirrhosis, Treatment yes! (if liver can tolerate)
Types of Hep C
Hepatitis C is like a family with 6 different brothers or sisters.
These “siblings” represent the different genotypes of Hep C
In the U.S. we see mainly 3 different genotypes: Genotype 1: needs one year of treatment, by far
the most common type in the U.S. Genotype 2 or 3: needs six months of treatment
Is there a cure?
Yes, for many but not all.
Cure rates for Hep C
After 6-12 months of treatment about 70-80% of people will be cured
If HCV- after 4 weeks, cure rate is 90%+
Hep C Treatment
Combination of 3 drugs: interferon, ribavirin and a protease inhibitor
Treatment Goals Kill the virus Stop scarring of the liver Prevent cirrhosis Get rid of the fatigue and other symptoms
Interferon
Interferon is an injection given just under the skin 3 times per week Pegylated interferon is injected once a week.
Fever Headache Nausea
Diarrhea Hair Thinning Thyroid
Problems
Side Effects: Depression Irritability Fatigue
Ribavirin
Ribavirin is a pill taken twice a day
Anemia “low blood”, makes a person feel tired
Rash
Insomnia
Loss of appetite
Cough
Side Effects:
Protease Inhibitors Two new drugs:
Telaprevir Boceprevir
Both are oral medications taken every 8 hrs Both were added to IFN/riba treatment in 2011
Side Effects:
Telaprevir – main side effect: Rash
Boceprevir – main side effect: Anemia
Alternatives to TreatmentMay be useful for easing side effects
Complimentary/ alternative treatments Massage therapy Prayer & meditation Naturopathic medicine Herbal medicine*
Milk thistle Yoga Aroma therapy Acupuncture
Herbs that may be harmful to the liver* Heliotropium Skullcap Jin Bu Huan Germander Sassafras Comfrey Senna Valerian Pennyroyal
Sources: NIH, NCCAM, May 2000
Hepatitis C Support Project, www.hcvadvocate.org, August 2011
*Caution should be taken in the use of herbals
If you have Hep C, you should NOT…
Share needles or “works” Share tattoo equipment Share razors, nail clippers or
toothbrushes Donate blood
Hepatitis B & C are NOT spread by casual contact, i.e.
Hugging Kissing Sharing food or drinks Playing Sharing a house
Now that you know…
Get tested
And if you have Hep C… Limit alcohol Get vaccinated against
Hep A and B Talk with your doctor to
find out if you need treatment
For more information Books on Hep C are available in all Washington State
prison libraries
Go online to learn more at http://www.hcvadvocate.org
Visit your local Public Health Clinic
Contact the Hepatitis Education ProjectPhone: 1-800-218-6932Address: 911 Western Ave. #302, Seattle, WA 98104Websites: http://www.hepeducation.org
http://hcvinprison.org