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Hepatitis C has been showing up recently in the media, withattention paid to some of the celebrities that have it.1 So, what is it and
Linda Checky, BSN, RN, MBA,
why is it such a big deal? Hepatitis is a general term that means
How is Hepatitis C Treated?
Drug use by nasal inhalation:
Drugs that are "snorted" such as cocaine and
crystal methamphetamine may carry a risk of Hepatitis C acquisition when
Hepatitis is caused by a number of things, including:
straws are shared, through contact with trace amounts of mucus and blood.
Transfusion of blood products:
Recipients of clotting factors made before
• Receive vaccinations for Hepatitis A and B which would radically worsen
1987 are at a high risk of HCV infection and should receive testing to
determine if they are infected. Those that have received blood products
and/or solid organs before 1992 are at an intermediate risk and should also
• Receive combination therapy with pegylated interferon and ribavirin—
be tested. With current testing of blood products, the risk of acquiring HCV
duration of treatment will vary depending on which genotype of HCV is
Hepatitis C is caused by a virus. Currently, six viruses are known to cause
through a transfusion is exceedingly small (<1 per 2 million transfused
hepatitis: A, B, C, D, E, and G. Hepatitis F is under investigation. Each
• Consider "triple therapy," if indicated. Some studies have shown higher
of these viruses differs in terms of structure, signs of infection, virulence,
success rates with the addition of the antiviral drug amantadine
Improperly sterilized medical or dental equipment
can harbor HCV. Use
of appropriate sterilization techniques and proper disposal of used
(Symmetrel®), especially for "nonresponders."5,6
equipment can reduce the risk of exposure to HCV to virtually zero.
Why is Hepatitis C such a problem?
of HCV is rare in monogamous, heterosexual
relationships. The highest risk of transmission is associated with multiple
When Hepatitis C first enters the body, it stimulates an immune response,
sexual partners and with traumatic sex that results in blood exposure. Use of
causing the body to make an antibody called anti-HCV (Hepatitis C virus).
latex condoms correctly and every time may help prevent the spread of this
Then it mutates into a different shape – one that the body does not recognize.
and other sexually transmitted diseases.
1. Celebrities with Hepatitis C. (2003, Nov. 9). Kansas City Star website, retrieved 6/16/08:
Over the course of many years, the virus changes multiple times; remaining,
for the most part, hidden from the immune system.
Mother to child transmission
of HCV only occurs among infants born to
women who are HCV RNA positive at the time of delivery (transmission
2. Centers for Disease Control and Prevention website (March 6, 2008). Viral hepatitis C fact
sheet, retrieved 5/28/2008: www.cdc.gov/NCIDOD/Diseases/hepatitis/c/fact.htm
Because HCV mutates again and again, the body cannot mount an adequate
risk approximately 4 %). However, if the mother is both HCV and HIV
immune response – which means that HCV cannot be eradicated in most
positive at the time of delivery, the risk increases to about 19%.2
3. Leshner, A. , National Institute on Drug Abuse website. (May, 2000). NIDA Community
Drug Alert Bulletin—Hepatitis, Retrieved 5/28/2008. www.drugabuse.gov/
people. About 85% of those infected with HCV will develop a chronic
are at risk of acquiring HCV. The annual incidence
infection. Researchers have not been able to develop a vaccine to prevent
is currently reported at between 0.73-3%. A major risk factor for
Hepatitis C infection because the viral mutation makes it like trying to hit a
4. Alter, M. and Tokars, J. (April 27, 2001).Recommendations for Preventing Transmission of
hemodialysis patients is the number of years on dialysis. The longer the
Infections Among Chronic Hemodialysis Patients. Centers for Disease Control website.
patient is on dialysis, the more likely it is that they will acquire HCV.
Retrieved 6/18/2008: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5005a1.htm
Prevalence rates for patients who have been on dialysis <5 years is around
5. Smith et. al. (May 2002). Amantadine Therapy for Chronic Hepatitis C. (Online) PubMed
The NIH estimates that about 20% of the people with chronic Hepatitis C
12%, increasing to 37% in patients receiving dialysis ≥5years. Investigations
will develop cirrhosis of the liver over at least 20-30 years. Cirrhosis is a
of dialysis-related outbreaks of HCV suggest that transmission is most likely
serious condition that can lead to liver failure. Currently, Hepatitis C is the
related to inadequate infection control practices.4
6. Wikipedia website (June 16, 2008). Hepatitis C. Retrieved 6/16/2008:
number one reason for liver transplants. In a smaller percentage (1-5%) of
Health Care Workers
are at risk of acquiring HCV through accidental
those with chronic HCV, hepatocellular carcinoma (HCC) will develop. In
needle sticks, sharps exposure, or a blood splash to the eye or an open
some parts of the world (i.e., Japan), the chance of developing HCC is much
wound. Universal precautions can significantly reduce the risk of exposure
According to the CDC, an estimated 4.1 million (1.6%) Americans have
Other potential sources of transmission
include tattoo or body piecing
Some of the material in this article was excerpted from
been infected with HCV. There are, on average, 19,000 new infections per
with unsterilized equipment or through sharing personal care items such as
toothbrushes, nail clippers or razors with an infected individual.
the Hepatitis C homestudy offered by TCHP. The TCHP
Education Consortium offers homestudy education on a
While the incidence of new infections has declined dramatically in the last
Who should be tested for HCV?
variety of health care topics on their website at
ten years, the clinical effects of past infections are emerging now.
• Anyone who has ever injected illegal drugs—even just once
www.tchpeducation.com. Homestudies are available to
• Those who are notified that they had received blood from a donor
read free of charge on their website. If contact hours are
who later tested positive for hepatitis C
desired, the processing cost is $5 per contact hour.
How is Hepatitis C transmitted?
• Recipients of clotting factors made before 1987• Hemodialysis patients
The Hepatitis C virus is a blood-borne pathogen. Contact with the blood or
• Recipients of blood and/or solid organs prior to July, 1992
body secretions of someone infected with Hepatitis C puts you at risk.
• People with undiagnosed liver problems• Infants born to infected mothers (test at 12-18 months of age)
Injectable drug users
are most at risk of contracting HCV. Even people
• Health care/public safety workers after a known exposure
who have only used injectable drugs once or twice may become infected.
According to the NIDA, at least 60% of HCV infection in the United States
is related to injection drug use, and 50-80% of all new injectable drug users
Ý¿-» îæïðó½ªóðïìïíóÍÎÞ Ü±½«³»²¬ èëÚ·´»¼ ðéñîéñïð Ð¿¹» ï ±º ëArthur R. GoldbergAssistant Director, Federal Programs BranchU.S. Department of Justice, Civil Division20 Massachusetts Avenue, N.W. Washington, DC 20530Tel. (202) 305-7920/Fax (202) 616-8470 PLAINTIFF’S RESPONSE TO THE MOTION OF DAVID SALGADO AND CHICANOS POR The State of
Neues von Bonus-Malus: Protonenpumpenhemmer werden aus der Bonus-Malus-Regelung herausgenommen Seit 2007 gilt für Vertragsärzte die Bonus-Malus-Regelung. Die Spitzenverbände der Krankenkassen und die Kassenärztliche Bundesvereinigung haben dafür sieben Arzneimittelgruppen festgelegt. In Berlin wurde die Vorgabe der KBV 1:1 übernom-men. Regional werden für jede dieser Arzneimittel