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Hep 202

Hep 202. Just when you thought you knew everything. 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. Case Study Jane and Julia.

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Hep 202

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  1. Hep 202 Just when you thought you knew everything.

  2. 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

  3. Case Study Jane and Julia

  4. What Would You Tell Jane and Julia if You Were Bob? Discuss in your groups: • What does hepatitis and viral hepatitis mean and what do you know about the five major types of viral hepatitis? • What are the signs and symptoms of hepatitis C? • What are the risk factors for hepatitis C and how can one prevent getting it?

  5. Hep 101 Overview Liver inflammation • Hepatitis = • Hepatitis C • Name signs/symptoms, risk factors and prevention Virus that causes liver inflammation • Viral Hepatitis = • Name 5 identified types of viral hepatitis

  6. How Does Hep C Damage The Liver? BC Hepatitis Services, 2003

  7. Hepatocellular Carcinoma

  8. Viral Hepatitis 5 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 Vaccine Preventable There are also other less common strains Adapted from Corneil, 2003

  9. 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

  10. Hepatitis C

  11. 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

  12. Highly Debatable 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

  13. Health Canada, Hepatitis C Prevention, Support and Research Program, 2002

  14. Health Canada, Hepatitis C Prevention, Support and Research Program, 2002

  15. Health Canada, Hepatitis C Prevention, Support and Research Program, 2002

  16. Health Canada, Hepatitis C Prevention, Support and Research Program, 2002

  17. Health Canada, Hepatitis C Prevention, Support and Research Program, 2002

  18. Tests Screening: Detects if the body has produce antibodies to Hepatitis C (anti-HCV) 1st test that is done when someone gets tested • Usually need a minimum of six weeks to detect antibodies. After 6 months 95% will have detectable antibodies

  19. Looks for virus RNA 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.

  20. Tests • Other tests are used to monitor liver function and damage • They include: Corneil, 2003

  21. 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

  22. 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

  23. 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

  24. Milk Thistle Example

  25. Other HCV-related conditions These may occur when the immune system tries to fight off the virus Dead antibodies deposit in the body causing Blood & Kidney Disorders Toxins in the blood may deposit in the body causing: Skin Disorders Mental Disorders

  26. HIV Co-infection Appears to increase rate of liver scarring and long-term complications such as cirrhosis Seems to speed up the rate of viral replication

  27. 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

  28. Pegylated Interferon + Ribavirin Treatment • Best treatment currently available is a combination of two antiviral drugs:

  29. 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

  30. Questions?

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