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Overview
Someone can get infected through contact with an infected individuals blood. Nowadays, majority of the people get it after sharing needles used to inject or prepare drugs. For some, the condition is short-term whereas for others, it is long-term to the extent it is referred to as chronic. At its chronic stage, it can lead to severe and life-threatening medical issues such as liver cancer and cirrhosis. Patients can usually lack symptoms and not feel sick. When indicators appear, they occur as a sign of advanced liver illness. It is important to understand that there is no vaccine for Hepatitis C. The most ideal way of preventing this condition is avoiding actions that can help in spreading the illness, particular through injections.
It is estimated that one hundred and seventy million individuals globally are impacted by the HCV which is about 3% of the world populace (Bradshaw et al., 2019).
HCV is categorized by the World Health Organization as the most common chronic bloodborne infection in the United States (Bradshaw et al., 2019). Initially, it was obtained from serum of someone with non-A, non-B hepatitis in 1989 (Bradshaw et al., 2019). Shortly after its cloning, the novel virus was found to be responsible of ninety percent of non-A, non-B hepatitis in the country (Bradshaw et al., 2019). This shows that the government, through health agencies, needs to invest more resources into its study and prevention.
Persistent infection depends on quick production of virus and continuous cell-to-cell spread, as seen in figure 1 (Dustin et al., 2016). The turnover rate of the virus can be high with replication from 1010 to 1012 virions on a daily basis. The fast reproduction and absence of error proofreading by the viral RNA polymerase consist of major reasons behind the frequent mutation of HCV RNA genome which in turn makes it difficult to produce a vaccine. There is much proof illustrating the relationship between chronic hepatitis C, hepatocellular carcinoma as well as cirrhosis. The virus has increasingly become a world health challenge causing a major segment of chronic liver illness worldwide
Lab Diagnosis
One of the tests is anti-HCV antibodies test, as suggested by Bradshaw et al. (2019). To perform this, a physician performs an enzyme-linked immunosorbent assay (ELISA) screen test to check for the presence of antibodies released by the body to fight against the virus. The test can either yield positive results which means that the patient has been infected with HCV or negative results indicating that the blood sample shows no signs of HCV. Identification is done serologically by detecting anti-HCV immunoglobulin G.
Anti-HCV Antibodies Test
An example of immunoblot assays includes Recombinant Immunoblot Assays such as RIBA-3 and strip immunoblot assays (Hofmeister et al., 2019). They are more specific tests used for detection of anti-HCV IgG in the plasma or serum samples which have been found to be reactive anti-HCV screening assays. Detection of anti-HCV using these assays is based on immobilization of HCV recombinant antigens and synthetic peptides from the core, NS3, and NS5 proteins as single bands onto a membrane.
This may result from an infection in the past with spontaneous clearance. Additionally, there are rapid assays which have basis on the recombinant antigens obtained from the core, NS3, NS4, and NS5 proteins in an immunochromatographic format (Hofmeister et al., 2019). Although they are efficient in giving fastidious results they can only be used for a small quantity of samples. Rapid anti-HCV positive test indicates the presence of anti-HCV with absence of active infection.
Lastly, there is the RNA test refers to a blood test which involves a polymerase chain reaction (PCR) that checks for the viral load by measuring the number of viral RNA particles in a blood sample.
Transmission and Symptoms
Majority of the people today get infected with the condition by utilizing same syringes, needles, or any equipment that can be used in the preparation and injection of drugs. Users of heroine have been found to be at higher risks than non-users since they share same apparatus to inject the substance into their veins. Apart from that, a child can contract the disease from an infected mother during birth. The process involves exchange of fluids which puts the infant in danger of acquiring the virus. It is estimated that at least 6% of births result in infection of hepatitis C (Morozov & Lagaye, 2018).
When drawing on the skin of an individual, a needle is used. If it is not sterilized properly, used on another customer while the first one was infected, it is possible for the second person to acquire the HCV. Before 1992 when screening of donated blood came to action, the disease was spread via blood transfusion or organ transplant (Morozov & Lagaye, 2018). Regarding symptoms, majority of the patients do not exhibit symptoms. Those who develop them may experience nausea, fatigue, appetite loss as well as yellow appearance on the skin and eyes. It is possible for one to have pain in the abdomen area, and bleed and produce fluid in that section.
Treatment
In the event the illness is diagnosed early, treatment may not require to start immediately. Rather, a patient may have a second blood test after some months to check whether their body can fight the virus (Morozov & Lagaye, 2018). In case, the disease continues for an extended period, a treatment plan will often be suggested. When the condition is chronic, the treatment involves a test to check whether the liver has been damaged, tablets to battle the virus, and lifestyle change. Despite the effectiveness, many people have complained that the antiviral medication is expensive. For instance, a whole twelve-week treatment course costs more than $80,000.
It is important to note that the length of treatment is dependent on the hepatitis C one has. Some of the medicines approved by the NHS include the sofosbuvir, ribavirin, combination of sofosbuvir and ledipasvir as well as that of sofosbuvir and velpatasvir. In case the treatment plan does not work, one may be advised to attempt a different medicine. This will only impact a small number of individuals (Morozov & Lagaye, 2018). The doctor as well examines the liver for scarring through blood test or scanning. When completing the procedure, patients undergo another blood test to check whether the virus is cleared and a second test 3 or 6 months after stopping of the treatment. Some of the side effects of treatment include anxiety, depression, hair loss, and skin irritation.
Case Study
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Mary, a 52-year-old female works in a medical laboratory.
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She has been married for 25 years and has two teenage kids.
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She has been experiencing fatigue for a while.
In addition to that, her older child, John (19 years old), noticed yellowing of her eyes. She has complained of pain in her abdomen and feeling nauseous. Anyone who has known her for an extended period can identify that she has lost weight. She was advised by her friends to seek medical attention. She was medically diagnosed with hepatitis C after a positive HCV antibody testing and a PCR test. Treatment was administered for Hepatitis C and associated comorbidities using vitamin D supplements of Hepatitis C, Ribavirin, Sofosbuvir and insulin. It started with pegylated interferon administered once every week after diagnosis for 24 to 48 weeks. Later, the treatment was replaced with sofosbuvir and ribavirin which normally takes 12 to 16 weeks. It is three years now and Mary states that she has been cured, something uncommon in the past.
Summary
This is due to the number of individuals living with the condition, especially in the United States. It is estimated that more than 2 million people have been infected and experts claim that the figure could be as high as five million. While many other illnesses result in physical and visible symptoms on the body of a human, a patient with this condition can fail to exhibit any. The physician can thus only discover it through subjecting a person to blood tests. In the event, the diagnosis happens early, the treatment plan can delay for a while. However, if the condition becomes worse, a treatment plan is recommended which mainly consists of antiviral medication. The government needs to find a way to lower the costs of the medicines to guarantee an increased quality of life of the citizens.
References
Bradshaw, D., Mbisa, J. L., Geretti, A. M., Healy, B. J., Cooke, G. S., Foster, G. R., & The Hepatitis C Trust, U. K. (2019). Consensus recommendations for resistance testing in the management of chronic hepatitis C virus infection: Public Health England HCV Resistance Group. Journal of Infection, 79(6), 503-512.
Dustin, L. B., Bartolini, B., Capobianchi, M. R., & Pistello, M. (2016). Hepatitis C virus: life cycle in cells, infection and host response, and analysis of molecular markers influencing the outcome of infection and response to therapy. Clinical Microbiology and Infection, 22(10), 826832.
Hofmeister, M. G., Rosenthal, E. M., Barker, L. K., Rosenberg, E. S., Barranco, M. A., Hall, E. W., & Ryerson, A. B. (2019). Estimating prevalence of hepatitis C virus infection in the United States, 20132016. Hepatology, 69(3), 1020-1031.
Morozov, V. A., & Lagaye, S. (2018). Hepatitis C virus: Morphogenesis, infection and therapy. World journal of hepatology, 10(2), 186.
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