Hepatitis C: More Widespread Than HIV And AIDS

Masses of people are fearful of contracting the virus that causes acquired immunodeficiency syndrome (AIDS). However, some of these same individuals remain blissfully unaware of a more widespread threat. The intended purpose of this article is to discuss hepatitis C and bring it to the attention of the public. Nurses Announcements Archive Article

Hepatitis C: More Widespread Than HIV And AIDS

An insidious killer has attacked an estimated 170 million people globally and continues to lurk in the shadows. As a nurse, nursing student, other type of healthcare worker, or member of the public, you have undoubtedly encountered people who have this disease and you probably did not even realize it.

Hepatitis C is an infectious hepatic disease of viral origin that typically results in chronic liver damage, and in numerous instances around the world, death. Politicians, public health officials, epidemiologists, pharmaceutical firms, and researchers focus the vast majority of their funds, research, and energies on other diseases such as tuberculosis and AIDS because they do not yet deem hepatitis C as a viable threat to the public.

More awareness, funding, and research on hepatitis C is necessary for the prevention of the disease and the creation of effective treatments for the millions of individuals who are now affected. Hepatitis C warrants further scrutiny because it is epidemically widespread, a deadly killer, widely misunderstood, and easy to transmit.

Hepatitis C is quite widespread; in fact, an epidemic proportion of the population is afflicted with this liver disease. It is currently the most common blood-borne infection in the United States and affects an estimated four million people in its most chronic form. Hepatitis C infects nearly four times as many people in the U.S. as HIV and is projected to cause the deaths of more American persons than HIV by the year 2020.

Internationally, the number of people who are presently afflicted with hepatitis C is even more astounding. According to estimates, 170 million people have hepatitis C worldwide. The numbers of individuals afflicted will, in all likelihood, continue to epidemically burgeon unless more public awareness is cast on this infectious disease.

A deadly and silent killer, hepatitis C triggers a painstakingly slow course of events that inflict a bodily toll on its sufferers. In fact, the effects of chronic liver disease triggered by the hepatitis C virus are normally not overt until ten to twenty years after the initial infection. Most people who are infected are not aware that they have any disease since hepatitis C takes its course over a period of numerous years before the noticeable symptoms begin to arise. According to the Centers for Disease Control, hepatitis C-induced chronic liver disease is the most common reason for liver transplants in adults.

Some sufferers display signs and symptoms, although they are subtle and happen to be mistaken for milder ailments. The earliest symptoms include a weak appetite, nausea, muscular aching, sore joints, and mild fever. These symptoms are quite common in the general population; therefore, doctors often attribute them to other causes that are not lethal. According to CDC estimates, hepatitis C results in 8,000 to 10,000 deaths every year in the U.S. Hepatitis C is a deadly and silent illness that deserves more attention due to its insidious onset.

Hepatitis C demands more attention because of its relatively simple mode of transmission. The hepatitis C virus is transmitted from person to person by contact with the blood of an individual who has the virus. About half of all transmissions occur through intravenous drug use and nearly one-fourth of cases occur due to unprotected sexual activity.

Uncommon ways of spreading this virus include contaminated tattoo needles, used toothbrushes, and nail files that contain traces of infectious blood. To make matters worse, hepatitis C tends to resist a wide range of infection control measures such as heat, UV light, drying, freezing, bleach, and other disinfectants.

Further research, money, and public knowledge regarding hepatitis C is absolutely imperative to stop the rampant spread of the disease and to yield more treatment options for the millions of persons afflicted worldwide. Hepatitis C needs attention since it is so prevalent, misunderstood, lethal, and easy to transmit. Countless people will needlessly die if our politicians, epidemiologists, and major researchers continue to complacently vegetate on this topic. It is time to make the public aware of this frightful plague on a massive scale so that a myriad of human lives can be saved.

TheCommuter

About TheCommuter, BSN, RN

TheCommuter, BSN, RN, CRRN is a longtime physical rehabilitation nurse who has varied experiences upon which to draw for her articles. She was an LPN/LVN for more than four years prior to becoming a Registered Nurse.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Official: NH Hospital Employee Misused Drugs, Causing Hepatitis C Outbreak......

CONCORD, N.H. (CBS/AP) — New Hampshire’s public health director says officials suspect an Exeter Hospital employee misusing drugs led to an outbreak of hepatitis C among patients who were treated at the hospital’s cardiac catheterization lab.

Read: Exposed Patients Want Answers

Dr. Jose Montero said Wednesday that the ongoing investigation points toward drug diversion as a cause, which generally involves someone using a syringe to inject medication meant for someone else and then re-using the syringe on patients.

A total of 20 people, including a hospital worker, have been diagnosed with the same strain of the liver-destroying virus since the state began investigating the outbreak last month.

Official: NH Hospital Employee Misused Drugs, Causing Hepatitis C Outbreak « CBS Boston

Frightening isn't it?

I remember when they first started talking about "non A non B hep." At that time it was thought to be only IV drug users that would be infected. Now I know a few people, not drug users, not health care workers who are positive.

Where are we with a vaccine for Hep C? I have not kept up to date on that.

Could you elaborate a bit about current treatments other than organ transplants.

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
Where are we with a vaccine for Hep C? I have not kept up to date on that.
Since the hepatitis C virus mutates so quickly, we still have not developed a vaccine to protect against the infection.

Could you elaborate a bit about current treatments other than organ transplants.
Both of my parents had infection with HCV. My mother was infected after having received a tainted blood transfusion in 1983. Apparently, the blood products that she had received during her surgical procedure were infected with the virus. She felt fine until 1997 and ended up receiving a liver transplantation in 2002 after developing end-stage liver disease.

My father, on the other hand, contracted HCV through occasional IV drug use and was officially diagnosed in 2002. He never displayed any symptoms and was classified as a carrier. His physicians treated him with interferon and antiviral medications last year because his viral load was in the millions. Although his viral load dropped into the hundreds, they could not eradicate all traces of the virus from his body.

My father secretly admitted to me that he did not take his antiviral pills five times per day as instructed because it was 'too hard' for him to follow. Instead, he was only taking them two to three times per day. I told him that he needed a constant blood level of these antivirals, and that's why they were prescribed for five times a day. My father's lack of compliance is the reason why I suspect that the treatments did not work .

Official: NH Hospital Employee Misused Drugs, Causing Hepatitis C Outbreak......

Official: NH Hospital Employee Misused Drugs, Causing Hepatitis C Outbreak « CBS Boston

Frightening isn't it?

My mother had contracted HCV in a cath lab. Unfortunately she was not a candidate for the therapy she lived for 18 years with it primarily alternative medicine and vegetarian lifestyle , she consequently passed away from liver failure a few months ago RIP.

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
My mother had contracted HCV in a cath lab. Unfortunately she was not a candidate for the therapy she lived for 18 years with it primarily alternative medicine and vegetarian lifestyle , she consequently passed away from liver failure a few months ago RIP.
I'm so sorry about your loss. :saint:

HCV is, in my opinion, a bigger threat to public health than HIV and AIDS. 700,000 people in the US have HIV/AIDS, but 4 million people in the US have HCV.

bluemartian, I am sorry for your loss. It sounds like she found a way to live and certainly did treatments that woul do no harm. I am glad you had those important years with her.

Specializes in allergy and asthma, urgent care.

HCV is much more common than people think. We would routinely test patients when I worked at a community health center, and the positive rate was alarmingly high. Many of these patients had no idea that they were at risk, and also did not know how serious a disease HCV is. They continued with high risk behaviors because they did not know how to protect themselves. Treatment for Hep C exists, but it's not easy tolerated and is not 100% effective. Early in 2012, 2 companies received FDA approval for a more effective, shorter therapy course, which will hopefully help more people.

What happened in New Hampshire is horrible beyond words. These patients now have to go through a very difficult treatment protocol, and it may not help them all. Commuter, I'm so glad your mother did well and I hope your father may be eligible for re-treatment. Bluemartian, I'm so sorry for your loss.

Thank you for increasing awareness of a horrible, preventable disease.

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

Someone had posted yesterday requesting website links regarding the spread of HCV through sexual contact. Unfortunately, this person's post was lost during last night's database issue.

Well, here are several website links below that pertain to the spread of hepatitis C via unprotected sexual contact. Enjoy.

Sex and the C Virus

Hep C - What Gay Men Need to Know | Q News

'Explosion' of Sex-Spread Hepatitis C in HIV-Positive Men - HIV: Health and Medical Information About HIV and AIDS on MedicineNet.com

The chances that Hep C would be transmitted sexually are very small in committed relationships, but still there is a chance. No sharing of razors, toothbrushes and use protection during sex are the rule. I know much about hepatitis C and the havoc it causes in people's lives. The most common HCV in US is type 1a. This particular strain is very resistant to treatment and only permanently effective in a low number of patients. Prior to the new antivirals that were finally OKed by the FDA, only treatment available was PEG-interferon and Ribavirin. These two drugs have a lot of side effects and sometimes they are so bad that the patient goes off treatment. There are other factors that will cause a patient to be taken off treatment by their doctor, such as viral load not lowering enough within treatment parameters.

The new antivirals along WITH PEG interferon and Ribavirin are a major step in treatment. More patients (esp. 1a) have a faster decrease in viral load and clear the virus. Treatment protocols do not have to be as long as previous but this is up to the individual hepatologist.

Vietnam era veterans have a high number of HCV occurances. When talking with your patient, ask if they were in the military and during what conflict. If it was during Viet Nam era encourage them to get tested.

All people with the virus need to be regularly screened for Hepatocellular Cancer!! This virus contributes to the development of HCC (hepatocellular carcinoma) This cancer is not usually detected until it is quite advanced.

As to the person in NH who spread the virus...he wasn't only in NH. He was in many other places too. Sad that this *^%$ cannot be tried for attempted murder.

I just lost my wonderful husband of 8.5 years 6 weeks ago to this damnable virus. He found out he was infected in 1996. When he had his first biopsy he was told that he probably caught it in the early 70s. The same time he was in the Army. We feel that the air guns that were used by the military for vaccination was the cause for many of the infections. There was no cleaning between people and there was blood spatter. Of course, Hep C is not service connected. It was the wild 60s-70s.

He had tried treatment 3 times. First time was when it was just interferon and ribavirin. This required 3xweek injections along with the daily pills. It didn't work. Second time he developed sepsis from a UTI and had to be taken off PEG interferon and riba. Last attempt with PEG and Riba was 3 years ago and he did not decrease his viral load enough to meet criteria. When the new antivirals came out, he didn't want to try again. He was rushed through a liver transplant workup 18 months ago due to two bean sized lesions "were not definately HCC but were suspicious" and the decision was made to "watch" them every three months. AFP levels did not rise. His biopsy came back negative. July 2011-same on MRI, Nov-9, 2011 9 tumors. No chance of transplant. Tried with SIR spheres to zap them and hopefully get him in transplant criteria. What happened after that is another post for another day. I took him home on June 20 and he passed on June 25th.

VA has a lot of information on their website on HCV

Many people with HCV do not clear depending on the type of HCV virus. He may not have been compliant due to the side effects he was experiencing.

Please, please make sure that he is screened for HCC on a regular basis. Usually AFP level (which is not a 100% indicator) and an ultrasound every 6 months.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
The chances that Hep C would be transmitted sexually are very small in committed relationships, but still there is a chance. No sharing of razors, toothbrushes and use protection during sex are the rule. I know much about hepatitis C and the havoc it causes in people's lives. The most common HCV in US is type 1a. This particular strain is very resistant to treatment and only permanently effective in a low number of patients. Prior to the new antivirals that were finally OKed by the FDA, only treatment available was PEG-interferon and Ribavirin. These two drugs have a lot of side effects and sometimes they are so bad that the patient goes off treatment. There are other factors that will cause a patient to be taken off treatment by their doctor, such as viral load not lowering enough within treatment parameters.

The new antivirals along WITH PEG interferon and Ribavirin are a major step in treatment. More patients (esp. 1a) have a faster decrease in viral load and clear the virus. Treatment protocols do not have to be as long as previous but this is up to the individual hepatologist.

Vietnam era veterans have a high number of HCV occurances. When talking with your patient, ask if they were in the military and during what conflict. If it was during Viet Nam era encourage them to get tested.

All people with the virus need to be regularly screened for Hepatocellular Cancer!! This virus contributes to the development of HCC (hepatocellular carcinoma) This cancer is not usually detected until it is quite advanced.

As to the person in NH who spread the virus...he wasn't only in NH. He was in many other places too. Sad that this *^%$ cannot be tried for attempted murder.

I just lost my wonderful husband of 8.5 years 6 weeks ago to this damnable virus. He found out he was infected in 1996. When he had his first biopsy he was told that he probably caught it in the early 70s. The same time he was in the Army. We feel that the air guns that were used by the military for vaccination was the cause for many of the infections. There was no cleaning between people and there was blood spatter. Of course, Hep C is not service connected. It was the wild 60s-70s.

He had tried treatment 3 times. First time was when it was just interferon and ribavirin. This required 3xweek injections along with the daily pills. It didn't work. Second time he developed sepsis from a UTI and had to be taken off PEG interferon and riba. Last attempt with PEG and Riba was 3 years ago and he did not decrease his viral load enough to meet criteria. When the new antivirals came out, he didn't want to try again. He was rushed through a liver transplant workup 18 months ago due to two bean sized lesions "were not definately HCC but were suspicious" and the decision was made to "watch" them every three months. AFP levels did not rise. His biopsy came back negative. July 2011-same on MRI, Nov-9, 2011 9 tumors. No chance of transplant. Tried with SIR spheres to zap them and hopefully get him in transplant criteria. What happened after that is another post for another day. I took him home on June 20 and he passed on June 25th.

VA has a lot of information on their website on HCV

I am so sorry for your loss.......:hug::kiss