The most serious symptoms of this stage are:

Size: px
Start display at page:

Download "The most serious symptoms of this stage are:"

Transcription

1 The Natural Progression of Hepatitis C The natural history of hepatitis C looks at the likely outcomes for people infected with the virus if there is no medical intervention. However, the process of trying to predict how hepatitis C will affect the body over time and get a picture of the likely disease progression is complicated by a number of factors: Difficulties in Mapping the Progression of Disease caused by HCV Firstly it has only been 19 years since the virus was identified, and in terms of time to study a disease this is relatively short. Although a great deal has been learnt about what can take place during the first 20 years of infection with hepatitis C, the prognosis from the third decade of infection remains largely uncharted. In order to get a picture of likely progression over time it is necessary to know when people were infected This is problematic as many people with HCV do not know when or how they were infected. Also many people have now had treatment, which may well have changed the course of the disease for them. In order to try and chart a natural history of hepatitis C it means studying the course of an infection without any medical intervention (treatment). One of the main conundrums about HCV infection is that people have such dramatically different outcomes and experiences. While some people clear the virus in the very early stages, most will develop a long term or chronic infection. The course of the disease then is very variable. One person may have no liver damage after twenty years while another person will develop cirrhosis and subsequently liver failure or liver cancer. The range and degree of symptoms also varies significantly. Many people remain asymptomatic (without symptoms) for years, while others will experience fatigue, depression, digestive problems and other symptoms among the many varied extrahepatic (outside of the liver) complications of hepatitis C infection. Confusingly the symptoms people suffer are not necessarily an indication of whether they have liver damage or not. One person may have almost no liver damage and yet their quality of life is severely affected by symptoms, while somebody with extensive scarring of the liver may be symptom free. Existing blood tests for example viral load, liver enzyme levels, or HCV genotype also cannot reliably forecast the outcome of untreated HCV infection. Despite these variations and difficulties an increasing amount has been learnt about how the disease does generally progress. The Progression of Hepatitis C is divided up into four stages: The Acute Stage The Chronic stage Compensated Cirrhosis Decompensated Cirrhosis The period immediately after infection is called the acute phase. This lasts about six months. If the immune system does not manage to clear the virus by then the disease is Scotland

2 considered to have moved into a long-term or chronic phase. This is confirmed when a test for antibodies to the virus is positive and when HCV RNA (viral nucleoprotein) is detectable on at least two occasions over a six month period using the Polymerase Chain Reaction detection system this is a PCR test. It is rare to spontaneously clear the virus once it has reached this chronic stage. Hepatitis C is classified as a liver disease because of the damage it causes to the liver, however the virus affects other body systems and causes symptoms, illnesses and complications outside of the liver. Doctors have previously tended to focus mainly on the state of your liver as opposed to symptoms you feel or other complications caused by the virus because they have often been seen as unconnected or unrelated. This has meant that they have been given less attention and been studied less. The effects of Hepatitis C are described in terms of the changes to the liver as scarring develops. This progression moves from the initial inflammation of the liver caused by the virus hijacking, infecting and killing off liver cells through to the gradual scarring (fibrosis) and then hardening of liver tissue (cirrhosis). Throughout this progression the immune system plays a highly influential role both in stemming the disease but also in accelerating scarring of the liver. Cirrhosis is severe scarring that alters the structure of the liver and over time will seriously undermine the liver s ability to function. Cirrhosis is classified as being either compensated or de-compensated. If the liver can continue to carry out most of its functions despite extensive scarring then this is known as compensated cirrhosis (meaning that the liver can compensate for the damage). If the liver s functions are seriously affected then this is called decompensated cirrhosis. The most serious symptoms of this stage are: Portal Hypertension, (when blood cannot properly flow into the liver and causes bleeding from distended veins (varices) in the oesophagus and the build up of abdominal fluid (ascites) Hepatic Encephalopathy. If blood is forced to bypass the liver it is not filtered for poisons and toxins and there is risk of serious mental confusion leading to coma. Cirrhosis also significantly increases the risk of developing liver cancer. This can develop from either compensated or decompensated cirrhosis. Recent studies suggest that chronic infection with HCV will almost invariably result in cirrhosis. It is the time that this takes that varies. For those people who develop a chronic or long term infection (between 70-80% of those infected with HCV) around 20-30% will develop cirrhosis within 20 years. For some it may be quicker but for others it may take up to sixty years so they may well die of unrelated diseases beforehand. Acute Phase Hepatitis C The term Acute Phase can be confusing, because it only refers to a 6 month period of time after the virus has entered your body. It bears no relation to acuteness of symptoms, or severity of disease. Scotland

3 After the virus has entered your body there are three tests that will show or suggest its presence, HCV Antibodies, PCR and liver function tests (LFTs). Antibodies to the virus can start to be detectable in the blood between 3-12 weeks after infection. Different people s immune systems take different lengths of time to create antibodies, depending on the amount of time it takes for the virus to take hold in the body. This is called the window period. Because it can take 3 months or more for the antibodies to show up in a blood test, it is important to wait this long before having a test if you suspect you have recently been infected. Polymerase chain reaction (PCR) test may be given if infection is strongly suspected for instance if someone has had a needle stick injury then a PCR test will be worth checking 2 weeks after the injury. A PCR test becomes positive sooner than the antibody test. (But as it is more expensive is not usually the first test given). There is an average incubation period of seven to eight weeks before there may be a rise in liver enzymes levels. Liver function tests or LFT s are a set of blood tests measuring specific proteins and enzymes to see how well the liver is performing its various functions. As liver cells are damaged by the virus, enzymes leak into the bloodstream leading to a rise of specific enzyme levels. However, there is not necessarily a rise in enzyme levels even in this acute phase. Symptoms during the Acute Phase Most people do not seem to experience symptoms during the acute phase. For the 25-35% of people who do experience symptoms they are normally vague and non-specific. They can include low-grade fever, fatigue, appetite loss, abdominal pain, nausea and vomiting. About 20% of the people who develop symptoms contract jaundice which is the yellowing of the skin and the whites of the eyes. This is a sign of the liver s function being compromised as bilirubin (the pigment of bile) builds up in the body. Jaundice is a recognised sign of liver problems and as such it may lead to a test for hepatitis C being suggested. The problem for most people is that they are unaware that they have been infected because of this lack of symptoms or vagueness of them. As these symptoms are similar to many other short term infections most people are unlikely to seek medical attention. Even if they do, most doctors will not suspect or test for hepatitis C. In very rare instances some people will develop a severe form of short-term hepatitis in which the liver is rapidly and almost completely destroyed. It is usually fatal as a liver transplant cannot be organised in time. This is called fulminant hepatitis C. Spontaneous clearance of the virus during the acute phase Somewhere between 15% and 30% of people clear the virus completely during the acute phase. This is the spontaneous clearing of HCV by the immune system through elimination of all viral particles in the circulation and destruction all infected cells. Evidence of this infection in the form of antibodies to hepatitis C will possibly always remain in the body, but they will definitely remain for at least for some years. Unlike Scotland

4 some other diseases these antibodies do not provide immunity against a further HCV infection at a later date. Contributory factors to clearing hepatitis C during the acute phase It is not clear exactly why some people clear the virus while others do not, but some common factors are known: a) The younger a person is at the time of HCV infection, the more chance they have of clearing the virus b) Women are more likely to clear the virus than men. c) People who develop symptoms during the acute phase seem to have a greater chance of clearing the virus. d) A healthy immune system, particularly the T cell response to the virus, plays an important part. e) Low alcohol consumption f) Genotype. There is some evidence that people with genotype 3 have a higher chance of clearing the virus than those with genotype 1. g) The amount of virus transmitted at the time of infection. People who contracted the virus through transfusion and so have a higher viral load appear to be at greater risk of developing chronic hepatitis C than people with some other sources of infection. h) Genetics. People with certain genetic makeup are more likely to clear the virus. Does viral clearance mean absolute clearance? Some recent reports, however, have called into question the traditional understanding of viral clearance. A recent study using ultra-sensitive tests was carried out amongst a group of people who had spontaneously cleared the virus and had maintained undetectable HCV viral load in the blood with no clinical signs of hepatitis. The tests revealed the presence of HCV RNA in all participants of the study group, with the majority showing signs of active reproduction by the virus. HCV RNA was found in serum, (the liquid part of blood without the clotting factors) Dendritic cells (specialist cells of the immune system) and in some white blood cells where there were also signs of viral replication. The study is too limited to be conclusive but it challenges assumptions that resolved infections really do mean the complete eradication of HCV from the body. When does acute hepatitis C become chronic hepatitis C? The 70% to 85% of individuals who do not achieve spontaneous viral clearance are considered to be in the chronic phase of Hepatitis C after six months of infection. This is confirmed when HCV antibody testing is positive and HCV RNA viral presence is detectable on at least two occasions over a six month period. So a diagnosis of chronic hepatitis C, means you have passed the time when spontaneous viral clearance is likely or possible. The virus has won the fight for its life against the immune defences inside your body and now has taken up firm residence in your liver cells. Chronic Phase of Hepatitis C The 70% to 85% of individuals who do not manage to clear the virus spontaneously in the acute phase of infection are considered to be in the chronic phase of hepatitis C after Scotland

5 six months of infection. This is when hepatitis C becomes a chronic or long-term infection. The diagnosis of chronic hepatitis C is confirmed when HCV antibody testing is positive and HCV RNA viral presence is detectable on at least two occasions over a six month period. The intense battle that goes on inside the body during the acute stage between the virus and the immune system has been won by the virus. It is now highly unlikely that the virus can be cleared without treatment. How the disease then progresses will vary significantly from person to person. In terms of liver damage some people infected will have minimal liver damage with no scarring after many years while a few people can progress to cirrhosis (extensive scarring of the liver) within less than ten years. On average it takes about twenty years for significant liver scarring to develop. It is still a matter of debate whether chronic HCV infection inevitably leads to cirrhosis. At present it is thought that this is the case, but that for some people it may take at least 50 years or more. They may well die of other unrelated diseases or conditions before cirrhosis develops. The rate of progression of liver damage cannot be accurately determined by liver enzyme levels, viral load or by genotype tests. Symptoms people experience as with liver damage vary dramatically. Some people will have few, if any, symptoms for many years, while for others the symptoms can be severely debilitating. It was originally thought that the virus only infected liver cells. However, recently it has become clear that HCV also infects parts of the immune system and some blood cells. This means that hepatitis C is not just a liver disease but is a systemic disease, in that it can affect other organs in the body. HCV triggers damage to the liver firstly in the form of inflammation, which then leads to scarring or fibrosis of the liver. This is discussed in the sections on liver damage. Other sections include symptoms during the chronic stage and the complications that can occur outside of the liver: the extra-hepatic manifestations of the disease. How the virus affects the functions of the liver is discussed in the sections on the Liver. Symptoms during the Chronic Stage There is no set symptom pattern with hepatitis C. For some people symptoms are severe enough to significantly and consistently affect their quality of life whilst other people experience none at all. Sometimes they will be vaguely noticeable, but for many people they come and go and the severity varies. People who have cleared the virus with treatment often only realise that they were experiencing symptoms in retrospect when they are feeling better. Symptoms related to the chronic stage of the disease can include: Fatigue with non-refreshing sleep Depression Short-term memory problems Difficulty concentrating Mood swings Digestive problems Joint and muscle aches and pains Scotland

6 Headaches Flu-like symptoms Discomfort or pain in the liver area Abdominal pain. Itching Research has tended to focus on looking at liver damage rather than symptoms or associated extra-hepatic illnesses (illnesses outside of the liver). And it is only recently that the medical profession has started to accept that symptoms and associated illness are indeed caused by the virus, although the reasons for them are not totally understood yet. These symptoms are referred to by doctors as non-specific symptoms when they don t relate directly to liver damage or any of the associated illnesses the virus can trigger. The cause of many of these non-specific symptoms is not clear, but there is some evidence to show that hepatitis C may infect neural tissue and this could at least be part of an explanation for some symptoms. One study has confirmed that fatigue, depression and feelings of anger caused by HCV are more severe and more intractable than when these symptoms are experienced by people with non liver-related chronic diseases. Brain fog (confusion and impaired memory) has been reported by many people with HCV. A study amongst people with chronic hepatitis C and those who had cleared the virus showed greater cognitive impairment amongst those with chronic HCV infection. HCV has been found in cerebrospinal fluid and it is believed this might be linked to brain fog, but more research is needed to pin this link down. The study, although small, revealed several things that suggests an underlying mechanism for cognitive impairment: Those with HCV demonstrated greater cognitive impairment than those who had cleared the virus The choline/creatine ratio on MRI brain scanning was higher in this group and a significantly higher ratio was found in the white matter and basal ganglia of the brain in people with hepatitis C as opposed to hepatitis B Autopsied brain tissue showed HCV replication HCV was found in the cerebral spinal fluid of 8 out of 13 individuals. Scotland

Hepatitis A, B, C. This material is intended for insurance informational purposes only and is not personal medical advice for clients.

Hepatitis A, B, C. This material is intended for insurance informational purposes only and is not personal medical advice for clients. Hepatitis A, B, C Hepatitis is a general term referring to inflammation of the liver. The usual cause is viral, either Hepatitis A, B, or C. However, toxins and drugs may also induce a hepatitis. The onset

More information

INFORMATION ABOUT HEPATITIS C

INFORMATION ABOUT HEPATITIS C INFORMATION ABOUT HEPATITIS C PATIENT BOOKLET Index 1 About Hepatitis C About Hepatitis C Page 1 Hepatitis C Transmission Page 3 Hepatitis C Disease Progression Page 4 Hepatitis C Diagnosis and Treatment

More information

Module 1: The liver and hepatitis viruses

Module 1: The liver and hepatitis viruses Module 1: The liver and hepatitis viruses Module 1: The liver and hepatitis viruses Session goal This introductory session will provide a basis for the training programme by providing an overview of the

More information

Toronto People With AIDS Foundation. Hepatitis C & HIV. March 2011

Toronto People With AIDS Foundation. Hepatitis C & HIV. March 2011 Toronto People With AIDS Foundation Treatment Bulletin Hepatitis C & HIV March 2011 Silybum marianum (Milk thistle) Disclaimer The Treatment Resources Program at the Toronto People With AIDS Foundation

More information

Alcohol and the Liver

Alcohol and the Liver The facts about... Alcohol and the Liver Five key things you need to know This is a part of your body that regularly works overtime. The liver is our largest organ and it has 500 different roles. One of

More information

Bile Duct Diseases and Problems

Bile Duct Diseases and Problems Bile Duct Diseases and Problems Introduction A bile duct is a tube that carries bile between the liver and gallbladder and the intestine. Bile is a substance made by the liver that helps with digestion.

More information

HEPATITIS C. The Facts. Get Tested. Get Cured! Health

HEPATITIS C. The Facts. Get Tested. Get Cured! Health HEPATITIS C The Facts Get Tested. Get Cured! Health EVEN IF YOU FEEL HEALTHY, HEPATITIS C MAY BE DAMAGING YOUR LIVER. Your liver keeps you healthy in many ways, such as by removing toxins from your blood

More information

BASIC INFORMATION ABOUT HIV, HEPATITIS B and C, and TUBERCULOSIS Adapted from the CDC

BASIC INFORMATION ABOUT HIV, HEPATITIS B and C, and TUBERCULOSIS Adapted from the CDC BASIC INFORMATION ABOUT HIV, HEPATITIS B and C, and TUBERCULOSIS Adapted from the CDC HIV What are HIV and AIDS? HIV stands for Human Immunodeficiency Virus. This is the virus that causes AIDS. HIV is

More information

When to Consider Liver Transplantation for Patients with Hepatitis C

When to Consider Liver Transplantation for Patients with Hepatitis C Transcript Details This is a transcript of an educational program accessible on the ReachMD network. Details about the program and additional media formats for the program are accessible by visiting: https://reachmd.com/programs/advances-in-transplantation/when-to-consider-liver-transplantation-forpatients-with-hepatitis-c/6366/

More information

HEPATITIS C DIAGNOSIS AND MANAGEMENT

HEPATITIS C DIAGNOSIS AND MANAGEMENT HEPATITIS C DIAGNOSIS AND MANAGEMENT Introduction The hepatitis C virus (HCV) is one of six viruses (A, B, C, D, E, G) that account for the majority of cases of viral hepatitis. It is responsible for about

More information

MANAGEMENT OF LIVER CIRRHOSIS

MANAGEMENT OF LIVER CIRRHOSIS MANAGEMENT OF LIVER CIRRHOSIS Information Leaflet Your Health. Our Priority. Page 2 of 6 What is cirrhosis? Cirrhosis is a result of long-term, continuous damage to the liver and may be due to many different

More information

Commonly Asked Questions About Chronic Hepatitis C

Commonly Asked Questions About Chronic Hepatitis C Commonly Asked Questions About Chronic Hepatitis C From the American College of Gastroenterology 1. How common is the hepatitis C virus? The hepatitis C virus is the most common cause of chronic viral

More information

What you should. know

What you should. know H e p a t i t i s C What you should know Table of Contents Hepatitis C: a part of life for many people.......4 What is hepatitis C?.......................6 What does my liver do?....................8 How

More information

Hepatitis C. Laboratory Tests and Hepatitis C

Hepatitis C. Laboratory Tests and Hepatitis C Hepatitis C Laboratory Tests and Hepatitis C If you have hepatitis C, your doctor will use laboratory tests to check your health. This handout will help you understand what the major tests are and what

More information

testing and treatment

testing and treatment H e p a t i t i s C Hepatitis C information resources American Liver Foundation 75 Maiden Lane, Suite 603 New York, NY 10038 (800) GO-LIVER (465-4837) (888) 4-HEP-ABC (443-7222) http://www.liverfoundation.org

More information

DIET IN DISORDERS OF LIVER

DIET IN DISORDERS OF LIVER DIET IN DISORDERS OF LIVER See inside.. Introduction Liver diseases Dietary care & management Conclusion Introduction Liver is the largest gland in the body, which plays a vital role, performing many complex

More information

Hepatitis C Glossary of Terms

Hepatitis C Glossary of Terms Acute Hepatitis C A short-term illness that usually occurs within the first six months after someone is exposed to the hepatitis C virus (HCV). 1 Antibodies Proteins produced as part of the body s immune

More information

Metabolic Disorders , The Patient Education Institute, Inc. idg90101 Last reviewed: 08/14/2014 1

Metabolic Disorders , The Patient Education Institute, Inc.  idg90101 Last reviewed: 08/14/2014 1 Metabolic Disorders Introduction Metabolism is the process your body uses to make energy from the food you eat. Your body can use this fuel right away, or it can store the energy in your body tissues,

More information

Cirrhosis. An information guide

Cirrhosis. An information guide TO PROVIDE THE VERY BEST CARE FOR EACH PATIENT ON EVERY OCCASION Cirrhosis An information guide Cirrhosis What is cirrhosis? Cirrhosis is the result of long term, continuous damage to the liver and may

More information

HEPATITIS WEB STUDY Acute Hepatitis C Virus Infection: Epidemiology, Clinical Features, and Diagnosis

HEPATITIS WEB STUDY Acute Hepatitis C Virus Infection: Epidemiology, Clinical Features, and Diagnosis HEPATITIS WEB STUDY Acute C Virus Infection: Epidemiology, Clinical Features, and Diagnosis H. Nina Kim, MD Assistant Professor of Medicine Division of Infectious Diseases University of Washington School

More information

HBV & HCV induced. Liver Cirrhosis Iradj Maleki MD Gut & Liver Research Center Mazandaran University of Medical Sciences

HBV & HCV induced. Liver Cirrhosis Iradj Maleki MD Gut & Liver Research Center Mazandaran University of Medical Sciences HBV & HCV induced Liver Cirrhosis Iradj Maleki MD Gut & Liver Research Center Mazandaran University of Medical Sciences Definition of Cirrhosis Final pathway for a wide variety of chronic liver diseases

More information

Albumin. Prothrombin time. Total protein

Albumin. Prothrombin time. Total protein Hepatitis C Fact Sheet February 2016 www.hepatitis.va.gov Laboratory Tests and Hepatitis If you have hepatitis C, your doctor will use laboratory tests to about learn more about your individual hepatitis

More information

THE A, B, C S OF HEPATITIS. Matt Eidem, M.D. Digestive Health Associates of Texas 1600 Coit Road Suite #301 Plano, Texas 75075 (972) 867-0019

THE A, B, C S OF HEPATITIS. Matt Eidem, M.D. Digestive Health Associates of Texas 1600 Coit Road Suite #301 Plano, Texas 75075 (972) 867-0019 THE A, B, C S OF HEPATITIS Matt Eidem, M.D. Digestive Health Associates of Texas 1600 Coit Road Suite #301 Plano, Texas 75075 (972) 867-0019 WHAT IS HEPATITIS? Hepatitis means inflammation of the liver

More information

Alcoholic liver disease

Alcoholic liver disease Alcoholic liver disease Introduction Harmful drinking Harmful drinking means drinking alcohol at levels that lead to significant harm to physical and mental health, and that may cause harm to others. Women

More information

www.hepinfo.ie Are you Hep C aware? awareness information support prevention To find out more visit

www.hepinfo.ie Are you Hep C aware? awareness information support prevention To find out more visit Are you Hep C aware? awareness information support prevention To find out more visit www.hepinfo.ie What is Hepatitis C? Hepatitis C is a viral infection that affects the liver, causing it to become inflamed

More information

HEPATITIS E VIRUS AND ALLOGENIC STEM CELL TRANSPLANTATION

HEPATITIS E VIRUS AND ALLOGENIC STEM CELL TRANSPLANTATION Date 13 August 2015 Dear Colleague HEPATITIS E VIRUS AND ALLOGENIC STEM CELL TRANSPLANTATION We are seeing a significant increase in the number of reports of cases of hepatitis E virus (HEV) arising from

More information

Information about hepatitis C for patients and carers

Information about hepatitis C for patients and carers Information about hepatitis C for patients and carers What is hepatitis C? Hepatitis C is an illness caused by a virus which can be passed through blood from one person to another. It mainly affects the

More information

Autoimmune Hepatitis

Autoimmune Hepatitis Autoimmune Hepatitis National Digestive Diseases Information Clearinghouse U.S. Department of Health and Human Services NATIONAL INSTITUTES OF HEALTH What is autoimmune hepatitis? Autoimmune hepatitis

More information

Take Action Against Hepatitis C For People in Recovery From Mental Illness or Addiction

Take Action Against Hepatitis C For People in Recovery From Mental Illness or Addiction Take Action Against Hepatitis C For People in Recovery From Mental Illness or Addiction Attention treatment providers in behavioral health programs! This booklet is intended for use with clients who: Are

More information

12/2/2015 HEPATITIS B AND HEPATITIS C BLOOD EXPOSURE OBJECTIVES VIRAL HEPATITIS

12/2/2015 HEPATITIS B AND HEPATITIS C BLOOD EXPOSURE OBJECTIVES VIRAL HEPATITIS HEPATITIS B AND HEPATITIS C BLOOD EXPOSURE DISEASE 101 ONLINE CONFERENCE SARAH WENINGER, MPH VIRAL HEPATITIS.STD.HIV PREVENTION COORDINATOR DECEMBER 3, 2015 OBJECTIVES Describe the populations that should

More information

Alcoholic hepatitis describes liver inflammation caused by drinking alcohol.

Alcoholic hepatitis describes liver inflammation caused by drinking alcohol. visited on Page 1 of 9 Diseases and Conditions Alcoholic hepatitis By Mayo Clinic Staff Alcoholic hepatitis describes liver inflammation caused by drinking alcohol. Though alcoholic hepatitis is most likely

More information

Hepatitis C - genotype 2/3

Hepatitis C - genotype 2/3 Hepatitis C - genotype 2/3 Information for you Follow us on Twitter @NHSaaa Find us on Facebook at www.facebook.com/nhsaaa Visit our website: www.nhsaaa.net All our publications are available in other

More information

Hepatitis C treatment What to expect.

Hepatitis C treatment What to expect. Hepatitis C treatment What to expect. Anne Glass Hepatitis Clinical Nurse Consultant Liver Clinic SSWAHS Bankstown and Liverpool Hospital Contact 87384074 Monday -Friday What s hepatitis? Hepatitis means

More information

RITUXIMAB (Rituxan) Rituximab 2007 Page 1 of 5

RITUXIMAB (Rituxan) Rituximab 2007 Page 1 of 5 RITUXIMAB (Rituxan) Rituximab is FDA approved for the treatment of low-grade or follicular CD20-positive, B-cell non-hodgkin's lymphoma (NHL); treatment of diffuse large B-cell CD20-positive NHL; treatment

More information

Alcohol Liaison Service. Liver Disease. Information

Alcohol Liaison Service. Liver Disease. Information Alcohol Liaison Service Liver Disease Information Introduction Most liver diseases do not show symptoms and when they do, the symptoms are often vague. There are hundreds of liver disorders and some are

More information

HEPATITIS A, B, AND C

HEPATITIS A, B, AND C HEPATITIS A, B, AND C INTRODUCTION Hepatitis is a medical term that means infection and inflammation of the liver, and hepatitis is caused by infection with a virus. There are seven types of hepatitis,

More information

Beginner's guide to Hepatitis C testing and immunisation against hepatitis A+B in general practice

Beginner's guide to Hepatitis C testing and immunisation against hepatitis A+B in general practice Beginner's guide to Hepatitis C testing and immunisation against hepatitis A+B in general practice Dr Chris Ford GP & SMMGP Clinical Lead Kate Halliday Telford & Wrekin Shared Care Coordinator Aims Discuss:

More information

Newly Diagnosed: HEPATITIS C. American Liver Foundation Support Guide

Newly Diagnosed: HEPATITIS C. American Liver Foundation Support Guide Newly Diagnosed: HEPATITIS C American Liver Foundation Support Guide T he American Liver Foundation's mission is to facilitate, advocate, and promote education, support, and research for the prevention,

More information

What you need to know about hepatitis C when you have HIV

What you need to know about hepatitis C when you have HIV What you need to know about hepatitis C when you have HIV Where patients matter Table of Contents Introduction................................4 What is Hep C?.............................5 Why is my liver

More information

NUTRITION IN LIVER DISEASES

NUTRITION IN LIVER DISEASES NUTRITION IN LIVER DISEASES 1. HEPATITIS: Definition: - Viral inflammation of liver cells. Types: a. HAV& HEV, transmitted by fecal-oral route. b. HBV & HCV, transmitted by blood and body fluids. c. HDV

More information

Addendum. Issue 1: Clarification of risk for infection if you get poked with a needle or cut with an instrument and the person has hepatitis B

Addendum. Issue 1: Clarification of risk for infection if you get poked with a needle or cut with an instrument and the person has hepatitis B Public Health and Primary Health Care Division Communicable Disease Control 4 th Floor, 300 Carlton St, Winnipeg, MB R3B 3M9 T 204 788-6737 F 204 948-2040 www.manitoba.ca July 4, 2012 Addendum Issue 1:

More information

Viral Liver Disease. The Liver and Its Functions

Viral Liver Disease. The Liver and Its Functions Viral Liver Disease The Liver and Its Functions The liver, the body's largest organ weighing about three pounds, is located on the right side of the abdomen, protected by the lower rib cage. It is responsible

More information

Ribavirin/Pegylated Interferon Combination Therapy for People with Hepatitis C

Ribavirin/Pegylated Interferon Combination Therapy for People with Hepatitis C Ribavirin/Pegylated Combination Therapy for People with Hepatitis C 1. Introduction 2. What the treatment does 3. When to take it 4. What is? 5. What is interferon? 6. What is pegylated interferon? 7.

More information

Sepsis: What You Should Know

Sepsis: What You Should Know Issues & Answers Sepsis: What You Should Know Answers to your questions about what it is and how it is treated in the ICU. 2003 SCCM Your doctor or the intensivist (a doctor with special expertise and

More information

a series of fact sheets written by experts in the field of liver disease HCV DISEASE PROGRESSION

a series of fact sheets written by experts in the field of liver disease HCV DISEASE PROGRESSION www.hcvadvocate.org HCSP FACT SHEET Symptoms & Complications of Cirrhosis Foreword After many years of infection with hepatitis C the liver can become severely scarred. The process starts with inflammation

More information

LUPUS. and the Brain LUPUSUK 2015

LUPUS. and the Brain LUPUSUK 2015 12 LUPUS and the Brain LUPUSUK 2015 LUPUS and the Brain This factsheet endeavours to answer some of the many questions asked regarding lupus and the brain. Doctors throughout the world are now recognising

More information

Cirrhosis of the liver

Cirrhosis of the liver Cirrhosis of the liver Fighting liver disease Cirrhosis of the liver The liver Your liver is your body s factory, carrying out hundreds of jobs that are vital for life. You only have one liver, but it

More information

Gallbladder Diseases and Problems

Gallbladder Diseases and Problems Gallbladder Diseases and Problems Introduction Your gallbladder is a pear-shaped organ under your liver. It stores bile, a fluid made by your liver to digest fat. There are many diseases and problems that

More information

Update on Hepatitis C. Sally Williams MD

Update on Hepatitis C. Sally Williams MD Update on Hepatitis C Sally Williams MD Hep C is Everywhere! Hepatitis C Magnitude of the Infection Probably 8 to 10 million people in the U.S. are infected with Hep C 30,000 new cases are diagnosed annually;

More information

Understanding How Existing and Emerging MS Therapies Work

Understanding How Existing and Emerging MS Therapies Work Understanding How Existing and Emerging MS Therapies Work This is a promising and hopeful time in the field of multiple sclerosis (MS). Many new and different therapies are nearing the final stages of

More information

Hepatic Encephalopathy

Hepatic Encephalopathy Hepatic Encephalopathy Hepatic Encephalopathy (HE) can occur as a result of either acute liver failure or chronic liver disease. The information provided below explains HE in adults and is intended to

More information

Treating Chronic Hepatitis C. A Review of the Research for Adults

Treating Chronic Hepatitis C. A Review of the Research for Adults Treating Chronic Hepatitis C A Review of the Research for Adults Is This Information Right for Me? Yes, this information is right for you if: Your doctor* has told you that you have chronic hepatitis C.

More information

Liver Enzymes. AST and ALT (Transaminases)

Liver Enzymes. AST and ALT (Transaminases) Liver Enzymes Four separate liver enzymes are included on most routine laboratory tests. They are- aspartate aminotransferase (AST or SGOT) and alanine aminotransferase (ALT or SGPT), which are known together

More information

Hepatitis C. Screening, Diagnosis and Linkage to Care

Hepatitis C. Screening, Diagnosis and Linkage to Care Hepatitis C Screening, Diagnosis and Linkage to Care Diagnosis If your hepatitis C antibody test is reactive, a second test will be needed to diagnose and determine if you are currently infected. Screening

More information

Transmission of HCV in the United States (CDC estimate)

Transmission of HCV in the United States (CDC estimate) Transmission of HCV in the United States (CDC estimate) Past and Future US Incidence and Prevalence of HCV Infection Decline among IDUs Overall incidence Overall prevalence Infected 20+ years Armstrong

More information

The Hepatitis B virus (HBV)

The Hepatitis B virus (HBV) The Hepatitis B virus (HBV) There are 400 million people in the world who live with chronic hepatitis B, including France. Most people don t even know they are infected. But there are several important

More information

Liver Cancer And Tumours

Liver Cancer And Tumours Liver Cancer And Tumours What causes liver cancer? Many factors may play a role in the development of cancer. Because the liver filters blood from all parts of the body, cancer cells from elsewhere can

More information

Liver disease. When to see a doctor. Diseases and Conditions

Liver disease. When to see a doctor. Diseases and Conditions Diseases and Conditions Liver disease By Mayo Clinic Staff The liver is an organ about the size of a football that sits just under your rib cage on the right side of your abdomen. The liver is essential

More information

2014 Fatty Liver Disease

2014 Fatty Liver Disease 2014 Fatty Liver Disease Fatty Liver Disease Fatty liver disease happens when there is a buildup of extra fat cells in the liver. A liver is fatty when fat makes up 5-10% of the liver. Simple fatty liver

More information

The Facts You Need To Know. Developed by

The Facts You Need To Know. Developed by The Facts You Need To Know Developed by TODAY YOU LL FIND OUT What s the big deal about the liver? What is hepatitis???? Common types of viral hepatitis How can I protect myself from viral hepatitis? What

More information

Multiple Myeloma. This reference summary will help you understand multiple myeloma and its treatment options.

Multiple Myeloma. This reference summary will help you understand multiple myeloma and its treatment options. Multiple Myeloma Introduction Multiple myeloma is a type of cancer that affects white blood cells. Each year, thousands of people find out that they have multiple myeloma. This reference summary will help

More information

Hepatitis C Infections in Oregon September 2014

Hepatitis C Infections in Oregon September 2014 Public Health Division Hepatitis C Infections in Oregon September 214 Chronic HCV in Oregon Since 25, when positive laboratory results for HCV infection became reportable in Oregon, 47,252 persons with

More information

Sepsis. Introduction. Sepsis, septicaemia and blood poisoning

Sepsis. Introduction. Sepsis, septicaemia and blood poisoning Sepsis Introduction Sepsis, septicaemia and blood poisoning Sepsis is often referred to as either blood poisoning or septicaemia, although it could be argued that both terms are not entirely accurate.

More information

A handbook for people who have injected drugs

A handbook for people who have injected drugs A handbook for people who have injected drugs Introduction This handbook has been written for current and ex-drug injectors. It gives information and advice about the hep C virus, and the tests you can

More information

A Definition of Multiple Sclerosis

A Definition of Multiple Sclerosis English 182 READING PRACTICE by Alyx Meltzer, Spring 2009 Vocabulary Preview (see bolded, underlined words) gait: (n) a particular way of walking transient: (adj) temporary; synonym = transitory remission:

More information

The Liver and Alpha-1. Antitrypsin Deficiency (Alpha-1) 1 ALPHA-1 FOUNDATION

The Liver and Alpha-1. Antitrypsin Deficiency (Alpha-1) 1 ALPHA-1 FOUNDATION The Liver and Alpha-1 Antitrypsin Deficiency (Alpha-1) 1 ALPHA-1 FOUNDATION What Is Alpha-1 Antitrypsin Deficiency? Alpha-1 is a condition that may result in serious lung disease in adults and/or liver

More information

A guide for people with hepatitis C-related cirrhosis

A guide for people with hepatitis C-related cirrhosis A guide for people with hepatitis C-related cirrhosis Living with cirrhosis is published by Hepatitis Australia as part of the National Hepatitis C Education Program, funded by the Australian Department

More information

Viral Hepatitis A, B, and C

Viral Hepatitis A, B, and C Viral Hepatitis A, B, and C What is Hepatitis? Hepatitis means inflammation of the liver Elizabeth A. Bancroft, MD, SM Acute Communicable Disease Control County of Los Angeles Department of Public Health

More information

1.How did I get Hepatitis C?

1.How did I get Hepatitis C? 1.How did I get Hepatitis C? Sharing needles and syringes ( iv drug use ) or using contaminated straws to snort cocaine Reused needles or medications in a health care setting- (LV endoscopy outbreak, glucometers

More information

Depression in Older Persons

Depression in Older Persons Depression in Older Persons How common is depression in later life? Depression affects more than 6.5 million of the 35 million Americans aged 65 or older. Most people in this stage of life with depression

More information

Liver Cancer What is the liver? What is liver cancer?

Liver Cancer What is the liver? What is liver cancer? Liver Cancer What is the liver? The liver is the largest internal organ in the body and is important in digesting food. The liver performs many other functions, including collecting and filtering blood

More information

Ansh. Liver Clinic. Prevention to Cure. Dr. Jayshri A. Shah. Dr. Ankur J. Shah. For Appointments : l

Ansh. Liver Clinic. Prevention to Cure. Dr. Jayshri A. Shah. Dr. Ankur J. Shah. For Appointments : l (Division of ANSH MEDICARE SOLUTIONS PVT. LTD.) CIN : U74999MH2016PTC284829 Dr. Jayshri A. Shah MD, DNB, MNAMS, MRCP (UK), CCST (UK) Consultant Hepatologist, Gastroenterologist, Endoscopist Dr. Ankur J.

More information

english facts about hepatitis A, B and C

english facts about hepatitis A, B and C english facts about hepatitis A, B and C What is hepatitis? Hepatitis means inflammation of the liver. Many viruses can cause liver inflammation, including the hepatitis A, B and C viruses. Some people

More information

Acute Myeloid Leukemia

Acute Myeloid Leukemia Acute Myeloid Leukemia Introduction Leukemia is cancer of the white blood cells. The increased number of these cells leads to overcrowding of healthy blood cells. As a result, the healthy cells are not

More information

BE SURE. BE SAFE. VACCINATE.

BE SURE. BE SAFE. VACCINATE. DON T GET OR GIVE THE FLU THIS YEAR THANK YOU Vaccination is the only protection. www.immunisation.ie BE SURE. BE SAFE. VACCINATE. FLU VACCINE 2013-2014 Healthcare workers prevent the spread of flu and

More information

Liver Disease & Hepatitis Program Providers: Brian McMahon, MD, Steve Livingston, MD, Lisa Townshend, ANP. Primary Care Provider:

Liver Disease & Hepatitis Program Providers: Brian McMahon, MD, Steve Livingston, MD, Lisa Townshend, ANP. Primary Care Provider: Liver Disease & Hepatitis Program Providers: Brian McMahon, MD, Steve Livingston, MD, Lisa Townshend, ANP Primary Care Provider: If you are considering hepatitis C treatment, please read this treatment

More information

LIVER CANCER AND TUMOURS

LIVER CANCER AND TUMOURS LIVER CANCER AND TUMOURS LIVER CANCER AND TUMOURS Healthy Liver Cirrhotic Liver Tumour What causes liver cancer? Many factors may play a role in the development of cancer. Because the liver filters blood

More information

Global Patient Survey. Country-Specific Report Egypt

Global Patient Survey. Country-Specific Report Egypt Global Patient Survey Country-Specific Report Egypt HCV Quest Country-Specific Report The biggest barrier I have faced in the fight against viral hepatitis is... Waiting for the new medication and fear

More information

HCSP TRAINING MANUAL

HCSP TRAINING MANUAL HCSP TRAINING MANUAL SECTION II: THE LIVER Alan Franciscus, Editor-in-Chief The information in this guide is designed to help you understand and manage HCV and is not intended as medical advice. All persons

More information

Liver Function Essay

Liver Function Essay Liver Function Essay Name: Quindoline Ntui Date: April 20, 2009 Professor: Dr. Danil Hammoudi Class: Anatomy and Physiology 2 Liver function The human body consist of many highly organize part working

More information

Viral Hepatitis Serology Tests

Viral Hepatitis Serology Tests Test Code Test Name CPT HBCOR Hepatitis B Core Total Antibody 86704 (HBcAb) HBCAB Hepatitis B Core Antibody IgM 86705 (HBcAb IgM) HBSAB Hepatitis B Surface Antibody 86706 (HBsAb) HBEAB Hepatitis Be Antibody

More information

Common Infectious Diseases. Chapter 28 Lesson 2

Common Infectious Diseases. Chapter 28 Lesson 2 Common Infectious Diseases Chapter 28 Lesson 2 Respiratory Infections Respiratory tract infections are infections of the breathing passages, which range from the nose to the alveoli of the lungs. Most

More information

What does Hepatitis C mean to me as a CKD Patient?

What does Hepatitis C mean to me as a CKD Patient? What does Hepatitis C mean to me as a CKD Patient? Clinical Practice Guidelines for the Prevention, Diagnosis, Evaluation and Treatment of Hepatitis C in CKD Introduction Worldwide, about 170 million people

More information

Goals of Therapy. Treatment Options for Hepatitis C. Patterns of Response. Progress in Hepatitis C Therapy

Goals of Therapy. Treatment Options for Hepatitis C. Patterns of Response. Progress in Hepatitis C Therapy Treatment Options for Hepatitis C Helen S. Te, M.D. Center for Liver Diseases University of Chicago Hospitals Chicago, Illinois Primary: To eliminate the virus Goals of Therapy Secondary: To decrease inflammation

More information

Information about. Hepatitis C. What is Hepatitis C? Who should be tested for Hepatitis C?

Information about. Hepatitis C. What is Hepatitis C? Who should be tested for Hepatitis C? Information about Hepatitis C What is Hepatitis C? Hepatitis C is an infectious disease affecting the liver, caused by the Hepatitis C virus (HCV). Hepatitis C is now thought to be the most common cause

More information

Methamphetamine. Like heroin, meth is a drug that is illegal in some areas of the world. Meth is a highly addictive drug.

Methamphetamine. Like heroin, meth is a drug that is illegal in some areas of the world. Meth is a highly addictive drug. Methamphetamine Introduction Methamphetamine is a very addictive stimulant drug. People who use it can form a strong addiction. Addiction is when a drug user can t stop taking a drug, even when he or she

More information

Alanine aminotransferase test

Alanine aminotransferase test Alanine aminotransferase test Also known as: Serum glutamic-pyruvic transaminase, SGPT or ALT The alanine aminotransferase test, also known as ALT, is one of a group of tests known as liver function tests

More information

Understanding Cirrhosis of the Liver: First steps for the newly diagnosed

Understanding Cirrhosis of the Liver: First steps for the newly diagnosed Understanding Cirrhosis of the Liver: First steps for the newly diagnosed 1 3 Cirrhosis Basics 3 I was told I have cirrhosis 4 What is cirrhosis? 5 What causes cirrhosis? 6 Symptoms, Monitoring your Liver

More information

Hepatitis C: Tests and Treatments

Hepatitis C: Tests and Treatments This Fact Sheet provides a summary of information about tests and treatment for people with hepatitis C virus (HCV). If you are looking for specific information about treatment with Pegylated Interferon/Ribavirin

More information

PATIENT INFORMATION INSURANCE INFORMATION

PATIENT INFORMATION INSURANCE INFORMATION (mm/dd/yyyy): Have you been to Physicians Urgent Care before? Yes No Arrival Time: If yes, when? Is this a follow-up to a previous visit: Yes No PATIENT INFORMATION Patient s First Name: Middle Name: Last

More information

PREGNANCY AND THE LIVER

PREGNANCY AND THE LIVER Imtiaz Alam, M.D. Phone: [512] 719-4370 Mandy Mishra, CNS Fax: [512] 719-4371 Austin Hepatitis Center 12201, Renfert Way Suite 235 Austin, TX 78758 PREGNANCY AND THE LIVER How does pregnancy affect the

More information

National Digestive Diseases Information Clearinghouse

National Digestive Diseases Information Clearinghouse Cirrhosis National Digestive Diseases Information Clearinghouse U.S. Department of Health and Human Services NATIONAL INSTITUTES OF HEALTH What is cirrhosis? Cirrhosis is a condition in which the liver

More information

Thinking about donating stem cells or bone marrow? Information for potential donors

Thinking about donating stem cells or bone marrow? Information for potential donors Thinking about donating stem cells or bone marrow? Information for potential donors From the Bone Marrow Transplant Team at Hamilton Health Sciences, 2015. Thinking about donating stem cells? Reading this

More information

Exposure. What Healthcare Personnel Need to Know

Exposure. What Healthcare Personnel Need to Know Information from the Centers for Disease Control and Prevention National Center for Infectious Diseases Divison of Healthcare Quality Promotion and Division of Viral Hepatitis For additional brochures

More information

LYME DISEASE CO-INFECTIONS

LYME DISEASE CO-INFECTIONS LYME DISEASE CO-INFECTIONS Co-Infections Babesiosis Ehrliciosis Bartonella Mycoplasma/Anaplasma And More Dirty Tick The condition where a tick carries other infections in addition to Lyme Disease, the

More information

Combating Hepatitis B & Hepatitis C in Rwanda

Combating Hepatitis B & Hepatitis C in Rwanda Combating Hepatitis B & Hepatitis C in Rwanda BY MINNIE KARANJA Hepatitis is not a commonplace disease. However, there have been rising cases of Hepatitis B and Hepatitis C infections and related deaths

More information

>PREPARING FOR TESTING HEPATITIS C

>PREPARING FOR TESTING HEPATITIS C >PREPARING FOR TESTING HEPATITIS C Are you thinking of being tested for? ( 2 ) If you are thinking about being tested for hepatitis C, this booklet provides answers to these questions: What is hepatitis

More information

Using Electronic Medical Record Decision Support to Increase Testing for Hepatitis C

Using Electronic Medical Record Decision Support to Increase Testing for Hepatitis C Using Electronic Medical Record Decision Support to Increase Testing for Hepatitis C Camilla S. Graham, MD, MPH Division of Infectious Diseases Beth Israel Deaconess Medical Center None Disclosures Advantages

More information

Brain Cancer. This reference summary will help you understand how brain tumors are diagnosed and what options are available to treat them.

Brain Cancer. This reference summary will help you understand how brain tumors are diagnosed and what options are available to treat them. Brain Cancer Introduction Brain tumors are not rare. Thousands of people are diagnosed every year with tumors of the brain and the rest of the nervous system. The diagnosis and treatment of brain tumors

More information

Amylase and Lipase Tests

Amylase and Lipase Tests Amylase and Lipase Tests Also known as: Amy Formal name: Amylase Related tests: Lipase The Test The blood amylase test is ordered, often along with a lipase test, to help diagnose and monitor acute or

More information