acute hepatis c 2012

7/23/2019 Acute Hepatis C 2012

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Acute viral hepatitis C

Hepatitis C is an infectious disease affecting primarily the liver,

caused by the hepatitis C virus (HCV)

Extrahepatic manifestations:-Cryoglobulinemia,

-Glomerulonephritis

- Sjogren syndrome

- Hashimoto thyroiditis

http://en.wikipedia.org/wiki/Infectious_disease

http://en.wikipedia.org/wiki/Liver

http://en.wikipedia.org/wiki/Liver

http://en.wikipedia.org/wiki/Infectious_disease



Etiology

Hepatitis C virus is a small (55–65 nm in size), enveloped,positive-sense single-stranded RNA virus of the familFlaviviridae, genus Hepacivirus!

"even genotpes (#-$) %ith several su&tpes %ithin ea'h genotpe!"u&tpes are further &roen do%n into uasispe'ies &ased on their

geneti' diversit! "u&tpes #a and #& are found %orld%ide and 'ause 6*+ of all 'ases enotpes # and are less responsive to interferon-&ased treatment

than are the other genotpes (., /, 5 and 6) "ustained virologi'al responses o''ur in $*+ of genotpe # 'ases,

01*+ of genotpes . and /! In Romania genotype is predominant



HCV population attributable ris! percent for liver canceris"

– #$ in Italy and %#$ in Romania

&he prevalence of HCV infection in Romania (') range

bet*een +'+$ to %$ in comparison *ith -$ . $ inthe E/

&he prevalence of H0s Ag is --$



Clinical features of acuteClinical features of acute HCHC

IncubationIncubation average 1.# *!saverage 1.# *!s

2imit2imits '.'1 *!ss '.'1 *!s

Acute disease (3aundice)Acute disease (3aundice) 4ild4ild ((55'$)'$)6atality rate of acute disease6atality rate of acute disease Very lo*Very lo*

Chronic infectionChronic infection 1$.7-$1$.7-$



Predictive factors for chronicPredictive factors for chronicdiseasedisease

Alcohol consumption Alcohol consumption

Age > 40 years when acute disease occurs Age > 40 years when acute disease occurs

HIV co-infectionHIV co-infection

OthersOthers malesmales persistent H!V infectionpersistent H!V infection



Acute viral hepatitis " - "ase definition- Acute viral hepatitis " - "ase definition-

surveillancesurveillanceClini'al 2resentationClini'al 2resentation An a'ute illness %ith a dis'rete onset of an sign or smptom 'onsistent %ith a'ute viral hepatitisAn a'ute illness %ith a dis'rete onset of an sign or smptom 'onsistent %ith a'ute viral hepatitis

(e!g!, anore3ia, a&dominal dis'omfort, nausea, vomiting)(e!g!, anore3ia, a&dominal dis'omfort, nausea, vomiting)

AN4, eitherAN4, either

a) aundi'edar urine 7R &) serum alanine aminotransferase (A89) levels :** ;<8!a) aundi'edar urine 7R &) serum alanine aminotransferase (A89) levels :** ;<8!

8a&orator 'riteria for diagnosis8a&orator 'riteria for diagnosis

7ne or more of the follo%ing three 'riteria=7ne or more of the follo%ing three 'riteria=

a) Anti&odies to hepatitis C virus (anti-HC>) s'reening-test-positive!a) Anti&odies to hepatitis C virus (anti-HC>) s'reening-test-positive! 7R7R

&) Hepatitis C >irus Re'om&inant ;mmuno&lot Assa (HC> R;?A) positive&) Hepatitis C >irus Re'om&inant ;mmuno&lot Assa (HC> R;?A) positive

7R7R

') Nu'lei' A'id 9est (NA9) for HC> RNA positive (in'luding genotpe)') Nu'lei' A'id 9est (NA9) for HC> RNA positive (in'luding genotpe)

AN4, meets the follo%ing t%o 'riteria=AN4, meets the follo%ing t%o 'riteria=

@@ ;g anti&od to hepatitis A virus (;g anti-HA>) negative;g anti&od to hepatitis A virus (;g anti-HA>) negative

AN4AN4@ ;g anti&od to hepatitis ? 'ore antigen (;g anti-H?') negative@ ;g anti&od to hepatitis ? 'ore antigen (;g anti-H?') negative

Case 'lassifi'ation=Case 'lassifi'ation=



8elf.limited acute viral hepatitis C

8ymptoms 9:.

&

i t r e

anti.HCV

A2&

;ormal

' + % - 1 ' + %

yearsmonths

HCV R;A



8ymptoms9:.

&

i t e r

anti.HCV

A2&

;ormal

' + % - 1 ' + %

<ears4onths

HCV R;A

"hronic hepatitis ""hronic hepatitis "



H"V e#posuresH"V e#posures

iivv$ drug addiction$ drug addiction %ransfusions &in the pre testing era'%ransfusions &in the pre testing era' Occupational e#posureOccupational e#posure VerticalVertical transmission - H"V infected mother transmission - H"V infected mother (e#ual(e#ual

)ultiple partners)ultiple partners



Occupational transmission of H"VOccupational transmission of H"V

Very lowVery low

#!B+-/+#!B+-/+ after e#posure to an H"V infectedafter e#posure to an H"V infectedsourcesource

Very rarely through splashes on mucosaVery rarely through splashes on mucosa )edical staff - *-+ , H"V prevalence)edical staff - *-+ , H"V prevalence



H"VH"V in (Ain (A

8e=ual -$

>ther $?

/n!no*n $

In3ecting drug use 1$

&ransfusion $(before screening)

? ;osocomial@ iatrogenic@ perinatal

8ource" Centers for isease Control and Brevention

>ccupational %$



Ponderea şi distribuţia HAtip C prezumtivnosocomiale 1998!""#

Ponderea şi distribuţia

HAV tip C prezumtivnosocomiale !""$!""9



Hepatita acuta tip " .00/-.00Hepatita acuta tip " .00/-.00

Hepatita C noso'omialHepatita C noso'omial RaportRaport== ?? DDE *,B6E *,B6

>>FFrsta=rsta= BB #,6#,6 ani (pE*,***5)ani (pE*,***5)

Hepatita C 'FGtigat n 'omunitateHepatita C 'FGtigat n 'omunitate

>Frsta>FrstaE /BE /B,,5B5B #B#B,,1111 aniani

Raport ?Raport ? D E# D E#,,// .**5- Cluster noso'omial de #6.**5- Cluster noso'omial de #6

'azuri 'u instrumentare urologi'a'azuri 'u instrumentare urologi'a

.**5 – alte #B 'azuri 'u transmiter.**5 – alte #B 'azuri 'u transmiter'erta noso'omial'erta noso'omial in servi'iiin servi'ii'hirurgi'ale (in'lusiv . 'azuri la'hirurgi'ale (in'lusiv . 'azuri la

personal medi'al)personal medi'al)!!



.00/- "luster nosocomial.00/- "luster nosocomial de hepatit1 acut1 tip "de hepatit1 acut1 tip " *2*2

ca3uri cu instrumentare urologicca3uri cu instrumentare urologic11

"lu-5apoca"lu-5apoca "au3a6"au3a6 flacoane multido31 de heparin1 manipulateflacoane multido31 de heparin1 manipulate

incorectincorect

7fect67fect6 %ratamentul cu interferon%ratamentul cu interferon 88 .a.a timp de .4 detimp de .4 de

s1pt1m9ni &s1pt1m9ni &/ ):3i 4 s/ ):3i 4 s1pt1m9ni apoi +#/) ;nc1 .01pt1m9ni apoi +#/) ;nc1 .0

s1pt1m9ni's1pt1m9ni' aa pacien pacien<i dintre care<i dintre care == &cu v9rsta su /0&cu v9rsta su /0

de ani' au r1spuns la tratament cu ;ncarc1tur1 viral1de ani' au r1spuns la tratament cu ;ncarc1tur1 viral1

nedetectaila la 2 luni?nedetectaila la 2 luni?

@@ pacien<i nu au eneficiat de tratament etiologic cupacien<i nu au eneficiat de tratament etiologic cu

vindecarevindecare spontanspontan1 &cu v9rsta su 4/ ani'$1 &cu v9rsta su 4/ ani'$



isB reductionisB reduction niversal testing of lood and organ donorsniversal testing of lood and organ donors Virus inactivation in lood productsVirus inactivation in lood products "ounseling"ounseling

isB evaluationisB evaluation &d&drug addicts? se#ual ehavior at risB'rug addicts? se#ual ehavior at risB'

H!V vaccinationH!V vaccination &&not for H"V protectionnot for H"V protection''

(afe inection techniCues(afe inection techniCues

Brevention and control

44R 7@%# (;o RR.)



"ounseling H"V infected individuals"ounseling H"V infected individuals

5o lood donation5o lood donation

Do not share personal oects and shouldDo not share personal oects and shouldinform the medical staff aout eing H"Vinform the medical staff aout eing H"Vinfectedinfected

"overs the sBin arasions and lesions"overs the sBin arasions and lesions

Avoidance of blood e=posures

acute hepatis c 2012

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