Download - Hepatitis A, B, C & HIV presentation (2011)
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Hepatitis A, B, C and HIV
The Hepatitis Education Project
Seattle, Washington
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Topics of Discussion
What is hepatitis?
How are the hepatitis viruses different?
How is HIV/AIDS similar to the hepatitis viruses?
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Goals
Increase awareness and understanding Prevent transmission Educate patients about care and treatment
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Ground Rules
Open and interactive Educational focus Respectful and attentive No medical diagnosis
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Liver Function
“Hepa” means liver; “itis” means inflammation
2nd largest organ Performs over 500
different functions Lacks nerve
endings Able to regenerate
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Hepatitis - caused by many different agents:
Viruses Alcohol Drugs/prescriptions Herbs Genetic disorders Obesity
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Hepatitis Viruses
Hep A Fecal-oral transmission Contaminated food & water
Hep B Blood & bodily fluids
Hep C: Blood
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Some Similarities:HIV and Hep B
Transmitted via contaminated blood & bodily fluids
Risk of sexual transmission is high More easily transmitted through sex than
hep C
There is no cure for HIV or hepatitis B
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Hepatitis B
Vaccine preventable In the U.S. most adults get over this infection on
their own (90-95%) People infected for a long time have a higher risk
of getting liver cancer Liver cancer possible before cirrhosis (unlike HCV) Liver cancer screening is important
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Protect Yourself
Get immunized against Hep A and Hep B
Practice good hygiene Wash your hands with soap
& water
Practice safer sex with any new partner Use condoms
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Hepatitis C
Hepatitis C is a virus transmitted via contaminated blood
There is NO VACCINE It is very common U.S. and Worldwide
About 4-5 million Hep C+ people in the U.S. About 200 million Hep C+ people in the World
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How do people get infected with hepatitis C?
Injection drug use Tattoos (especially in jail or
prison, street tattoos) Blood transfusions (pre-1992) Intranasal drug use
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Lower Risks of Exposure
Sexual transmission Mother-to-child at birth (3-5%) Sharing personal hygiene tools
Toothbrushes, razors, nail clippers Occupational exposure
Firefighters, healthcare workers Fighting
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Drug Use is #1
Sharing any drug equipment can pass Hep C and Hep B “works” – needles, syringes, cottons, cookers,
pipes, straws, rinse water, etc.
Cleaning with bleach is preferred, but isn’t reliable against hepatitis viruses
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Tattoos
Tattoos done in prison or jail are the most risky
Best protection: get tattoos at licensed shops (autoclave, disposable inks and needles)
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How will I know if I have Hep C?
Get tested First blood test looks for exposure. This is called
an Antibody test. Second blood test looks for virus. This is called a
PCR or confirmatory test.
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100 People
25% Resolve 75% Chronic
Natural History of Hep C
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100 People
Resolve (25) Chronic (75)
Stable (34) Cirrhosis (41)
Mortality (25)
Liver Cancer (10)
Natural History of Hep C
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Long-term effects of viral hepatitis Healthy livers are
plump and smooth Cirrhotic livers are
nodular; bumpy and shrunken
HCV is the leading cause of liver transplant in the U.S.
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Dangerous Combinations
Alcohol + Hep C
HIV + Hep C
Hep B + Hep C
These can cause much worse & much faster liver damage
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Symptoms of Hep C
Most people have no symptoms.
Symptoms can include: Fatigue (frequently tired) Memory or concentration problems (brain fog) Joint pains Insomnia (can’t sleep) Depression
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Liver Biopsy
Gives you a scar stage, a rating of the amount of scarring
Stages of scarring: Stage 0: No scarring Stage 1: Mild Stage 2: Moderate scarring, Treatment maybe Stage 3: Bridging fibrosis, Treatment yes! Stage 4: Cirrhosis, Treatment yes! (if liver can tolerate)
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Types of Hep C
Hepatitis C is like a family with 6 different brothers or sisters.
These “siblings” represent the different genotypes of Hep C
In the U.S. we see mainly 3 different genotypes: Genotype 1: needs one year of treatment, by far
the most common type in the U.S. Genotype 2 or 3: needs six months of treatment
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Is there a cure?
Yes, for many but not all.
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Cure rates for Hep C
After 6-12 months of treatment about 70-80% of people will be cured
If HCV- after 4 weeks, cure rate is 90%+
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Hep C Treatment
Combination of 3 drugs: interferon, ribavirin and a protease inhibitor
Treatment Goals Kill the virus Stop scarring of the liver Prevent cirrhosis Get rid of the fatigue and other symptoms
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Interferon
Interferon is an injection given just under the skin 3 times per week Pegylated interferon is injected once a week.
Fever Headache Nausea
Diarrhea Hair Thinning Thyroid
Problems
Side Effects: Depression Irritability Fatigue
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Ribavirin
Ribavirin is a pill taken twice a day
Anemia “low blood”, makes a person feel tired
Rash
Insomnia
Loss of appetite
Cough
Side Effects:
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Protease Inhibitors Two new drugs:
Telaprevir Boceprevir
Both are oral medications taken every 8 hrs Both were added to IFN/riba treatment in 2011
Side Effects:
Telaprevir – main side effect: Rash
Boceprevir – main side effect: Anemia
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Alternatives to TreatmentMay be useful for easing side effects
Complimentary/ alternative treatments Massage therapy Prayer & meditation Naturopathic medicine Herbal medicine*
Milk thistle Yoga Aroma therapy Acupuncture
Herbs that may be harmful to the liver* Heliotropium Skullcap Jin Bu Huan Germander Sassafras Comfrey Senna Valerian Pennyroyal
Sources: NIH, NCCAM, May 2000
Hepatitis C Support Project, www.hcvadvocate.org, August 2011
*Caution should be taken in the use of herbals
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If you have Hep C, you should NOT…
Share needles or “works” Share tattoo equipment Share razors, nail clippers or
toothbrushes Donate blood
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Hepatitis B & C are NOT spread by casual contact, i.e.
Hugging Kissing Sharing food or drinks Playing Sharing a house
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Now that you know…
Get tested
And if you have Hep C… Limit alcohol Get vaccinated against
Hep A and B Talk with your doctor to
find out if you need treatment
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For more information Books on Hep C are available in all Washington State
prison libraries
Go online to learn more at http://www.hcvadvocate.org
Visit your local Public Health Clinic
Contact the Hepatitis Education ProjectPhone: 1-800-218-6932Address: 911 Western Ave. #302, Seattle, WA 98104Websites: http://www.hepeducation.org
http://hcvinprison.org