Hepatitis C

Hepatitis C scare at Royal Adelaide Hospital

Posted in Hepatitis C on October 13th, 2009 by std_test – Be the first to comment

Recently, the Royal Adelaide Hospital found that an employee was positive for Hepatitis C.  This raised concern, because as many as 30 patients could have been exposed to the virus.  These patients have been offered precautionary screening tests for Hepatitis C, as well as counseling, if needed.

An investigation was began immediately to determine which patients could have been at risk for Hepatitis C.  They determined that, by national and international guidelines, 30 patients were at risk of transmission.

Hepatitis C is spread by blood-to-blood contact. Newly infected people do not usually have any symptoms but some will eventually develop liver cirrhosis.

Hepatitis C affects around one per cent of South Australians, with around 16,000 cases recorded in SA since 1995.

For the original article, please refer to www.stdtestingblog.com/original-articles/

Hepatitis C rate high in trucker study

Posted in Hepatitis C on October 6th, 2009 by std_test – Be the first to comment

Long-haul truckers have shown high rates of hepatitis C, and most of the infected truckers were unaware of their status.

Many truckers engage or have engaged in high risk behavior, including injection drug use.

International studies have shown similar results, that long-haul truck drivers have high rates of sexually transmitted diseases.

Testing for hepatitis C should be considered by truck drivers, especially if they have ever injected drugs or received blood transfusions prior to 1992.

Also, many drivers engage in high-risk behavior, including having sex with casual partners and commercial sex workers.  It is recommended that workers should follow safe sex practices, including consistent condom use.  It is also recommended by the CDC to get tested for the majority of STDs at least once every six months.

For the complete article, please refer to www.stdtestingblog.com/original-articles/

Hepatitis C Virus Tests

Posted in Hepatitis C, STD Testing on August 16th, 2009 by std_test – Be the first to comment

Test Overview

Hepatitis C virus (HCV) test is a blood test that looks for proteins (antibodies) or genetic material (RNA) of the virus that causes hepatitis C. These proteins will be present in your blood if you have a hepatitis C infection now or have had one in the past. It is important to identify the type of hepatitis virus causing the infection, to prevent its spread and start the proper treatment.

HCV is spread through infected blood.

  • Anti-HCV antibody tests look for antibodies to HCV in the blood, indicating an HCV infection has occurred. This test cannot tell the difference between an acute or long-term infection. The enzyme immunoassay (EIA) may be the first test done to detect anti-HCV antibodies.
  • HCV RIBA is an additional test that detects antibodies to HCV. This test can tell whether a positive result was caused by an actual HCV infection or whether the result was a false-positive. This test may be done to double-check a positive EIA test result.
  • HCV RNA PCR genetic material (RNA) testing uses polymerase chain reaction (PCR) to identify an active hepatitis C infection. The RNA can be found in a person’s blood within 1 to 2 weeks after exposure to the virus. HCV RNA testing may be done to double-check a positive result on an HCV antibody test, measure the level of virus in the blood (called viral load), or show how well a person with HCV is responding to treatment.
    • HCV quantitative test (also called viral load) is often used before and during treatment to find out how long treatment needs to be given and to check how well treatment is working.
    • HCV viral genotyping is used to find out which genotype of the HCV virus is present. HCV has 6 genotypes, and some are easier to treat than others.

There is no vaccine available to prevent hepatitis C.

Why It Is Done

Hepatitis C virus testing is done to:

  • Identify the type of hepatitis C virus causing the infection.
  • Screen people (such as doctors, dentists, and nurses) who have an increased chance of getting or spreading a hepatitis C infection.
  • Screen potential blood donors and donor organs to prevent the spread of hepatitis C.
  • Find out if a hepatitis C infection is the cause of abnormal liver function tests.

How It Is Done

The health professional taking a sample of your blood will:

  • Wrap an elastic band around your upper arm to stop the flow of blood. This makes the veins below the band larger so it is easier to put a needle into the vein.
  • Clean the needle site with alcohol.
  • Put the needle into the vein. More than one needle stick may be needed.
  • Attach a tube to the needle to fill it with blood.
  • Remove the band from your arm when enough blood is collected.
  • Put a gauze pad or cotton ball over the needle site as the needle is removed.
  • Put pressure on the needle site, and then put on a bandage.

How It Feels

The blood sample is taken from a vein in your arm. An elastic band is wrapped around your upper arm. It may feel tight. You may feel nothing at all from the needle, or you may feel a quick sting or pinch.

Risks

There is very little chance of a problem from having blood sample taken from a vein.

  • You may get a small bruise at the site. You can lower the chance of bruising by keeping pressure on the site for several minutes.
  • In rare cases, the vein may become swollen after the blood sample is taken. This problem is called phlebitis. A warm compress can be used several times a day to treat this.
  • Ongoing bleeding can be a problem for people with bleeding disorders. Aspirin, warfarin (Coumadin), and other blood-thinning medicines can make bleeding more likely. If you have bleeding or clotting problems, or if you take blood-thinning medicine, tell your doctor before your blood sample is taken.

Results

The hepatitis C virus (HCV) test is a blood test that looks for proteins (antibodies) the body makes against HCV or for the genetic material (RNA) of the hepatitis C virus.

Results of hepatitis C virus testing that show no infection are called negative. This means that no antibodies against HCV or HCV genetic material was found. Results are usually available in 5 to 7 days.

Hepatitis C virus tests
Normal (negative): No hepatitis C antibodies are found.
No hepatitis C genetic material (RNA) is found.
Abnormal (positive): Hepatitis C antibodies are found. A test to detect HCV RNA is needed to determine whether the infection is current or occurred in the past. If HCV RNA is found, genotyping can determine which strain of HCV is causing the infection.
Hepatitis C genetic material (RNA) is detected. This result indicates a current hepatitis C virus infection.

What Affects the Test

Many conditions can change HCV antibody levels. Your doctor will talk with you about any abnormal results that may be related to your symptoms and medical history.

Your results may need to be rechecked if you are taking some herbs or other natural products.

What To Think About

  • There is no vaccine at this time to prevent infections with the hepatitis C virus.
  • Hepatitis antibodies can take weeks to develop, so your results may be negative even though you have the early stages of an infection (false-negative).
  • All donated blood and organs are tested for hepatitis C before being used.
  • Other tests that show how well the liver is working are usually done if your doctor thinks you may have hepatitis C. These may include blood tests for bilirubin, alkaline phosphatase, alanine aminotransferase, and aspartate aminotransferase. For more information, see the medical tests Bilirubin, Alkaline Phosphatase, Alanine Aminotransferase (ALT), and Aspartate Aminotransferase (AST).
  • Many states require that some types of hepatitis infections be reported to the local health department. The health department can then send out a warning to other people who may have been infected with the hepatitis virus, such as those who are close contacts of someone who has hepatitis C.

Hepatitis C RNA Quantitative Testing

Posted in Hepatitis C, STD Testing on August 16th, 2009 by std_test – Be the first to comment

The quantitative HCV RNA tests use either a process called polymerase chain reaction (PCR) or transcription-mediated amplification (TMA) or signal amplification (branched DNA). These are all “quantitative” techniques and will give an actual level of HCV RNA — a measurement of the amount of hepatitis C virus in the blood. The result will be an exact number, such as “1,215,422 IU/L.” Many people refer to the quantitative measurement as the hepatitis C “viral load”.

Explanation of test results:

There are 2 situations in which a quantitative test is useful:

The quantitative HCV RNA test is checked before a patient starts treatment.

For each patient, the result can be described as either a “high” viral load, which is usually >800,000 IU/L, or a “low” viral load, which is usually <800,000 IU/L. Knowing the viral load before starting treatment is useful because patients with “high” viral loads can have a difficult time getting the virus to become completely undetectable on treatment. Patients with “low” viral loads have a better chance of getting their virus to become completely undetectable on treatment.

The quantitative HCV RNA test is used to monitor a patient who is currently on treatment.

The response to treatment is considered good when the quantitative HCV RNA measurement drops and the virus eventually becomes completely undetectable.

Clinical significance of hepatic HCV RNA in patients with chronic hepatitis C demonstrating long-term sustained response to interferon-alpha therapy.

Posted in Hepatitis C on August 15th, 2009 by std_test – Be the first to comment

Larghi A, Tagger A, Crosignani A, Ribero ML, Bruno S, Portera G, Battezzati PM, Maggioni M, Fasola M, Zuin M, Podda M

Department of Internal Medicine, Ospedale San Paolo, Milan, Italy.

Whether sustained biochemical response and absence of serum HCV RNA in the 6-12 months following suspension of interferon-alpha (IFN-alpha) therapy reflect definitive viral clearance in patients with chronic hepatitis C virus (HCV) infection is controversial. To obtain more information on this topic, HCV RNA was sought in both liver and serum samples of 25 long-term responders who were followed for a median period of 39 months (range 21-79) after discontinuation of IFN-alpha. Liver biopsy was undertaken before and 6 to 12 months after IFN-alpha withdrawal. Liver and serum HCV RNA were tested by a nested polymerase chain reaction. Twenty-two patients (88%) tested negative for both liver and serum HCV RNA, two patients had detectable HCV RNA in both liver and serum, and one patient showed persistent HCV RNA only in the liver. Post-treatment liver histology improved markedly in all patients, including those with viral persistence. During further follow-up, biochemical remission was maintained in all patients except one in whom both serum and liver specimens remained HCV RNA positive. The data indicate that the large majority of long-term responders test negative for HCV RNA in the liver, which suggests definitive eradication of HCV RNA infection.

HCV RNA Tests

Posted in Hepatitis C on August 11th, 2009 by std_test – Be the first to comment

Unlike antibody tests, HCV RNA tests directly measure for the presence of the hepatitis C virus. HCV RNA tests may be qualitative or quantitative. Qualitative HCV RNA tests are used to diagnose hepatitis C. Your doctor might choose to perform an HCV RNA test instead of the ELISA, especially if you are at high-risk for hepatitis C. The HCV RNA test will be positive in as little as 1 to 2 weeks after exposure. A positive HCV RNA test means a person has hepatitis C infection.

Quantitative HCV RNA tests allow your doctor to determine exactly how much virus is in the blood. This is referred to as the viral load. The viral load is usually expressed as units per milliliter or copies per milliliter. In patients with chronic hepatitis C infection, viral loads vary widely from 50,000 to 5 million copies per milliliter. A higher viral load may not necessarily be a sign of more severe or more advanced disease but it does correlate with likelihood to respond to treatment. HCV RNA tests can also be used to monitor response to hepatitis C treatment. For example, if the viral load decreases during treatment, this suggests that treatment is working and should be continued. Conversely, if the viral load remains the same, it suggests that the patient is not responding to treatment.

Hepatitis C

Posted in Hepatitis C on August 7th, 2009 by std_test – Be the first to comment

Hepatitis C is one of the many viral infections with the tendency to affect the liver. In approximately 75% of cases, the infection will become chronic, meaning that it does not go away. After about 20 years of a chronic Hepatitis C infection, approximately 20% of these people will develop cirrhosis (or hardening) of the liver. Liver failure is also a very common complication, although Hepatitis C infection may also result in a number of blood cell disorders which manifest most typically in the skin as itching, bruises and other odd discolorations as well as intestinal bleeds manifesting as vomiting blood or passing stools that are black, indicating the presence of digested blood. There is also an increased tendency to develop a type of cancer known as Non-Hodgkin’s Lymphoma.

Depending on your general state of health and the type of Hepatitis C infection that you have, you may not be treated for the infection. This is because of the high costs associated with treatment, as well as the associated side effects and the fact that a small number of persons will recover without treatment and furthermore, only about 60% of persons will actually be cured by the current medical standards. The goals of treating Hepatitis C infections are to eliminate the virus as well as to prevent the development of liver cirrhosis and liver failure, thereby reducing the likelihood that a liver transplant will be required. How long you are treated for will depend on the type of Hepatitis C virus with which you have been infected, whether you have an acute (short-term) or chronic (long term) infection and your response to the treatment being given.

Most persons with an acute infection will not be treated, simply because they do not know they have it. If, however, it is known that a person is infected with Hepatitis C, prompt treatment may help prevent the progression to chronic Hepatitis though the actual guidelines for treatment in this case are still being debated. It is common for persons not to discover Hepatitis C infection until it has already become chronic. When this happens, treatment becomes necessary only in the presence of liver damage and a combination of medicines (such as interferon and ribavirin) may be required to fight the infection.

You will also need to be followed up by your doctor with routine blood tests to determine your level of liver function in response to treatment and any possible adverse reactions which might occur. Also, if you choose not to take your medicine then you will need to have a liver biopsy done every 5 years to assess the level of liver damage.

Note, that antiviral therapy for Hepatitis C is not recommended for persons who use IV drugs or drink alcohol, have advanced cirrhosis, are pregnant or may become pregnant, suffer from major depression or other mental disorder, have an autoimmune disease (e.g. psoriasis, lupus, or rheumatoid arthritis), or have other medical conditions such as seizures, heart disease or severe diabetes.

Alternatively, there are certain alternative and complimentary treatments for Hepatitis C which include plant extracts like ginseng, licorice root and milk thistle. Other therapies that may be used include relaxation techniques, chiropractic care and massage; none of which are curative, but they have been credited with relieving the pain associated with Hepatitis C. These natural therapies are used to boost the immune system, reduce liver inflammation and improve gastrointestinal function and they have been reported as being successful by as much as 40% of Hepatitis C patients who were not cured by traditional medicine.

For the complete article and more information from this author, please refer to http://ezinearticles.com/?expert=Nicholas_Russi

Histological changes in HCV antibody-positive, HCV RNA-negative subjects suggest persistent virus infection

Posted in Hepatitis C on July 9th, 2009 by std_test – Be the first to comment

Abstract:

It is unclear whether hepatitis C virus (HCV) has been eradicated or persists at a low level in HCV antibody-positive HCV RNA-negative individuals. The natural history and liver histology are not well characterized. One hundred seventy-two HCV antibody-positive, serum HCV RNA-negative patients underwent diagnostic liver biopsy between 1992 and 2000 and were followed a median 7 years (range, 5-12). Patients with any possible cause of liver injury other than HCV were excluded. A single histopathologist scored sections using Ishak criteria. Characterization of the inflammatory infiltrate in selected cases used a novel semiquantitative technique and compared with HCV RNA-positive patients and healthy controls. One hundred two patients were excluded because of a risk factor for liver injury other than HCV. Seventy patients met the study criteria; four (5.7%) became HCV RNA-positive during follow-up. Sixty-six cases remained HCV RNA-negative; five (7.5%) had a normal liver biopsy; 54 (82%) had fibrosis (stage 2 or 3 in 16 (24%)). Nonviremic cases revealed expanded portal tracts (P < 0.05), with fewer CD4+ (P < 0.05) and more CD8+ cells (P < 0.05) than healthy controls, but were indistinguishable from HCV RNA-positive cases for these parameters. Lobular CD4 staining, absent in healthy controls, was noted in both HCV RNA-negative and -positive cases and was more marked in the latter (P < 0.05) with a sinusoidal lining cell distribution. Conclusion: Nonviremic HCV antibody-positive patients have a liver biopsy that is usually abnormal. Fibrosis was present in most with similar inflammatory infiltrate to viremic cases. The presence of a CD8+ rich inflammatory infiltrate suggests an ongoing immune response in the liver, supporting the view that HCV may persist in the liver in the majority of HCV RNA-negative cases.

Discussion:

HCV infection leads to chronic viremia in the majority of individuals exposed to HCV. The natural history in this group, the risk factors for progressive injury and the benefits of antiviral therapy are well established. However, the clinical status of the minority without viremia after exposure to HCV is less clear. It is uncertain whether this group has resolved infection, with or without long-term immunity and protection from further exposure to HCV or, alternatively, low-level viral replication, where HCV RNA can only be detected within the liver.[11][19] Neither the natural history nor the liver histology in this cohort has been described in detail.
For the complete article, please refer to http://www.natap.org/2008/HCV/122208_01.htm

Causes Behind Development of Hepatitis B&C

Posted in Hepatitis B, Hepatitis C on July 1st, 2009 by std_test – Be the first to comment

Hepatitis is one of the prominent health problems. Many illnesses and conditions can cause inflammation of the liver. Hepatitis is most often viral, due to infection with one of the hepatitis viruses (A, B, C, D, and E) or another virus (such as those that cause infectious mononucleosis, cytomegalovirus disease, or yellow fever).

Hepatitis B virus

It is a rigorous disease caused by a virus that harms the liver. It is commonly known as hepatitis B virus (HBV). It can cause a wide number of symptoms ranging from general malaise to lifelong infection, cirrhosis of the liver, liver cancer, liver failure, and death.

HBV spreads by contaminated body fluids, such as blood, saliva, semen, vaginal fluids, tears, and urine, an infected blood transfusion, shared infected needles or syringes for injecting drugs, sexual activity with an HBV-infected individual, and transmission from HBV-infected mothers to their newborn infants.

Hepatitis C virus

It is one of the common liver disease caused by a virus known as HCV(hepatitis C virus). Infection with the hepatitis C virus can cause chronic liver disease and is the leading reason for liver transplant . HCV is spread by direct contact with an infected person’s blood, getting a tattoo or body piercing with non sterilized tools, sharing drug needles, sexual contact with infected person.

For the complete article, please see http://www.webarticles.co.za/articlebase/?p=6967