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/

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.

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.

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.

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.

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

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