INFECTIOUS DISEASE
Hepatitis C is an infectious disease of the liver. The disease is transmitted through blood to blood contact, and besides IV drug use, which is the main cause, this can happen through sex when a woman is menstruating or anal sex and by using a shaving razor previously used by an infected person. Individuals infected by the Hepatitis C virus (HCV) have nothing to fear from sex in a monogamous, heterosexual relationship. Transmission of HCV from an infected partner during sex is rare according to new research published in the March issue of Hepatology, a journal published by Wiley on behalf of the American Association for the Study of Liver Diseases (AASLD) (Peters, 2013). It was discovered in 1989, and, with so many cases contracted before then, Hepatitis C sometimes goes without diagnosis. It was originally named Post-transfusion, non-A, non-B hepatitis (Sargent, 2009). In 2013, the CDC can only estimate 4.4 million Americans living with it. Most chronic carriers have no symptoms of HCV for the first 10 or 20 years of the infection. As the infection progresses, chronic carriers may experience symptoms tiredness, itchy skin, dark urine, muscle soreness, nausea, loss of appetite, stomach pain, jaundice (a yellowing of the skin and whites of the eyes), as well as fluid retention, easy bruising, and personality changes. These usually occur about two to six months after exposure. About 20% of chronic carriers eventually develop liver cirrhosis (scarring). Persons with cirrhosis from HCV are at a moderate risk for developing liver cancer (Virginia Department of Health, 2013).
THE DISEASE
Many people were infected between the years of 1949 - 1982. Approximately 90% of infections are attributable to injecting drug use (Health Protection Agency (HPA), 2011). Some caught the virus by receiving blood transfusions before 1992 when widespread screening of the blood supply began. That being said, not everyone who has the virus will be offered treatment. People who have an unstable lifestyle or other life threatening illnesses are for the most part unsuccessful with the therapy. Unwise consumption could even cause death in a person who does accept treatment on a lark that it could work but who does not stop drug and alcohol use. The “flu-like” symptoms and mood changes, anxiety and depression coming with the treatment are dependant upon having a healthy self-esteem, but even accomplished people suffer immensely trying to tolerate treatment.
Hepatitis C progresses with the sign of multiplying viruses in the blood stream, and consumption of drugs and alcohol increases virus multiplication. You cannot contract Hepatitis C through drinking alcohol, but alcoholism too is known to cause cirrhosis of the liver, and studies also show that when people infected with the hepatitis C virus (HCV) stop drinking alcohol, levels of the virus decreases. That is to say if you have been diagnosed with Hepatitis C, drinking alcohol adds to the strain on the liver, increasing the risk of damage to cells. Therefore, HCV patients are advised to cease alcohol consumption (Jaret, 2009).
TREATMENT
Minimizing the impact of Hepatitis C is really about surviving the side effects of treatment, which are on par with intensive chemotherapy. One intervention is using botany such as green tea and even marijuana to alleviate the crippling symptoms which are extreme fatigue, loss of appetite, and nausea. The thing about cannabis is that it is not legal in over half of the United States, but the FDA has approved its extract in a mouth spray form called Sativex for those who do not like smoke. States in which it is allowed, cannabis is an antidote not only for the side effects, but cannabinoids halt VEGF (vascular endothelial growth) production by producing Ceramide. Ceramide controls cell death (n.d., 2013). More research is required before the plant can be approved to be used in its fullest potential.
The U.S. Food and Drug Administration (FDA) has approved two drugs in the first new class of drugs for hepatitis C since 2001. On May 13, 2011, the FDA approved boceprevir (Victrelis). On May 23, they approved a second drug, telaprevir (Incivek) (hepatitis.va.gov, 2013). These new drugs have a higher cure rate than Interferon and Riberfivin, but for some, a 3 drug combination may be best. The new drugs come with their own set of side effects. A plus is that for many patients, treatment time can be cut in half. Depending on the strength of their immune system and also what other medicines the patient takes, it could be a combination of only two that are prescribed. Sofosbuvir by Gilead is brad new, and it has been shown to cure up to 90% of patients in 12 weeks. It's currently estimated that sofosbuvir will likely generate about $5 billion in revenue for Gilead based on just the currently expected approvals, but if it clears that 12-week hurdle (of a cure) that number could easily move closer to $7 billion as it would become the preferred hepatitis C treatment for most patients (Shepard, 2013).
Accountability for and responsibility to keep others from being infected by you comes when you receive the diagnosis of Hepatitis C. Psycho-social challenges when you are knowingly carrying the virus are like being too self-conscious or forgetting to tell people that may need to know about your being infected. The Hepatitis C virus can survive outside the body at room temperature, on environmental surfaces, for at least 16 hours but no longer than 4 days (CDC, 2012). Therefore, if you carry the virus and happen to bleed, you should immediately clean up after yourself. This is how some doctors and nurses are becoming infected--by being stuck with bio-hazardous needles.
Also, since being treated for Hepatitis is so strenuous, and since the disease takes ten to twenty years to show symptoms, patients must decide weather or not to even attempt to cure it. If you contract the virus after you are forty years or more in age, the medicines that treat it could be more than your body can handle, so it’s best to try and live with it and just moderate one’s diet. As the Chinese Proverb states, “He who takes medicine and neglects to diet wastes the skill of his doctors.”
Complementary and Alternative Medicine (CAM) practitioners might recommend a diet of fruits and vegetables along with dandelion, licorice, milk thistle, alfalfa, burdock root, and fennel which are all known to enhance and maintain good liver function. Some studies, reported from outside the United States, have looked at glycyrrhizin, also known as licorice root extract, administered intravenously for hepatitis C. Preliminary evidence from these studies suggests that glycyrrhizin may have beneficial effects against hepatitis C. However, additional research is needed before reaching any conclusions (NCCAM, 2011).
Before any serious move towards treating Hepatitis C is made, the doctors will most likely want to do a liver biopsy where a surgeon will remove a very small piece of liver tissue that is studied in the lab to determine the liver’s condition and the extent of damage. A liver biopsy is a simple, outpatient procedure in which a small medical biopsy needle is being inserted into the liver to obtain the tissue sample. Understanding the whole procedure and all the needed preparations is an advancement for the patient and of course with the family. The patient will need to stop taking aspirin, ibuprofen and arthritis medications 3 days prior to the procedure and blood thinners 5 days prior to the procedure. As with most surgeries, food is prohibited after midnight the day of the procedure. The patient will be instructed to lay on their right side for up to 4 hours while the wound heels, and they will need someone to drive them home.
SUPPORT
The American Liver Foundation’s mission is to facilitate, advocate, and promote education, support, and research for the prevention, treatment, and cure of liver disease. Rapidly rising health care costs, unforeseen occurrences in one’s personal life, and increasing responsibilities can lead to the need for financial assistance. Financial needs for individuals with liver disease can vary from medication assistance to transportation assistance to transplant assistance. The American Liver Foundation connect s individuals with liver disease to the financial assistance resources they may need (American Liver Foundation, n.d.). The ALF also offers a help line on the telephone which can be reached by dialing 1-800-GO-LIVER.
Caring Bridge is another lifeline for patients and families. The American Liver Foundation partners with Caring Bridge to offer free, personal and private websites that connect people experiencing a significant health challenge to their family and friends, making each health journey easier. Saving time and energy is one positive attribute that using Caring Bridge can bring. In a 2010 study of patients using a Caring Bridge website to share health news, 91% of patients agreed that it helped make their health journey easier and 88% of patients agreed that it positively impacted their healing process (American Liver Foundation, 2011).
CONCLUSION
If left untreated hepatitis C can lead to serious liver disease. What this all means is that for HCV carriers, there should be a discernment of what the disease implies. How to change one’s ingestion and behavior and weather or not to receive treatment are both personal decisions each Hepatitis patient must come to terms with for themselves. The modifying life away from old, bad habits and the self-awareness to determine if the heavy treatment will work are interconnected actions and attributes. Managed care organizations would potentially, before the recent activation of the Affordable Care Act that guarantees coverage for pre-existing conditions, refuse treatment on “behalf" of their clients. A person has free will, and no doctors in America will force the treatment on anyone but there are patient advocates in the public health system. We should examine ourself and be wise to what is in our best interest and the best interest of our family and loved ones.
References:
American Liver Foundation (October 4, 2011). CaringBridge.org: A Lifeline for Patients and Families. Retrieved from http://www.liverfoundation.org/patients/caringbridge/
CDC DVH (2012). Hepatitis C FAQs for the Public. Retrieved from http://www.cdc.gov/hepatitis/C/cFAQ.htm
Health Protection Agency (2011). Shooting Up: Infections Among Injecting Drug Users in the UK 2010. An update: November 2011. Health Protection Agency, London
Jaret, P. (December 18, 2009). Alcohol and Hepatitis C. Consumer Health Interactive. Retrieved from http://cvscaremarkspecialtyrx.com/node/1086
NCCAM (March, 2011). Hepatitis C and CAM: What the Science Says. Retrieved from http://nccam.nih.gov/health/providers/digest/hepatitisC-science.htm
n.d. (July 17, 2013). There’s No Mistaking the Evidence, Cannabis Cures Cancer. Retrieved from http://www.whydontyoutrythis.com/2013/07/there-is-no-mistaking-the-evidence-cannabis-cures-cancer.html
Peters, D. (March 19, 2013). Sex between monogamous heterosexuals rarely source of hepatitis C infection. Retrieved from http://www.eurekalert.org/pub_releases/2013-03/w-sbm031913.php
Sargent, S. (2009). Liver Diseases An Essential Guide for Nurses and Health Care Professionals. Wiley-Blackwell
Shepard, B. (November 4, 2013). Gilead’s Race for a Cure. Retrieved from http://www.investingdaily.com/18702/gileads-race-for-a-cure/
Virginia Department of Health (June, 2013). Hepatitis C. Retrieved from http://www.vdh.virginia.gov/epidemiology/factsheets/pdf/Hepatitis_C.pdf
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