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Hepatitis C virus epidemiology

Hepatitis C virus epidemiology. Varsha Shete varshas@eden.rutgers.edu . Jeni gemini_breeze@hotmail.com. Discovery. Hepatitis C was discovered in the 1988 Original name was non-A, non-B Hepatitis virus Hepatitis C antibody test made available in 1990 1995 marked first sight under

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Hepatitis C virus epidemiology

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  1. Hepatitis C virus epidemiology Varsha Shete varshas@eden.rutgers.edu Jeni gemini_breeze@hotmail.com

  2. Discovery • Hepatitis C was discovered in the 1988 • Original name was non-A, non-B Hepatitis virus • Hepatitis C antibody test made available in 1990 • 1995 marked first sight under electron microscopy

  3. Basics • Flaviviridae • Linear • + Sense • SS RNA • Genome around10,000 bases • Enveloped • Spherical 40-50 nm • Replicates in cytoplasm

  4. HCV IRES • Secondary structure: • stem-loop structure • No cap • 5’ untranslated region of HCV shown here • AUG start codon • shown here

  5. Distribution • Deaths due to associated cirrhosis in the United States 10-20K • 4% develop chronic hepatitis C • Only 20% of infected people develop symptoms

  6. Prevalence • Found to be prevalent in incarcerated adults (as high as 80%) • More common in developing nations Shepard et al

  7. Transmission • Blood and body fluids Intravenous drug users Blood or organ donation before1992 or clotting factors before 1987 Unsterile body art / modification Sexual promiscuity Mother to child

  8. Other Factors Other cofactors are: • male sex • older age at acquisition of HCV infection • HIV co-infection • hepatitis B virus (HBV) co-infection • alcohol consumption HIV and HCV co-infection causes severe liver damage and further lowers the chances of survival

  9. Symptoms and Duration • Major cause of liver failure • Fever • Loss of appetite • Nausea • Abdominal pain • Dark colored urine • Clay-colored bowel • Joint pain • Jaundice • Fatigue • 10 yrs Chronic hepatitis • 20 yrs Cirrhosis • 30 yrs Hepatocellular carcinoma

  10. Healthy to Hepatitis C Liver Healthy Liver Liver damaged due to HCV

  11. Incidents and trends of infection (Epidemics) • Impractical to measure infection incidents • Center for Disease Control and Prevention (CDC) in USA uses mathematical model for estimation of trends of infection • Age-specific reported cases of acute disease and data from a cross-sectional national survey done from 1988 to 1994 was used by CDC • The general observation was steady rise in the cases of HCV infection since the 1980’s

  12. Incidents and trends of infection(continued)… • USA: steady and sharp drop through 1990’s • France: death rates from hepatocellular carcinoma was used as a model and similar trend was observed • Australia: steady increase from 1961 through 2001 • Italy: decline in 1990’s • Russia: dramatic increase since 1994 • England: clear decline after reduction of use of syringes and alternative drug therapy

  13. Treatment • No vaccine and no completely effective treatment! But pharmaceutical and medical research companies are working on a variety of possible new treatments • Belgian biotech firm Innogenetics is developing a hepatitis C vaccine that may be able to halt or reverse liver damage in people infected with the disease, BBC News reported on 11/04/02

  14. Treatment(continued)… • Interferon α Patients inject interferon 2-3 times a week 25% of patients have good results with interferon • Doctors will discontinue after 3 months if there isn’t a change with interferon and use the Rebetron. • Infergen (derivative of Interferon α) • Rebetron (Interferon + ribavirin)

  15. References • “Global epidemiology of hepatitis C virus infection”, Shepard W, Finelli L, Alter M, The Lancet infectious diseases, Vol 5 (9) September 2005, 558-567 • “Seroprevalence of hepatitis C among a juvenile detention population”, Feldman G, Sorvillo F, Cole B, Lawrence W, Mares R, Journal of Adolescent health Vol 35 (6), December 2004, 505-508 • “Hepatitis B virus (HBV) and hepatitis C virus (HCV) infection epidemiology in Moscow region during 1995–1999” Isakov V, Tsodikov G, Ivanikov I, Kaira A, Seliverstova A, Shakhovski Y Journal of Hepatology, Vol 34 (11), April 2001, 191 • www.who.org • http://www.ncbi.nlm.nih.gov/ICTVdb http://virology-online.com/viruses/HepatitisC.htm • http://www.virology.net/Big_Virology/BVRNAflavi.html • http://www.hepnet.com/hepc.html#history http://www.aafp.org/fpr/20031100/27.html • http://www.cnn.com/HEALTH/9703/26/nfm/hepatitis.c/index.html

  16. Thank You! Questions and Comments?

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