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Hep 101. Laying Down A Framework. Today We Will. Define hepatitis, viral hepatitis & the liver Learn about the 5 different types of viral hepatitis Learn more about hepatitis C: The scope of the disease Signs/symptoms Risk factors and prevention. What Is Hepatitis?.
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Hep 101 Laying Down A Framework
Today We Will • Define hepatitis, viral hepatitis & the liver • Learn about the 5 different types of viral hepatitis • Learn more about hepatitis C: • The scope of the disease • Signs/symptoms • Risk factors and prevention
What Is Hepatitis? • Hepatitis means inflammation of the liver • Hepat (liver) + itis (inflammation)= Hepatitis • Viral hepatitis means there is a specific virus that is causing your liver to inflame (swell or become larger than normal)
The Liver • Is located in the upper right quadrant of the abdomen • Cleans the blood • Regulates hormones • Helps with blood clotting • Produces bile • Produces important proteins • Maintains blood sugar levels • And much, much, more • The liver is essential • for life !
Inflammation Walls of scar tissue begin to form Healthy liver cells become trapped by a wall of scar tissue
Viral Hepatitis 5 types: A: fecal-oral transmission B: sexual fluids & blood to blood C: blood to blood D: travels with B E: fecal–oraltransmission Vaccine Preventable Adapted from Corneil, 2003
Hepatitis C Infection • World - 170 million people • Canada - 240,000 to 300,000 • (0.8% to 1% of pop.) • BC - 40,000 (1%) • Vancouver - 11,350 (2%) • DTES VIDUS Study - 1,437 • 90% hep C posititve WHO 2000, BC Hepatitis Service 2003, VIDUS 2003
Overall cure rate with new treatment is 55% * Hepatitis C • Affects each person differently • No vaccine available • Many people have the virus and do not even know it • Approximately 1 out of 100 Canadians infected *BC Hepatitis Service 2003
Only 20% will show symptoms Initially ! Natural History of Hep C 20% Clear the Virus Chronic Infection Acute Infection Healthy Liver 80% Virus Continues to Damage Liver Adapted from Lauer and Walker, NEJM 2001
Natural History Con’t Liver Cancer 1-4%/year Cirrhosis 20-30% Chronic Hepatitis Most symptoms begin to show only when liver is more severely damaged
Factors Affecting Progression • 30yrs or longer if: • Young at time of infection • Healthy liver at time of infection • Female • 20yrs or less if: • Drinking alcohol • Co-infection (HIV, Hep B) • Damaged liver before infection Adapted from Bigham, BC Hepatitis Services 2002
Signs and Symptoms • Individuals may have one or more of the following symptoms, while others experience no symptoms: • Weight loss • Abdominal pain • Itchiness • Depression • Dark urine (pee) • Tiredness • Nausea • Muscle or joint pain • Trouble sleeping • Loss of appetite
Signs and Symptoms • A few may have specific liver related symptoms initially: • Pale stool (poo) • Jaundice (yellowing of the skin or eyes)
IDU/snorting (51%) No RF identified (23%) Incarceration (3%) Transfusion/dialysis blood contact (4%) HCV-infected household member/sexual partner (7%) Hospitalization dental work (6%) Tattooing piercing (6%) Risk Factors Source: Health Canada Enhanced Surveillance, Oct 98-Oct 99, Calgary, Edmonton, Winnipeg, Ottawa
Hepatitis C Dispelling Myths • Hepatitis C is not spread by: • Casual contact • Hugging/kissing • Sharing eating utensils and drinking glasses • Sneezing/coughing • Shaking hands • Sitting on a toilet seat
Prevention • Never share drug equipment • Straws, bills, needles, syringes, water, filter, cooker, pipes etc… • Never share tooth brushes/razors or any personal hygiene articles that have blood on them (even tiny amounts). • Practice safer sex
Prevention • Always make sure new & sterilized equipment is being used for tattooing & piercing • Make sure ink for tattooing is not being shared • Do not touch dirty needles without proper equipment or following proper procedures
Dirty Needle Precautions • Handle only if you have proper equipment • Sturdy pair of gloves, tongs or pliers and a puncture proof container (heavy plastic or metal) • Place needle in puncture proof container • Do not touch needle with bare hands and do not try to recap needle if cap present • Can dispose container in garbage but better if it is taken to health clinic or needle exchange • At school, notify custodian, teacher, nurse or police liaison officer
Needle Prick • Do not “milk” prick site • Wash the area with soap and water • Go to nearest emergency department for assessment and treatment