1. Inflammation of the Liver Past | Present | Future
Hepatitis C Virus
Inflammation of the Liver
Past | Present | Future

2. Hepatitis C Virus Pandemic - Worldwide
Estimation is that 3% of humans are currently infected
#1 cause of Liver Cancer and Liver Transplants
Hepatitis C is a liver disease, but affects many other organs,  tissues, and systems.

3. Hepatitis C is An Ancient Virus
400 BC – Hippocrates Records the Symptoms of Jaundice. Records it as an epidemic.
1862 – American Civil War records 40,000 cases of “Jaundice Epidemic”.
1945 – World War II records 182,383 American solder and healthcare worker cases of Hepatitis C with the source link to blood.

4. Hepatitis C – is a Modern Virus
1960 –Hepatitis B discovered in an Aborigine. Researcher Baruch Blumberg, engineered vaccine, Nobel Prize.
1976 – Hepatitis A discovered, engineered vaccine by microbiologist Maurice Hilleman.
1989 – Hepatitis C discovered. To date, no vaccine has be created.

5. Hepatitis Case Study: Background Information
In 1995, Daniel was a senior in high school. Daniel wasn’t yet old enough to get a tattoo; however, her uncle gave her nice looking tattoo at home.
Daniel’s uncle used an unsterilized needle, which infected Daniel with Hepatitis C.

6. Case Study : Incubation, Acute Phase, and Recovery
Daniel’s incubation period lasted for four months.
Soon, Daniel started experiencing nausea, fatigue, and yellow circles under his eyes. Daniel was diagnosed with Hepatitis C.
However, there was no treatment for Hepatitis…
However, 15 years later, Daniel did received novel treatment medicine called Harvoni Harvoni cost is ($95,000 for a 12-week course of treatment)
He is now Hepatitis free.

7. Hepatitis: the Virus
Hepatitis is a parenterally transmitted virus; recognized as a “distinct” liver disease.

8. Hepatitis: Structure
Hepatitis is a single strand positive RNA molecule
Belongs to the Flavivirdae family
Has a circular shape. The average diameter is 55-65nm.
Consists of a core that contains RNA
The core is protected
by a protein sheath
The virus is encompassed
by a lipid bilayer envelope,
which anchors the
glycoproteins E1 and E2

9. Hepatitis: Characteristics
This virus moves by attaching to surface proteins of a host cell.
Hepatitis is transmitted through blood.
Hepatitis targets the hepatocytes of the liver.
Stains can be used determine damage to the liver tissue caused by Hepatitis.
Trichrome Stain
Iron Stain
Reticulin Stain

10. Hepatitis: Virulence Factors
No symptoms. The Hepatitis virus interferes with information from the liver to the brain; furthermore, the host does not realize they have the virus.
Hepatitis antibodies are not confirmed until weeks after exposure.
HCV changes shape and constantly mutates; furthermore, there is no vaccine for Hepatitis C.

11. Hepatitis C – Pathophysiology
Hepatitis C Virus is a spherical, single-stranded RNA molecule.
HCV targets hepatocytes
Incubation period is 6 to 10 weeks.
Infection is associated with high levels of T-lymphocytes and Helper T-cells

12. Pathophysiology HCV Effects on Liver
Cause continuous liver inflammation, leading to fibrosis, scare tissue formation
Extensive scaring blocks the blood supply, leading to decreased liver function – called cirrhosis.
Hepatitis C is the leading cause of liver transplants and liver cancer.

13. Patient Symptoms of HCV
jaundice
dark urine
muscle pain
abdominal pain
itchiness of the skin
nausea
fever
fatigue
Note: Hepatitis C infection often begins damaging the liver before it causes signs and symptoms

14. Hepatitis: Mode of Transmission
Hepatitis C is spread through large or repeated exposure to infected blood.
Blood Transfusion
Injected Drug Use
Sexual Transmission
Tattoos and Piercings
Infected Needles

15. Diagnosing Hepatitis C
The Blood Test
Doctors use a blood test, called a Hepatitis C Antibody Test, to find out if a person has ever been infected with Hepatitis C
The Anti-HCV Test looks for antibodies to the Hepatitis C virus that have been produce by an immune response.

16. Diagnosing Hepatitis C
Test Results: Non-Reactive vs. Reactive
A non-reactive antibody test means that a person does not have Hepatitis C.
A reactive antibody test means that the individual has likely been exposed to HCV.
If Reactive, a second RNA test is performed. If RNA test is positive, individual has HCV. Patient must seek medical advice.

17. Hepatitis: Prevention
Never share needles. Drug users are often at risk from Hepatitis C from infected needles.
Avoid direct exposure to blood and blood products.
Be cautious of piercing and tattoo parlors.
Practice safe intercourse.

18. Hepatitis: Treatment Medications – Interferons Surgery Ribavirin
Peginterferon
Harvoni
Surgery
Liver Transplant for Severe Cirrhosis or Liver Cancer

19. Oregon Health Statistics
Mandatory Reporting Since 2005 | Reveals High Prevalence of HCV
ATTENTION HEALTHCARE WORKERS
Since 2005, 47,252 case have been reported, and estimates are that 95,000 case are undiagnosed

20. World Health Organization - WHO
WHO Key Facts – A Global Outlook
Globally, between 130–150 million people globally have chronic hepatitis C infection.
Approximately 700, 000 people die each year from hepatitis C-related liver diseases.
A significant number of those who are chronically infected will develop liver cirrhosis or liver cancer.
There is currently no vaccine for hepatitis C; however research in this area is ongoing.

21. Funding HCV Vaccine Research
HCV is the #1 cause of liver cancer.
Hepatitis C is Pandemic and an underdiagnosed and often asymptomatic - A Silent Killer.
Hepatitis C is reported as infecting 3% of the world’s human population. HCV has a high prevalence , and an estimated high incidence.
World Health Assembly (WHA) and United Nations pass resolution to commit to "urgent action" to address the global hepatitis pandemic, May 22, 2014.
Current treatment for infected humans is very expensive. Vaccine will save lives.

22. References
The History of Hepatitis C: A Timeline
An insight into the diagnosis and pathogenesis of hepatitis C virus infection World J Gastroenterol Nov 28
MedScape Hepatitis C – Pathophysiology of HCV
University of Washington Resource – Hepatitis C Online ; diagnosis of acute HCV
Daniel’s Hepatitis C survivors story
Chevaliez S, Pawlotsky JM.(2006). HCV Genome and Life Cycle. In: Tan SL, editor. Hepatitis C Viruses: Genomes and Molecular Biology. Norfolk (UK): Horizon Bioscience; Chapter 1. Available from:
Reed, K. E., & Rice, C. M. (2000). Overview of Hepatitis C Virus Genome Structure, Polyprotein Processing, and Protein Properties. Current Topics in Microbiology and Immunology The Hepatitis C Viruses, doi: / _4
The Life Cycle of Hepatitis C. (n.d.). Retrieved July 10, 2016,

23. References
A Full List of Hepatitis C Medications. (n.d.). Retrieved July 11, 2016, from
World Health Organization Hepatitis C Statistics and Key Facts
Oregon Health Authority - Hepatitis C Infections in Oregon