Genotyping And Serotyping Of Hcv
Hepatitis C genotyping is helpful in defining the epidemiology of hepatitis C, but on an individual patient basis, genotyping is crucial in regard to treatment recommendations and duration. Genotyping is based on sequence analysis by sequencing or reverse hybridization. Although viral load can vary within a 0.5- to 1-log range, HCV genotype does not change during the course of infection. In case of suspected superinfection, another genotype might rarely be detected. For reliable genotyping, 5URT alone is insufficient, including parts of the core sequence enhance genotyping reliability. Sequencing of NS5b is the gold standard.
Serotyping is the only other option to test for the type of HCV in cases of remote infection. This, however, is relevant for epidemiologic studies only and is not used clinically.
Andrea D. Branch, in, 2004
How Is Hepatitis C Transmitted
Because HCV is primarily spread through contact with infected blood, people who inject drugs are at increased risk for HCV infection. HCV can also be transmitted from an infected mother to child at the time of birth, from unregulated tattoos or body piercings, and from sharing personal items that may be contaminated with infected blood, even in amounts too small to see. Much less often, HCV transmission occurs through sexual contact with an HCV-infected partner, especially among people with multiple sex partners and men who have sex with men. Currently in the United States, health care related transmission of HCV is rare, but people can become infected from accidental needle sticks and from breaches in infection control practices in health care facilities.
Gay Men Chemsex And Hep C
Group sex and chemsex parties provide the perfect storm for hepatitis C transmission.
If youre taking drugs and having sex for longer your inhibitions are likely to be lowered and the delicate skin lining the anus can be damaged, causing bleeding. Hep C is very infectious and is easily passed on through group sex it can even be passed from one person to another on fingers.
The virus spreads through anal sex and fisting when condoms and gloves are not used. Its also passed on during group sex, on objects such as sex toys, fingers, enema equipment, condoms, latex gloves or in contaminated lubricant.
The iBase guide Safer HCV sex for gay men is a useful reminder of what to avoid and what steps to take to protect yourself.
The Hepatitis C Trust has some useful information about transmission. They also provide an advocacy service for men who have sex with men who have been re-infected with hepatitis C after previously being successfully treated.
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What Are The Some Of The Most Common Side Effects Of Hepatitis C Medications
It depends on which drugs you take to treat hepatitis C.
This once-a-day tablet could cure hepatitis in 12 to 16 weeks.
You may have:
- Low blood cell counts
Talk to your doctor if youâve had an organ transplant, or if youâre pregnant, breastfeeding, or plan to get pregnant while taking it. It can cause miscarriages. Also tell your dentist or other doctor youâre on it before you have surgery or any other type of procedure.
This comes as a tablet, capsule, or liquid. You take it with food twice a day, in the morning and evening, for 24 to 48 weeks or longer.
You can expect to have:
- Flu-like side effects
- Gastrointestinal problems
- Low blood cell counts
- Low red blood cell count
Donât take St. Johnâs wort while youâre on this medication. Also, youâll need to use two methods of birth control to prevent pregnancy in you or your partner while taking ribavirin and for 6 months after you stop.
Youâll take it once a day for 12 weeks. Itâs OK for people who have cirrhosis and have already had some treatment.
It could cause side effects like:
Chiron Recombinant Gpe1/gpe2 Vaccine
A significant limitation to the chimpanzee studies of the gpE1/gpE2 vaccine is the lack of understanding of the significance of protection against an intravenous challenge with 10100 CID50 of virus. Although this has become a standard in the field, it is not clear how it relates to the real-world situation. While a contaminated blood transfusion would provide a challenge many orders of magnitude greater than this, such an event would be very unlikely today because of screening procedures in place to protect the blood supply. The typical inoculum size in the setting of community-acquired infections is not known and can only be guessed at. Nonetheless, the data obtained in these chimpanzee challenge experiments suggest that the gpE1/gpE2 vaccine may be capable of protecting against persistent infection with at least genotype 1a viruses . This is likely to be accomplished this via the induction of neutralizing antibodies, since the existence of sterilizing immunity in some animals correlated at least roughly with the magnitude of the antibody response to E2 as assessed by inhibition of E2 binding to CD81 and neutralization of HCVpp entry .
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Institute Of Medicine Report: Adverse Effects Of Vaccines: Evidence And Causality
It is often hard to tell if the vaccine caused the reaction or if it was caused by something else.
It is often hard to tell if a reaction was caused by the vaccine, or if it was caused by something else. For example, if you get hives right after a vaccination, it’s more likely to be caused by the vaccine than if you get them the next day.
Rare events, such as Guillain-Barre syndrome , a form of paralysis that usually resolves, are thought to be associated with some vaccines such as influenza and perhaps with tetanus. These events may occur in about one in a million people who receive the vaccine. Most of these events occur following infections with viruses or bacteria, and not following vaccines. For instance, the risk of GBS after influenza infection is about 17 times higher than it is after influenza vaccination. The vaccine is still safer than the risk of disease.
Where Can I Find More Information On Side Effects
During the immunization visit, your health care provider will review with you the common reactions to each vaccine and will advise that you seek medical attention if you or your child experiences a serious or unexpected reaction.
You can also find a list of possible reactions to each vaccine online in the vaccines HealthLinkBC File. B.C.s routine immunization schedules with links to the HealthLinkBC Files can be found here.
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Living With Hepatitis C
Coping with hepatitis C isnt easy. You may feel sad, scared, or angry. You may not believe you have the disease. These feelings are normal, but they shouldnt keep you from living your daily life. If they do or if they last a long time you may be suffering from depression. People who are depressed have most or all of the following symptoms nearly every day, all day, for 2 weeks or longer:
- Feeling sad, hopeless and having frequent crying spells.
- Losing interest or pleasure in things you used to enjoy .
- Feeling guilty, helpless, or worthless.
- Thinking about death or suicide.
- Sleeping too much or having problems sleeping.
- Loss of appetite and unintended weight loss or gain.
- Feeling very tired all the time.
- Having trouble paying attention and making decisions.
- Having aches and pains that dont get better with treatment.
- Feeling restless, irritated, and easily annoyed.
Talk to your doctor if you notice any of these symptoms. Your doctor can help by recommending a support group or a therapist. He or she may also prescribe a medicine for you to take.
Common And Local Adverse Events
HA vaccine is well tolerated. Reactions are generally mild and transient, and are usually limited to soreness and redness at the injection site. Other less frequent reactions include headache, irritability, malaise, fever, fatigue and gastrointestinal symptoms. Injection site reactions occur less frequently in children than in adults as do mild, systemic events . No significant difference in reactions is evident between initial and subsequent doses of vaccine or in the presence of pre-existing immunity.
Refer to Hepatitis B Vaccine in Part 4 for information about HAHB vaccine.
Injection site reactions following receipt of standard human Ig include tenderness, erythema and stiffness of local muscles, which may persist for several hours. Mild fever or malaise may occasionally occur.
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What Else Should I Know About Hepatitis B/hepatitis A Vaccine
What preparations of hepatitis B/hepatitis A vaccine are available?
- Hepatitis A/B vaccine is available as sterile, preservative-free, intramuscular injections.
- Hepatitis A/B vaccine injections are available in 1 ml single-dose vials and 1 ml single-dose pre-filled disposable syringes.
- Each 1 ml dose of vaccine contains 720 ELISA Units of inactivated Hepatitis A virus and 20 mcg of recombinant Hepatitis B antigen protein.
How should I keep hepatitis B/hepatitis A vaccine stored?
Store hepatitis A/B vaccine under refrigeration between 2 C and 8 C . Do not freeze hepatitis A/B vaccine vaccines and discard if they have been frozen.
Benefits Of The Hepatitis B Vaccine
The main benefit of the vaccine is its effectiveness. The AAP note that if doctors give the first dose of the hepatitis B vaccine within 24 hours of the babys delivery, it is 75 to 95 percent effective in preventing the passage of hepatitis B from the birth mother to the baby.
If the newborn also receives the medication hepatitis B immune globulin at the correct time and a series of follow-up vaccines, the AAP estimate that the infection rate drops to between 0.7 and 1.1 percent.
For the best possible protection, the baby will need to complete the full series of vaccines.
state that the vaccine is very safe. The full series of the vaccine provides the highest possible level of protection from the infection.
Some people still express concern about the safety of vaccination. The reasons for this worry may vary.
Part of the fear may be due to older research. For example, a 2009 study indicated an association between the Engerix B vaccine, a specific type of hepatitis B vaccine, and an increased risk of damage to the central nervous system later in life.
However, the researchers note that this was the exception, not the rule. They also highlight the need for more studies to validate this finding.
On the whole, their research indicates that hepatitis B vaccination generally does not increase the risk of damage to the CNS.
The majority of research indicates that hepatitis B vaccines are a safe and effective way to prevent the infection.
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What Does It Mean To Have A Successful Treatment What Is A Sustained Virologic Response
In an untreated state, the hepatitis C virus infects the cells of the liver and then continuously lives there, making copies of itself that circulate in the bloodstream. Antiviral medications can destroy the ability of the virus to reproduce, so the amount of virus in the bloodstream then decreases. The amount of virus in the blood is measured by aviral load.
Treatment is successful when the viral load drops toundetectablelevels, which means the virus cannot be detected in the bloodstream at all. The viral load becomes undetectable during treatment and remains undetected after treatment has ended. If there is still no detectable virus in the blood 12 weeks after the end of the treatment, the treatment was successful. This is called a Sustained Virologic Response .
A patient who has achieved an SVR is considered to be cured of the hepatitis C virus.
Is There A Vaccine For Hepatitis C
There are no vaccinations that prevent the hepatitis C virus. Vaccinations for hepatitis A and B, however, are given to patients with HCV to prevent the possibility of acquiring another hepatitis virus. Getting hepatitis A or hepatitis B on top of hepatitis C can add liver damage or even cause severe hepatitis. People with hepatitis C should be screened for past infection with hepatitis A and B. If they have no evidence of antibodies, they should receive vaccines for hepatitis A and/or B.
Hepatitis A vaccine may be given alone or in combination with hepatitis B vaccine, depending on whether the patient needs one or both. Hepatitis A vaccine is inactivated hepatitis A virus that stimulates the immune system to develop antibodies against hepatitis A. These antibodies kill the virus before it can cause infection. It is given in 2 doses intramuscularly 6 months apart.
Hepatitis B vaccine is made with hepatitis B antigens that stimulate antibodies against the hepatitis B virus. There is no live virus in the vaccine. It is given in 3 doses intramuscularly the second dose is given 1-2 months after the first, and the last is given 6 months after the first dose. The A and B vaccine is a combination of the above and is dosed in the same way as the Hepatitis B vaccine. It is available under the brand name Twinrix.
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Persons With Inadequate Immunization Records
Children and adults lacking adequate documentation of immunization should be considered unimmunized and started on an immunization schedule appropriate for their age and risk factors. HA vaccine may be given, if indicated, regardless of possible previous receipt of the vaccine or pre-existing immunity, because adverse events associated with repeated immunization have not been demonstrated.
Refer to Immunization of Persons with Inadequate Immunization Records in Part 3 for additional information about vaccination of people with inadequate immunization records.
Babies And Hepatitis B Vaccination
Pregnant women have a routine blood test for hepatitis B as part of their antenatal care.
Babies born to mothers infected with hepatitis B need to be given a dose of the hepatitis B vaccine within 24 hours of their birth, followed by further doses at 4, 8, 12 and 16 weeks of age, plus a final dose when they’re 1 year old.
Babies of mothers identified by the blood test as particularly infectious might also be given an injection of HBIG at birth on top of the hepatitis B vaccination to give them rapid protection against infection.
All babies born to mothers infected with hepatitis B should be tested at 1 year of age to check if they have become infected with the virus.
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Hiv And Hepatitis C Coinfection
HCV infection is common among people with HIV who also inject drugs. Nearly 75% of people living with HIV who report a history of injection drug use are co-infected with HCV. All people who are diagnosed with HIV are recommended to be tested for HCV at least once. People living with HIV are at greater risk for complications and death from HCV infection. Fortunately, direct acting antivirals that are used to treat HCV work equally well in people with and without HIV infection. For more information about HIV and HCV coinfection, visit the HIV.govs pages about hepatitis C and HIV coinfection.
Hepatitis A Adult Vaccine
Hepatitis is a serious disease caused by a virus. Hepatitis causes inflammation of the liver, vomiting, and jaundice . Hepatitis can lead to liver cancer, cirrhosis, or death.
The hepatitis A adult vaccine is used to help prevent this disease in adults.
This vaccine works by exposing you to a small amount of the virus, which causes the body to develop immunity to the disease. This vaccine will not treat an active infection that has already developed in the body.
Vaccination with hepatitis A adult vaccine is recommended for all adults who travel in certain areas of the world where hepatitis A is a common disease.
Like any vaccine, the hepatitis A vaccine may not provide protection from disease in every person.
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How Will My Provider Monitor Me During The Treatment
Your provider will meet with you during treatment to review how well you are tolerating treatment and review laboratory results. Laboratory tests help keep tabs on your health, track the viral load, and determine your response to treatment. You will be given specific dates to go get your blood tested at the lab during and after the treatment.
How Does Hepatitis A Spread
Hepatitis A virus is found in the stool of a person who has the virus. It spreads when a person puts something in his or her mouth that has the hepatitis A virus on it. Even if the item looks clean, it can still have virus on it that can spread to others. The amount of stool can be so tiny that it cannot be seen with the naked eye. You can get it by touching objects such as doorknobs or diapers or eating food that has the virus on it.
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Spread Of Hepatitis C
Hepatitis C is spread through blood-to-blood contact when blood from a person with hepatitis C enters another persons bloodstream.
The most common way people become infected with hepatitis C in Australia is by sharing injecting equipment such as needles, syringes, spoons and tourniquets. It is possible to be infected with hepatitis C after only one risk event.
Hepatitis C may also be spread through:
- tattooing and body piercing with equipment that has not been properly cleaned, disinfected or sterilised such as backyard tattoos’. Registered parlours with appropriate infection control procedures are not a risk
- needlestick injuries in a healthcare setting
- receiving blood transfusions in Australia prior to 1990 before hepatitis C virus testing of blood donations was introduced
- medical procedures, blood transfusions or blood products and mass immunisation programs provided in a country other than Australia
- pregnancy or childbirth there is a 5% chance of a mother with chronic hepatitis C infection passing on the virus to her baby during pregnancy or childbirth.
Breastfeeding is safe, however if nipples are cracked or bleeding cease breastfeeding until they have healed.
Less likely possible routes of transmission of hepatitis C include:
Hepatitis C cannot be transmitted by:
- sharing food, cups or cutlery
- shaking hands or day-to-day physical contact.