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Epidemiological analysis of the Hepatitis C Virus

Historical Perspective of hepatitis C

According to the National Center for Health Statistics (2006) of the hepatitis C virus (HCV) is blood chronic viral infection common in the United States; about three times as many people are infected with hepatitis C who are infected with HIV. First identified in 1988, HCV is the causative agent of what was once known as hepatitis A and B, and is estimated to have infected up to 242,000 Americans each year during the 1980s Since 1989, the annual number of new infections has fallen by more than 80 percent to about 41,000 in 1998. A national survey (the third Nutrition Survey [NHANES III] National Health and) the civilian population, noninstitutionalized US found that 1.8 percent of the citizens of the United States (3.9 million) have been infected with HCV, the majority (2.7 million) are chronically infected with HCV (National Center for Health Statistics, 2006). While new infections are declining steadily, the prevalence of liver disease caused by HCV is increasing due to the difference in time between the onset of infection and clinical manifestations.

Hepatitis C may be the most deadly disease ever heard. In part because of the delay between the occurrence and infection often causes no symptoms for decades. Carriers of the virus may never know or do not know they are infected. According to Betsy (2006) for many years, no one knew what was causing a wave of severe liver disease; they could only discern that was different from hepatitis A and B, which are acquired differently and are generally less severe, is called A and hepatitis B. The virus has eluded detection until 1989, when scientists have used innovative techniques to find him. Even now, it is very difficult to study and last year only 2,005 scientists were able to grow in a lab (Betsy, 2006).

Risk factors for infection

Hepatitis C is not spread, for example, squeezing, shaking hands, or sharing drinking glasses or utensils. People who are at increased risk of HCV transmission are intravenous users, individuals with a tattoo or body piercing history, cocaine users, or long-term sexual partners of HCV positive patients or even People with a history of multiple sexual partners. People with the disease should not share toothbrushes or razors, which could lead to small amounts of blood. According to the Center for Disease Control (2006), the rate of sexual transmission is low, especially for people in monogamous relationships, which rarely happens. The common risk factor through unprotected sexual intercourse with multiple partners. While other types of exposure are more likely to transmit HCV (eg transfusion from an infected donor), representing a smaller proportion of infections due to the relatively small proportion of the population that these exhibitions were held (Control Center Disease, 2006). Although the risk of transmission of HCV infection through sexual transmission is low, sex is a common behavior in the general population, which may increase the risk of transmission

According to the National Center for Health Statistics (2006) before the mid-1980s, there was a 7 percent to 10 percent risk of hepatitis C from blood transfusion. This risk has been reduced by over 50 percent between 1985 and 1990 as a result of the implementation of screening blood donors for HIV and hints for hepatitis C. In 1990 tests, the selection of donors for specific HCV was implemented and in 1992, the risk of HCV infection from a unit of transfused blood was reduced to 100 000. In 2001, the risk of HCV infection from a unit of transfused blood is less than one per million units transfused (National Center for Health Statistics, 2006).

Other risk factors associated with HCV infection are; clotting factor concentrates, which are plasma products used to treat people with hemophilia, employment in health care and the birth of a mother infected with HCV. Using virus inactivation procedures have reduced the risk of HCV transmission through plasma products. Currently, all immunoglobulin products are subjected to a virus inactivation procedure or test is negative for HCV prior to release.

Treating hepatitis C.

The Department of the New York City Health and Mental Health (2006) suggest that the ultimate goal of HCV treatment is sustained virologic response (SVR), which is associated with a lower risk for liver-related death and overall mortality. The treatment of choice for patients infected with the combination of interferon and ribavirin paged. The pegylated interferon is administered subcutaneously; Ribavirin is taken orally (NYC Department of Health and Mental Hygiene, 2006). Adverse effects associated with treatment can lead to symptoms of flu patients who have early in treatment, depression, fatigue, memory and concentration problems, disorders of the retina. Because the drug available can cause serious side effects, patients may choose not to pinch drug therapy with your health care. Another aspect that is common in the progression of hepatitis C are the consequences of chronic liver disease hepatitis C will become apparent until 10-20 years after infection, making it difficult to implement strategies to prevent the spread of HCV .

Implications Monitoring

The National Center for Health Statistics (2006) suggests monitoring is essential to determine the effectiveness of national, state, and local efforts to prevent hepatitis C. However, surveillance of hepatitis C is complicated by the absence of a laboratory test that can differentiate between the newly acquired infections acquired in the past infections. Although acute hepatitis (ie, clinical disease) is mandatory in all States, only a few states conduct surveillance for cases of acute hepatitis C to monitor the incidence of the disease. However, about 30 states have requirements for reporting laboratory test HCV positive, most people are infected with HCV resolved or chronic (National Center for Health Statistics, 2006). The CDC used surveillance important is the study and NHANES III sentinel surveillance. NHANES III identified the high prevalence of HCV infection in the United States. Intensive sentinel surveillance conducted in six counties is another CDC surveillance for chronic liver disease to determine trends of chronic HCV incidence estimates of HCV infection depend primarily on data from the Sentinel Counties Study. Fos and Fine (2005) indicates the objectives selected sentinel surveillance sites. The data collected is used to provide an assessment of the impact of intervention strategies and detailed study of demographics and behavior of the population (Fos & Fine, 2005 p.151). The prospective epidemiological surveillance programs help improve the understanding of the natural history of HCV infection, to monitor national trends in chronic hepatitis C, and provide estimates of the contribution of infection by HCV chronic liver disease in the United States . Monitoring of HCV ultimately used to continuously monitor the conditions that increase the risk of transmission.

Morbidity Hepatitis C

According to the National Association of County and City (2006) Currently, there are about four million Americans infected with hepatitis C virus (HCV), eight to ten thousand of them die each year from disease. In addition, the cost of HCV is estimated at more than $ 600 million a year in medical expenses and lost work (National Association of County and City, 2006). The dilemma for health professionals is clear because of the lack of rapid progression of the disease and the association with liver disease, it is very difficult to medically manage the disease and prevent infection. The Center for Disease Control (2006) indicates that approximately 15 percent to 25 percent of people with acute hepatitis C infection without solving their other problems. The rest develop chronic infection and about 60 percent to 70 percent of these people develop chronic hepatitis. Liver cirrhosis develops in 10 percent to 20 percent of people with chronic hepatitis C over a period of 20-30 years, and hepatocellular carcinoma (liver cancer) by 1-5 percent (Center for Disease Control, 2006).

The impact of HCV in health care organizations and providers

HCV is a problem for health care organizations and providers. It’s almost a creeping disease and monitoring HCV incidence is almost impossible. No reliable markers of clinical or laboratory for acute HCV infection. The Center for Disease Control (2006) indicates that the symptoms are absent or non-specific in at least 80% of newly infected patients, HCV antibodies appear a few months after exposure and chronic liver disease associated with HCV develops insidiously and take decades to present (Center for Disease Control, 2006).

The knowledge about hepatitis C is complex and rapidly evolving. Because hepatitis C is reported that recently, health professionals often are not aware of current information on diagnosis, medical treatment and prevention of this disease. Pen and the Center for Disease Control (2006) indicates that there is federal funding available to support the advice of the hepatitis C in the country setting and testing at national or local level. In response to this lack of federal funding, a number of services of state and local health projects funded counseling and testing for hepatitis C (Center for Disease Control, 2006). Most of these local programs depended heavily on technical and material support developed by the CDC.
Because there is not enough money and specialists to treat those infected with HCV, the majority of care for these patients is moving primary care providers. According to the New York Department of Health and Mental Hygiene (2006) when a patient is diagnosed with a chronic HCV infection, the primary care physician is involved in the initial stages of attorney to take other diagnostic tests and vaccines and detection. If primary care providers are aware of the most common pharmacological recommendations, then they can begin treatment in the patient (Department of the New York City Health and Mental Hygiene, 2006). Primary care providers must be able to detect, diagnose and treat HCV infected or to refer patients to a specialist patient.

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