Hepatitis C

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Disorders of the liver are intricate and often complicated to understand. Because of the vitality of the liver to the basic life process, even simple problems with its system have the potential to cause life-threatening problems. Life-style choices are often a contributing factor in many liver disorders such as: drug abuse and alcoholism. Some problems in the liver occur due to medical treatments that are prolonged for other illness and unfortunately, have an effect of the liver due to its role in processing of medication.

There are many forms of hepatitis including Hepatitis A, B, C, D, and G. For the purposes of this discussion, the concentration will be on Hepatitis C with the understanding that they are all, to a certain degree similar. All hepatitis affect the liver in varying degrees and ways with progression at different levels depending on the type of virus, Hepatitis C appears to be the most common in the United States at this time and its pathology and disease progression will be explored.

Hepatitis C is a blood borne infection with new cases being reported each year. The most prevalent reason reported for the cause of infection is needle sharing during illegal drug use. Some other reasons include exposure to infected blood at work, typically from needle sticks. Some transmission of the virus from mother to child during childbirth is reported as well “about 6%” (Tabers, 19th Edition). There is no evidence that breast-feeding spreads HCV. HCV-positive mothers should consider abstaining from breast-feeding if their nipples are cracked or bleeding. Classification of hepatitis as C is a result of a significant proportion of cases of viral hepatitis being neither hepatitis A, hepatitis B, or hepatitis D: with this discovery came the classification of hepatitis C. Hepatitis C was initially referred to as non-A, non-B hepatitis. Recent studies suggest the

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HCV may survive on environmental surfaces at room temperature at least 16 hours bur no longer than 4 days.

There seems to be an increased risk for hepatitis C for persons involved in certain lifestyle choices. The disease itself is primarily blood borne but can also be transmitted sexually and parentally. People with increased risk to hepatitis C are: injection drug users, sexually active people with more than one partner, persons requiring large volumes of blood products or frequent transfusions, and people working in the health care field. Tattooing, body piercing, and intranasal cocaine abuse have been related to some cases (Tabers, 19th ed.) Incubation from exposure to disease can range from 15 to 160 days with an average of 45 days (Stanhope & Lancaster 2004), with symptoms being usually mild. After contracting hepatitis C a person increases the risk for liver problems such as chronic liver disease and can manifest into cirrhosis of the liver and possibly liver cancer later in life (CDC website). With the initiation of blood screening, the occurrences of hepatitis associated with blood transfusions have reduced. Through the efforts of public health programs there is also a reduction in the number of cases associated with shared needles among illicit drug use. Chronic carrier state is possible with this disease and occurs in 85% or more of cases (Stanhope & Lancaster, 2004).

Diagnosis is often made after an asymptomatic person has repeatedly elevated liver enzymes on routing blood test. There does not appear to be any benefit from rest, diet, or vitamin supplementation as previously believed. There is no vaccine for Hepatitis C. The main focus for control and prevention is screening of blood and organ donors and reducing behaviors that increase risk of contracting the disease. Hepatitis C

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along with hepatitis B & D are associated with chronic hepatitis. Chronic use of alcohol and/or exposure to other toxins can also contribute to disease progression. During the physical assessment of the patient with a normal liver, the edge is firm and sharp with a regular ridge and smooth surface. If, during palpation, the liver is below the costal margin medially and laterally it is enlarged. Abnormality includes being enlarged, having an irregular border and having nodules present.

Treatment for hepatitis C that has been approved in the United States is mainly Interferon (interferon alfa-2b). Copstead