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 Vaccine D: travels with B Preventable E: fecal–oral transmission 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 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 Overall cure rate with new treatment is 55% *BC Hepatitis Service 2003 * Natural History of Hep C Only 20% will show symptoms Initially ! Healthy Liver Acute Infection 20% Clear the Virus Chronic Infection 80% Virus Continues to Damage Liver Adapted from Lauer and Walker, NEJM 2001 Natural History Con’t Chronic Hepatitis Cirrhosis 20-30% Liver Cancer 1-4%/year 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: –Tiredness –Nausea –Muscle or joint pain –Trouble sleeping –Loss of appetite –Weight loss –Abdominal pain –Itchiness –Depression –Dark urine (pee) Signs and Symptoms • A few may have specific liver related symptoms initially: – Pale stool (poo) – Jaundice (yellowing of the skin or eyes) Risk Factors IDU/snorting (51%) No RF identified (23%) Incarceration (3%) Transfusion/dialysis blood contact (4%) Hospitalization dental work (6%) Tattooing piercing (6%) HCV-infected household member/sexual partner (7%) 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 1. Handle only if you have proper equipment • Sturdy pair of gloves, tongs or pliers and a puncture proof container (heavy plastic or metal) 2. Place needle in puncture proof container • Do not touch needle with bare hands and do not try to recap needle if cap present 3. Can dispose container in garbage but better if it is taken to health clinic or needle exchange 4. At school, notify custodian, teacher, nurse or police liaison officer Needle Prick 1. Do not “milk” prick site 2. Wash the area with soap and water 3. Go to nearest emergency department for assessment and treatment Questions?