Laying Down A Framework

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Hep 101
Laying Down A Framework
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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

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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)

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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 !

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Inflammation
Walls of scar tissue begin to form
Healthy liver cells become trapped by a wall of
scar tissue
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Viral Hepatitis

• 5 types
• A fecal-oral transmission
• B sexual fluids blood to blood
• C blood to blood
• D travels with B
• E fecaloral transmission

Vaccine Preventable
Adapted from Corneil, 2003
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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
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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

BC Hepatitis Service 2003
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Natural History of Hep C
20 Clear the Virus
Chronic Infection
Acute Infection
Healthy Liver
80 Virus Continues to Damage Liver
Adapted from Lauer and Walker, NEJM 2001
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Natural History Cont
Liver Cancer 1-4/year
Cirrhosis 20-30
Chronic Hepatitis
Most symptoms begin to show only when liver is
more severely damaged
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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
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Signs and Symptoms

• Individuals may have one or more of the
  following symptoms, while others experience no
  symptoms

• Weight loss
• Abdominal pain
• Itchiness
• Depression
• Dark urine (pee)

• Tiredness
• Nausea
• Muscle or joint pain
• Trouble sleeping
• Loss of appetite

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Signs and Symptoms

• A few may have specific liver related symptoms
  initially
• Pale stool (poo)
• Jaundice (yellowing of the skin or eyes)

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Risk Factors
Source Health Canada Enhanced Surveillance, Oct
98-Oct 99, Calgary, Edmonton, Winnipeg, Ottawa
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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

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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

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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

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Dirty Needle Precautions

• Handle only if you have proper equipment
• Sturdy pair of gloves, tongs or pliers and a
  puncture proof container (heavy plastic or metal)
• Place needle in puncture proof container
• Do not touch needle with bare hands and do not
  try to recap needle if cap present
• Can dispose container in garbage but better if it
  is taken to health clinic or needle exchange
• At school, notify custodian, teacher, nurse or
  police liaison officer

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Needle Prick

• Do not milk prick site
• Wash the area with soap and water
• Go to nearest emergency department for assessment
  and treatment

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Questions?