Hep 101 Laying Down A Framework Today We Will вЂў Define hepatitis, viral hepatitis & the liver вЂў Learn about the 5 different types of viral hepatitis вЂў Learn more about hepatitis C: вЂ“The scope of the disease вЂ“Signs/symptoms вЂ“Risk factors and prevention What Is Hepatitis? вЂў Hepatitis means inflammation of the liver вЂ“ Hepat (liver) + itis (inflammation)= Hepatitis вЂў Viral hepatitis means there is a specific virus that is causing your liver to inflame (swell or become larger than normal) The Liver вЂў Is located in the upper right quadrant of the abdomen вЂўCleans the blood вЂўRegulates hormones вЂўHelps with blood clotting вЂўProduces bile вЂўProduces important proteins вЂўMaintains blood sugar levels вЂўAnd much, much, more вЂў 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: fecalвЂ“oral transmission Adapted from Corneil, 2003 Hepatitis C Infection вЂў World - 170 million people вЂў Canada - 240,000 to 300,000 (0.8% to 1% of pop.) вЂў BC - 40,000 (1%) вЂў Vancouver - 11,350 (2%) вЂў DTES VIDUS Study - 1,437 вЂў90% hep C posititve WHO 2000, BC Hepatitis Service 2003, VIDUS 2003 Hepatitis C вЂў Affects each person differently вЂў No vaccine available вЂў Many people have the virus and do not even know it вЂў 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 ConвЂ™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 вЂў 30yrs or longer if: вЂў Young at time of infection вЂў Healthy liver at time of infection вЂў Female вЂў 20yrs or less if: вЂў Drinking alcohol вЂў Co-infection (HIV, Hep B) вЂў Damaged liver before infection Adapted from Bigham, BC Hepatitis Services 2002 Signs and Symptoms вЂў Individuals may have one or more of the following symptoms, while others experience no symptoms: вЂ“Tiredness вЂ“Nausea вЂ“Muscle or joint pain вЂ“Trouble sleeping вЂ“Loss of appetite вЂ“Weight loss вЂ“Abdominal pain вЂ“Itchiness вЂ“Depression вЂ“Dark urine (pee) Signs and Symptoms вЂў A few may have specific liver related symptoms initially: вЂ“ Pale stool (poo) вЂ“ 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 вЂў Hepatitis C is not spread by: вЂ“Casual contact вЂ“ Hugging/kissing вЂ“ Sharing eating utensils and drinking glasses вЂ“ Sneezing/coughing вЂ“ Shaking hands вЂ“ Sitting on a toilet seat Prevention вЂў Never share drug equipment вЂ“ Straws, bills, needles, syringes, water, filter, cooker, pipes etcвЂ¦ вЂў Never share tooth brushes/razors or any personal hygiene articles that have blood on them (even tiny amounts). вЂў Practice safer sex Prevention вЂў Always make sure new & sterilized equipment is being used for tattooing & piercing вЂ“ Make sure ink for tattooing is not being shared вЂў Do not touch dirty needles without proper equipment or following proper procedures Dirty Needle Precautions 1. Handle only if you have proper equipment вЂў Sturdy pair of gloves, tongs or pliers and a puncture proof container (heavy plastic or metal) 2. Place needle in puncture proof container вЂў 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 вЂњmilkвЂќ prick site 2. Wash the area with soap and water 3. Go to nearest emergency department for assessment and treatment Questions?