Hepatitis C discussion essays – NSG-530-IKC – Advanced Pathophysiology
Mike is a 23-year-old white male admitted for severe depression. He has a history of bipolar disorder and is currently taking valproate (Depakote) 500 mg XR daily. His psychiatrist ordered LFT’s to follow the valproate therapy. LFT’s were abnormal: ALT 1178 u/L, AST 746 u/L. the patient was asymptomatic. He denies fever, abdominal pain, nausea, vomiting or jaundice. He denies using other medication or alcohol but admits using illicit IV drugs starting about 8 weeks ago and continuing to present. He never had a blood transfusion. Aside from Depakote he is presently taking clonazepam 1 mg prn and fluoxetine (Prozac) 40 mg qd.
Other blood work: Direct bili 1 mg/dL, alk phos 188 u/L, anti-HCV negative on hospital day 1, positive on day 3. HCV-RNA PCR positive. Hep A, B, and D markers negative Hepatitis C discussion essays – NSG-530-IKC – Advanced Pathophysiology.
Patient diagnosis: Acute Hepatitis C.
1. List some clinical manifestations typically seen in Hepatitis C and major treatment strategies.
Post your initial response by Wednesday at midnight. Respond to one student by Sunday at midnight. Both responses must be a minimum of 150 words, scholarly written, APA formatted, and referenced. A minimum of 2 references are required (other than your text). Refer to grading rubric for online discussion.
- Hepatitis C is a long-term viral infection that affects about 185 million people globally. Approximately 215,000 people have this disease in the U.S. (Tang et al. 2016). It is associated with liver inflammation, which may sometimes lead to serious and severe liver damages. The disease spread through contaminated blood (Huether et al. 2020). Some of the major signs and symptoms of this condition include loss of appetite, flu-like symptoms, fatigue, abdominal pain, jaundice, weight loss, and confusion. These symptoms can sometimes be mistaken for other conditions since the disease doesn’t show noticeable symptoms until it damages the liver.The treatment plan for individuals with chronic hepatitis c involves taking prescription drugs to fight the virus, testing for liver damages, and lifestyle changes to reduce the disease’s severity Hepatitis C discussion essays – NSG-530-IKC – Advanced Pathophysiology. Treatment involves taking direct-acting antiviral tablets (DAA), which are believed to be the most effective and safest medicines available in the healthcare system. Patients should take these medications between 8 and 12 weeks (NHS, 2021). Some of these drugs include simeprevir, sofosbuvir, and their combinations.Huether, S., McCance, K. L. & Brashers, V. L. (2020). Understanding Pathophysiology 7th ed. Elsevier Mosby.Tang, L., Marcell, L., & Kottilil, S. (2016). Systemic manifestations of hepatitis C infection. Infectious agents and cancer, 11(1), 1-8. https://core.ac.us/download/pdf/81269554.pdf less1 UnreadUnread2 ViewsViews
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- NHS, (2021). Treatment: Hepatitis C. NHS.us. https://www.nhs.us/conditions/hepatitis-c/treatment/
- The first clinical manifestation seen in hepatitis c is a mixed cryoglobulinemic syndrome, which can affect the patients’ blood vessels and manifest on other body organs including the kidney and skin. The second manifestation is B cell Non-Hodgkin’s lymphoma, which is highly associated with chronic HCV infection since 1994 (Tang et al. 2016). The other manifestations are diabetes mellites type 2 and kidney damage. Several researchers have proved that there is an association between HCV, diabetes and increased insulin resistance. HCV can also affect the brain leading to neurological impairment Hepatitis C discussion essays – NSG-530-IKC – Advanced Pathophysiology. The other manifestations include sicca syndrome, thyroid abnormalities, Mooren’s corneal ulcers, skin manifestations such as Porphyria cutanea tarda, Neuropsychiatric disorders, and Cardiovascular disease.
- Hepatitis C the silent chronicitySubscribe
- Caroline Otto posted Feb 25, 2021 6:26 PM
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- The overall prevalence of chronic hepatitis C virus (HCV) infection has been estimated at between 1.2% and 1.7% in the adult global population. This suggests that 62 -89 million people are affected by this disease (Kish, Aziz, & Sorio, 2017).People who are exposed to HCV have an estimated 75% to 85% likelihood of developing chronic infection. The Clinical Manifestations for hepatitis C are similar with all the different strains because they all cause inflammation of the liver, thereby causing symptoms that are similar. These similar symptoms include jaundice, nausea, dark urine, and right upper quadrant pain (Huether, McCance, & Brashers. 2020). Patients who are acutely infected will have moderate to high serum; aminotransferase elevations, and aspartate transaminase (AST), and alanine transaminase (ALT) levels.The first phase is known as the Prodromal -preicteric phase beginning about 2 weeks after exposure and ending with jaundice, often marked with fatigue, anorexia, malaise, nausea, vomiting, headache, a cough, and a low-grade fever. It is during this phase that the patient has the highest ability to transmit the virus to others Hepatitis C discussion essays – NSG-530-IKC – Advanced Pathophysiology.The recovery phase is the third phase beginning with the dissolution of the jaundice, six to eight weeks after the initial exposure. The overall symptoms dissipate; however, the liver remains enlarged and tender. It is during this phase that the liver function and enzymes return to normal, two to twelve weeks after the onset of jaundice.The diagnosis of HCV infection is based on the presence of anti-HCV antibodies. HCV RNA quantification is important for assessment of the viral load to evaluate antiviral therapy for chronic HCV infection. To date there is no HCV vaccine in the USA. Primary health care is paramount. Individuals who exhibit high risk behaviors such as intravenous drug abuse should be identified and screened to improve overall healthcare outcomes. Treatment is costly. The overall management of this dreadful disease depends on an easily accessible health system that is available to everyone. Horsley-Silva, J. L., & Vargas, H. E. (2017). New Therapies for Hepatitis C Virus Infection. Gastroenterology & hepatology, 13(1), 22–31 Kish, T., Aziz, A., & Sorio, M. (2017). Hepatitis C in a New Era: A Review of Current Therapies. P & T : a peer-reviewed journal for formulary management, 42(5), 316–329.less1 UnreadUnread3 ViewsViews
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- Huether, S. E., McCance, K.L. & Brashers, V.L. (2020). Understanding Pathophysiology 7th ed. Elsevier Mosby
- In short, Acute HCV has devastating consequences, as it often goes undiagnosed, and causes irreparable damage often resulting in Chronic Hepatitis C and Liver Failure Hepatitis C discussion essays – NSG-530-IKC – Advanced Pathophysiology. Patients who are infected often do not realize they have the disease and are not tested. Furthermore, the symptoms are vague and are not disease specific.
- In the past HCV was treated with pegylated-interferon (PEG-IFN) alpha plus ribavirin (RBV) which was historically given for 24 or 48 weeks. However, this combination was not that successful and had some nasty side effects such as hemolytic anemia, flu-like symptoms, and psychiatric disturbances. There have been other treatments since then, but it was through a paradigm shift which occurred in late 2013 that Simeprevir (Olysio, Janssen) and sofosbuvir (Sovaldi, Gilead Sciences); which were released within weeks of one another, created the first oral once-daily treatments that were well tolerated and were able to produce sustained virologic response SVR rates greater than 90% either together in combination or with PEG-IFN plus RBV in select genotypes (Horsley-Silva & Vargas, 2017).
- The second phase is known as the Icteric phase and it begins one to two weeks after the prodromal phase and lasts up to six weeks, with jaundice, dark urine, and clay-colored stools. On physical examination the patient’s liver will be found to be enlarged, smooth, and tender, and percussion or palpation of the livers causes pain. The patient will still have fatigue as well as abdominal pain which will be persistent or will increase in severity. This phase is seen as the actual phase of the illness. Patients who develop chronic HCV infection will not exhibit signs of jaundice here and may never actually be diagnosed Hepatitis C discussion essays – NSG-530-IKC – Advanced Pathophysiology.
- The clinical course of hepatitis usually has three phases which follows through after the incubation phase.
- If it were not for Mikes severe depression that caused him to seek out medical care, his Hepatitis C diagnosis would probably have gone unnoticed. Most patients who are acutely infected with HCV are asymptomatic (Huether, McCance, & Brashers, pg. 904).
- Discussion 6Subscribe
- Alfonsina Perez posted Feb 24, 2021 3:54 PM
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- Hepatitis C is defined as an inflammatory process of the liver caused by the hepatitis C virus (Dirchwold et al., 2017. Patients with hepatitis C have an increased level in their Alaine Aminotransferase (ALT) of over ten times what is considered within normal limits (Dirchwold et al., 2017). Complications associated with chronic infection of the hepatitis C virus include hepatic fibrosis, liver cirrhosis, and hepatic carcinoma (Zhao et al., 2018). Unfortunately, many patients, about 85% of those with acute hepatitis, will develop chronic hepatitis. The high risk of developing chronic hepatitis is due to the fact that many patients with acute hepatitis do not show any symptoms until infection has developed into a chronic one (Zhao et al., 2018). Acute hepatitis C is when the infection occurs within 6 months of exposure (Huether et al., 2020). Chronic hepatitis C is lifelong, often leading to complications. Some of the symptoms associated with hepatitis C infection include abdominal pain, fatigue, sleep disturbance, depression, musculoskeletal pain and jaundice (Evon et al., 2019). Petta, N. G., Borzi, S., Tanno, F., Ridruejo, E., Barreyro, F., Shulman, C., Plaza, P.,Evon, D. M., Sarkar, S., Amador, J., Lok, A. S., Sterling, R. K., Stewart, P. W., Reeve, B. B.,Harrington, P. R., Komatsu, T. E., Deming, D. J., Donaldson, E. F., O’Rear, J. J., & Naeger, L.Huether, S. E., McCance, K. L. & Brashers, V. L. (2020). Understanding Zhao, N., Zheng, W., Wu, D., Wang, X., Yang, W., Yuan, L., Niu, Z., Jiang, X., Huang, F., &hepatitis C spontaneous clearance or treatment‐induced clearance Hepatitis C discussion essays – NSG-530-IKC – Advanced Pathophysiology. Journal of Medicalless1 UnreadUnread5 ViewsViews
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- Virology, 90(12), 1787-1792. https://doi.org/10.1002/jmv.25256
- Li, Z. (2018). Clinical value of hepatitis C virus core antigen levels in monitoring acute
- Pathophysiology 7th ed. Elsevier Mosby.
- K. (2018;2017;). Impact of hepatitis C virus polymorphisms on direct‐acting antiviral treatment efficacy: Regulatory analyses and perspectives. Hepatology (Baltimore, Md.), 67(6), 2430-2448. https://doi.org/10.1002/hep.29693
- Serper, M., Reau, N., Rajender Reddy, K., Di Bisceglie, A. M., Nelson, D. R., Golin, C. E., Lim, J. K., & Fried, M. W. (2019). Patient-reported symptoms during and after direct-acting antiviral therapies for chronic hepatitis C: The PROP UP study. Journal of Hepatology, 71(3), 486-497. https://doi.org/10.1016/j.jhep.2019.04.016
- Carbonetti, R., Tadey, L., Schroder, T., & Fainboim, H. (2017). Clinical epidemiology of acute hepatitis C in south america. Journal of Medical Virology, 89(2), 276-283. https://doi.org/10.1002/jmv.24588
- Dirchwolf, M., Marciano, S., Mauro, E., Ruf, A. E., Rezzonico, L., Anders, M., Chiodi, D.,
- Although hepatitis C may not always require treatment as the person’s immunity may be able to clear the infection, antiviral medication may be prescribed in instances when treatment is required. Pan- genotype direct-acting antivirals (DAA’s) are the treatment of choice of hepatitis C (Harrington et al., 2018) Hepatitis C discussion essays – NSG-530-IKC – Advanced Pathophysiology.