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Greenview Hepatitis C Fund
Deborah Green www.hepcfund.org
Home:734- 665-3395Cell: [email protected]
5/31/2008
Differences Between Hepatitis A, B and C
Hepatitis A (HAV)• Transmitted through drinking water or eating food contaminated by fecal
matter• Usually runs its course in 6 months without treatment• Vaccine availableHepatitis B (HBV)• Transmitted through bodily fluids• About 5% of adult cases result in chronic condition which can lead to serious
liver problems and death (approx. 5,000/year in U.S.)• Vaccine availableHepatitis C (HCV)• Transmitted through blood• About 80% result in chronic condition which can lead to serious liver
problems and death (about 10,000 -12,000/year in the U.S.)• No vaccine available ( about 50 subtypes of the virus)
Hepatitis C (HCV)Magnitude of the Problem
• Worldwide: 170 million (3%)
• U.S.: 4 million (1.6%)
• Most common chronic blood borne infection in the U.S., affecting 3-5 times as many people as HIV/AIDS.
• Most common cause of chronic liver disease in western countries and accounts for 40-60% of adult liver transplants in the U.S.
Death Rate from HCV vs. AIDS
• Annual deaths in the U.S related to HCV as estimated by the National Institute (NIH) :
10,000 - 12,000
• CDC figures for HIV/AIDS deaths have not been updated since 2005 when they were 16,000, but a poll of the Departments of Health in all 50 states conducted by www.fairfoundation.org, yielded 10,962 deaths in 2007.)
At Risk Populations
• IV drug abusers • Veterans, especially Vietnam veterans• Homeless • Minorities• Prison inmates• Recipients of blood products prior to 1992
Hepatitis C Symptoms
• Most patients with acute hepatitis C have few or no symptoms.
• Many patients with chronic hepatitis C have no symptoms until they develop complications of cirrhosis.
• Common symptoms including fatigue, anorexia, and other flu-like symptoms correlate poorly with severity of liver disease.
• Quality of life frequently becomes impaired, even in pre-cirrhotic patients
Factors Associated With Disease Progression
• Alcohol consumption
– 30 g/day in men
– 20 g/day in women
• Disease acquisition at >40 years
• Male gender
• HIV coinfection
• Hepatitis B virus coinfection
• Immunosuppression
• Obesity
NIH Consensus Development Conference Statement. 2002.NIH Consensus Development Conference Statement. 2002.Poynard et al. Poynard et al. Lancet.Lancet. 1997;349:825-832. 1997;349:825-832.
~ 2 drinks per day~ 2 drinks per day
Possible Side Effects of Treatment
• Flu-like symptoms - fever, chills, headache, muscle ache
• Anemia, fatigue and/or sleep disturbance
• Anxiety, irritability, depression
• Hair loss, dry cough, skin rash
• Decrease in white cells and platelets
• Retinal hemorrhage/loss of vision in rare cases
•Birth defects and miscarriages
•Unmasking or exacerbation of autoimmune disease
Possible Long Term Complications of Untreated HCV
• Increased cirrhosis, liver cancer, liver failure• Increased skin, joint and muscle problems• Increased incidence of vascular disease
( circulation problems, heart attack, stroke)• 3 times higher rate of type 2 diabetes after age 40• Increased incidence of kidney disease and possible
kidney failure • Increased incidence of autoimmune thyroid disease.
Goals of Treatment of Individual
• Primary goal
- Eradicate HCV infection
• Secondary goals
- Slow or prevent disease progression and scarring of the liver (fibrosis) which otherwise might lead to extensive scarring, (cirrhosis).
- Reduce risk of liver cancer
- Improve health-related quality of life
2005 NIH Research Budget per DeathSource: Fair Foundation (http://www.fairfoundation.org/news_letter/2004/hepatitis_magazine.htm)
0
500
1000
1500
2000
2500
3000
3500
HIV HCV
Pe
r P
ati
en
t S
pe
nd
ing
($
)
2007 NIH Spending per Patient
$3052
$25