hepatitis c virus presented by: rabia ejaz tahira karim hafsa iftikhar
TRANSCRIPT
TABLE OF CONTENTS:•Introduction
• Structure
• Genome
• Genotype
• Life cycle
• Hepatitis C
• Risk factors
• Symptoms
• IDUs
• Prevalence
• Classification
• Treatment
INTRODUCTION:
• HCV was discovered in 1989 as the
major causative agent of non-A,
non-B hepatitis.
• It is plus stranded RNA virus.
• Hepatitis C virus (HCV) is a small
(55–65 nm in
size), enveloped, positive-
sense single-stranded RNA virus of
the family Flaviviridae. Hepatitis C
virus is the cause of hepatitis C in
humans.
• Hepatitis C virus mutate rapidly.
STRUCTURE:
Heptitis C virus particle consist of
core of genetic material (RNA)
• It is surrounded by icosahedral
protein
• further encased in a lipid (fatty)
envelope of cellular origin.
•Two viral envelope glycoproteins, E1
and E2, are embedded in the lipid
envelope.
GENOME• Hepatitis C virus genome is positive
sense single stranded RNA genome.
• at 5’ and 3’ end of RNA are UTR that
are not translated into proteins but are
important to translation and replication
of viral RNA.
• Genome is composed of both
structural and non-structural proteins.
GENOTYPES• There are eleven genotypes of HCV of which
six are major genotypes.
• genotype 3 is most common in pakistan • In 1997 it was reported in a small study that
the 87% individuals in Pakistan had genotype 3 .
• In 2004, a panel of 30 top gastroenterologist of the country met in a conference and reported that 75%-90% HCV patients in Pakistan had genotype 3a.
• Qazi et al in 2006 reported that 71% patients had genotype 3 while only 10% had genotype 1.
• In 2007 it was reported that 81% individuals had genotype 3 while only 9.5% had genotype 1.
INTRODUCTION:Hepatitis C is a viral disease that
leads to swelling (inflammation)
of the liver.
Hepatitis C is an infection of the
liver caused by the Hepatitis C
Virus (HCV). The hepatitis C virus
(HCV) is a virus that infects the
liver, and can cause inflammation
and scarring of the liver. The
initial phase of HCV infection is
called acute hepatitis C. If the
virus persists in the body for
more than six months, the
disease enters the chronic
hepatitis C phase.
.
HIGH RISK FACTORS:
• Blood transfusion
• Barber
• Unnecassry and unsave needles
• Breast feeding
• Babies born to infected mothers
• Heamodialysis
•LOWER RISK FACTOR:• sharing personal hiegene item
with infected
• person(toothbrushes ,
razors ,scissors and nail clippers)
• Contaminated tattoo needles and
ink
• contaminated body piercing
implements
SYMPTOMS:The HCV infection takes years to produce
symptoms in those infected with this virus.
About 35% of the infected people may
produce symptoms while the rest may not
produce symptoms at all. HCV does not have
prominent symptoms in the early stage. The
infected individual may experience vague
symptoms such as
• abdominal pain
• impaired digestion
• loss of appetite
• lassitude
• weakness
• itching
Patients in the advanced stage may experience
more severe symptoms such as
• paleness (whiteness) of eyes
• loss of appetite
• depression
• bleeding from rectum
• bloody vomiting
• exhaustion
• weight loss
Advanced stage symptoms of Hepatitis C are
those due to chronic inflammation of liver
(hepatitis), cirrhosis (scarring of tissues) of liver
and/or liver failure.
HCV in Injecting Drug Users (IDUs)
• It was estimated that there was about 5 million drug users in Pakistan out of which 15% were regular IDUs.
• There is an increase shift among addicts from inhalatory to injectable drugs due to decrease in quality and availability of heroin (common inhalatory drug used in Afghanistan and Pakistan) .
Prevalence in Pakistan:
• There are various reports regarding HCV
seroprevalence in IDUs from different areas of
Pakistan. It was reported that HCV
seroprevalence in Karachi population was 94 %.
• Kuo et al in 2006, reported that HCV
seroprevalence in IDUs population of Lahore and
Quetta was 88%, in a separate study from Quetta
it was reported that HCV seroprevalence was
60%. HCV seroprevalence among the IDUs of
Rawalpindi and Abottabad was 17.3% and 8%
respectively
Incubation period
2-25 weeks
average 7-9 weeks
Virus enter the
body• Binds & enters cell (usually liver receptor)
• Virus loses lipid coat and polyprotein
envelop – freeing RNA
• Enzymes in the cell make large viral
protein to help make new viral RNA
• Virus releases new virus into blood and
eventually kills host cell
• Replication - > 1 trillion per day
HEPATITIS C classificationACUTE HEPATITIS CHRONIC HEPATITIS
Acute hepatitis is the rapid, sharp, painful onset of the disease. Acute symptoms are more painful for patients, but they last for only three or four weeks. Depending on the patient's immune system, acute symptoms range from mild to severe liver failure
chronic hepatitis is less common and symptoms are less severe. Chronic hepatitis remains in the patient's system for months or even years. Its symptoms are usually mild, but continual infection and destruction of the tissue causes liver damage leading to cirrhosis. Cirrhosis is caused by scarring of the liver, and it can lead to failure or liver cancer.
TREATMENT FOR HCV
Interferon:
• Interferon is the only agent of proven efficacy in the treatment of hepatitis C. Standard treatment is interferon alfa-2b at a dose of three million units three times a week. The initial course of treatment is 6 months, but require retreatment.
• The goal of interferon treatment is suppression of active disease; this usually requires long term therapy.
• Eradication of virus does not appear to be a realistic goal in most patients
.
Ribavarin:•It inhibit the replication of RNA virus in cell culture.
• It is an anti-viral drug which is nucleoside analog.It
is taken orally twice a day.
•It decreases hepatitis C virus infectivity in a dose
treatment manner
• The exact way ribavirin work when it enter the cell
is unknown.
Side effects
Interferon Fatigue Muscle/Joint pain Nausea Headaches Anxiety Depression Dry Skin/rashes
Ribavirin seems to make
interferon side effects worse – especially fatigue-Anemia