Hepatitis

Laying Down A Framework

 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
 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)
 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 !
 Inflammation

Walls of
scar
tissue
begin to Healthy liver cells
form 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
D: travels with B Vaccine
Preventable
E: fecal–oral transmission
Adapted from Corneil, 2003
 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
 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
*
Overall cure rate with new treatment is 55%
*BC Hepatitis Service 2003
 Natural History of Hep C
20%
Only 20% will Clear the
show symptoms Virus
Initially !

Healthy Acute Chronic

Liver Infection Infection

80% Virus
Continues
to Damage
Liver
Adapted from Lauer and Walker, NEJM 2001
 Natural History Con’t

Chronic Cirrhosis Liver

Hepatitis 20-30% Cancer
1-4%/year

Most symptoms begin to show only when liver is more severely damaged
 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

 Signs and Symptoms
• Individuals may have one or more
of the following symptoms, while
others experience no symptoms:
–Tiredness –Weight loss
–Nausea –Abdominal pain
–Muscle or joint pain –Itchiness
–Trouble sleeping –Depression
–Loss of appetite –Dark urine (pee)
 Signs and Symptoms
• A few may have specific liver
related symptoms initially:
– Pale stool (poo)
– Jaundice (yellowing of the skin or
eyes)
 Risk Factors IDU/snorting
(51%)
No RF identified
(23%)

Incarceration (3%)

Transfusion/dialysis
blood contact (4%) HCV-infected household
member/sexual partner
Hospitalization Tattooing (7%)
dental work piercing
(6%) (6%)

Source: Health Canada Enhanced Surveillance, Oct 98-Oct 99, Calgary, Edmonton, Winnipeg, Ottawa
 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
 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
 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
 Dirty Needle Precautions
1. Handle only if you have proper equipment
• Sturdy pair of gloves, tongs or pliers and a puncture
proof container (heavy plastic or metal)
2. Place needle in puncture proof container
• 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 “milk” prick site

2. Wash the area with soap and water

3. Go to nearest emergency department

for assessment and treatment
Questions?