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Long-acting preparations may be given just once a week•Blood levels remain high between doses and clinical response is better.•Nucleoside and nucleotide anaolgs•Epivir, Hepsera…suppress HBV replication by inhibiting viral DNA synthesis•reduce viral load, decrease liver damage, decrease liver enzymes
Prevention•Screening of blood donors for HBAg•Disposable syringes, needles, lancets and needless IV administration sets•Avoid multiuse vials in clinical units•Gloves always when handling blood and body fluids or potential exposure to secretions•Pt. education on infectiousness and prognosis
Prevention, cont.•Active immunization for at risk population, those with Hepatitis C, and chronic liver disease–Yeast-recombinant hepatitis B vaccine (Recombivax HB)•IM X 3 doses •second and third doses at 1 month and 6 months•Passive immunity for those exposed to HBV but never had Hepatitis B or the vaccine and those needing post exposure treatment**–Hepatitis B Immune Globulin (HBIG)
Hepatitis C Virus•Basics -CONTAGIOUS–Transmission-percutaneously•needle sticks and sharing of needles (*most common mode)•blood (blood transfusions before 1992 at risk for chronic stage)•High-risk sexual behavior (↑ 20%)–Most common bloodborne infection •A cause of 1/3 of cases of liver cancer•most common reason for liver transplant–Symptoms are usually mild.•Chronic carrier state frequently occurs.
Hepatitis C•Hepatitis C is a contagious liver disease that results from infection with the hepatitis C virus. It can range in severity from a mild illness lasting a few weeks to a serious, lifelong illness that Progression of Hepatitis C damages the liver. Hepatitis C can be either “acute” or “chronic”. Acute hepatitis C virus infection is a short-term illness that occurs within the first 6 months after someone is exposed to the hepatitis C virus. Approximately 75%-85% of people who become infected with the hepatitis C virus develop chronic infection. For reasons that are not known, 15-25% of people “clear” the virus without treatment and do not develop chronic infection. •Chronic hepatitis C virus infection is a long-term illness that occurs when the hepatitis C virus remains in a person’s body. Chronic infection can last a lifetime. Over time, it can lead to serious liver problems, including liver damage, cirrhosis, liver failure, or liver cancer (see chart).
How is hepatitis C spread? •Hepatitis C is usually spread when blood from a person infected with the hepatitis C virus enters the body of someone who is not infected. Today, most people become infected with the hepatitis C virus by sharing needles or other equipment to inject drugs. Before widespread screening of the blood supply began in 1992, hepatitis was also commonly spread through blood transfusions and organ transplants. Although rare, outbreaks of hepatitis C have occurred from blood contamination in medical settings.