A Simple Guide to Hepatitis C

A Simple Guide to Hepatitis C
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What is Hepatitis C?
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Hepatitis C is a serious inflammatory liver disease caused by a virus which is called hepatitis C virus (HCV).

Who is at risk of Hepatitis C?
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Hepatitis C virus infection is one of the most common chronic bloodborne infection.
Persons at risk for infection are:

1. injection-drug users

2. blood transfusions or solid organ transplant recipients before July 1992

3. on long-term dialysis

4. sexual exposure to infected HCV carriers(rare)

What are the symptoms of Hepatitis C?
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Persons who has been newly infected with HCV usually are asymptomatic or have a mild clinical illness:

1.mild fever and bodyaches

2.slight jaundice

3.nausea

4.enlarged liver

How do you diagnose Hepatitis C?
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A person exposed to Hepatitis C infection can detect HCV RNA in blood within 1-3 weeks.
The time from exposure to antibody to HCV seroconversion(or Anti-HCV) is 8-9 weeks.
Therefore diagnosis can usually be confirmed by :

1.the presence of Anti-HCV in 98% of infected persons within 6 months of exposure.

2.Reverse transcriptase polymerase chain reaction to detect HCV RNA

Chronic HCV infection occurs in 70% of HCV-infected persons.

Two thirds of these have evidence of active liver disease but may not be aware of their infection because they are not clinically ill.

Infected HCV carriers can transmit the illness to others and develop chronic liver diseases for years after infection.

What is the treatment of Hepatitis C?
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There is no cure for HCV infections.
Persons found to be anti-HCV positive should be evaluated for presence of
1.active infection,

2.presence or development of Chronic Liver Disease,

3.for possible treatment of HCV.

Combination therapy with interferon and ribavirin may help in treatment of patients with chronic hepatitis C.

What is the Prevention for Hepatitis C?
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No vaccine for hepatitis C is available.

Immune globulin is not effective in preventing HCV infection after exposure.

Primary prevention is to reduce or eliminate HCV transmission.

Secondary prevention activities is to reduce liver and other chronic diseases in HCV-infected persons by identifying them and providing appropriate medical management and antiviral therapy.

Persons who test positive for anti-HCV should be provided information regarding

1) how to protect their liver from further harm by avoiding alcohol and taking any new medicines (including OTC and herbals)

2) how to prevent transmission to others
a) not donate blood, body organs, other tissue, or semen;

b) not share any personal items that might have blood on them (e.g., toothbrushes and razors);

c) cover cuts and sores on the skin to keep from spreading infectious blood or secretions

3) the need for medical evaluation including assessment of liver function tests, assessment for severity of liver disease and possible treatment, and determination of the need for hepatitis A and B.

HCV-positive women do not need to avoid pregnancy or breastfeeding.

Regardless of test results, persons who use or inject illegal drugs should be counseled to
1.stop using and injecting drugs;

2.enter a program to eradicate complete substance abuse treatment, including relapse prevention;

3.take the following steps to reduce personal and public health risks, if they continue to inject drugs:

4.never reuse or share syringes, water, or drug preparation equipment;

5. use only syringes obtained from a reliable source (e.g., pharmacies);

6.use a new, sterile syringe to prepare and inject drugs;

7.get vaccinated for hepatitis A and B.

A Simple Guide to Blood Cancer

A Simple Guide to Blood Cancer
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What are Blood Cancer?
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Blood cancer consists of mainly lymphoma, leukaemia and multiple myeloma.

These cancers developed either in the bone marrow or the lymphatic tissues of the body. These three types of blood cancers all involve an uncontrolled growth of abnormal cells within the blood and bone marrow.

Who is at risk of getting Blood Cancers?
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The risk of developing blood cancers increases with age.

Adults therefore are more prone to blood cancer than children.

The acute leukemia tends to affect children.

The chronic leukemia is more common in adults.

However children and adults can develop any kind of leukaemia.

In Multiple myeloma, the average onset is at age 60.

Lymphoma
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(refer to my blog on A Simple Guide to Lymphoma)

Lymphoma is a cancer of the lymphoid tissues which are composed of several types of immune-system cells that work together to fight infections.

Lymphoma usually begins in a lymph node as a primary cancer.

It can also begin in the stomach, intestines, skin or any other organ that contains lymphoid tissue.

Leukaemia
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Leukaemia is a cancer that affects the blood-forming system of the body which include the bone marrow and the lymphatic system.

Leukaemia can be classified as either acute or chronic.

The acute leukemia tends to affect children while the chronic leukemia is more common in adults.

Acute leukaemia
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In acute leukaemia, immature blood cells reproduce quickly in the bone marrow, slowly killing the normal cells.

These abnormal cells can also spread to other organs, ultimately leading to disruption and distortion of these organ functions.

Acute leukaemia can be further divided into two types according to the predominant type of cells affected:

1.Lymphoblasts are immature cells that normally develop into lymphocytes, a type of white blood cell

2.myeloblasts are immature cells that normally develop into other cells such as neutrophils, another type of white blood cell.

1. Acute lymphoid leukaemia (ALL) -
here the lymphoblasts reproduce without developing into normal blood cells.

These immature lymphoblasts block out the healthy blood cells and frequently congregate in the lymph nodes, causing a swelling in that area.

2. Acute myeloid leukaemia (AML) -

here the myeloblasts reproduce without developing into normal blood cells.

The immature blast cells gather in the bone marrow and upset the production of healthy normal cells.

Anaemia results due to lack of sufficient red blood cells.

Frequent infections occurs due to the low levels of white blood cells which fight infections.

Chronic leukaemia
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Chronic leukaemia occurs when there is over-production of blood cells that appear to be mature. Unfortunately these cells actually lack the normal functions of mature blood cells.

Chronic leukaemia usually has a slower, less dramatic course than acute leukaemia.

Chronic leukaemia can also be broken into two groups:

(a) Chronic lymphoid leukaemia (CLL) -
Here there is production of too many apparently mature lymphocytes in the bone marrow. The abnormal cells appear to be fully developed lymphocytes, but cannot fight infections as well as normal lymphocytes.

(b) Chronic myeloid leukaemia (CML) -
here the over-production of apparently mature but defective myeloid cells, reach a point where almost no healthy cells remain.


Multiple Myeloma
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(refer to my blog on A Simple Guide to Multiple Myeloma)

Multiple myeloma is cancer of the bone marrow which occurs from the uncontrolled growth of plasma cells, a form of immune-protective white blood cells.

Normally plasma cells make antibodies to fight infections.

In multiple myeloma, there is a malignant proliferation of plasma cells.

What are the Symptoms of Blood Cancer?
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All three blood cancers have similar symptoms.

Among the common warning signs are:

1.weight loss,

2.constant infections such as flu and diarrhoea,

3.bleeding of gums or nose and slow healing cuts or frequent bruises

In addition to the above,

4.severe kidney problems,

5.general numbness of the skin

6.pain in the bones
may indicate the existence of multiple myeloma and leukemia as the disease progresses.
The pain can radiate to the back, ribs and arms of the victims. The pain is a result of an increase in the number of myeloma cells where the bone marrow is being damaged.

7.swelling of lymph nodes in the neck, the armpits or in the groin may indicate more likely a diagnosis of lymphoma

8.Persistent fever

9.loss of appetite

10.generalised weakness and pallour

What are the Causes of Blood Cancer?
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1.Exposure to excessive radiation

2.hazardous chemicals like benzene, asbestos, herbicides and pesticides are known to be the primary causes of blood cancer. Avoid these harmful materials as much as possible.

3.certain genetic abnormalities, such as Down Syndrome and the inheritance of a particular chromosome called the Philadelphia chromosome, have also been linked to the development of specific forms of leukaemia. This is controversial.

How do you diagnose Blood Cancer?
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1.a full medical history and full examination especially for signs of:
anaemia,
enlarged liver and spleen,
bleeding tendencies in the skin such as petechie and ecchymoses
enlarged lymph nodes

2.a full blood and urine test should be done to examine the blood cells under the microscope for cancer cells as well as to assess the patient's kidney, liver functions and the severity of anaemia.

3.A bone marrow aspirate using a syringe and needle can be examined for further evidence of blood and bone marrow cell abnormailties.

The presence of the Philadelphia chromosome may suggest evidence of leukemia.

What is the Treatment of Blood Cancer?
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Before any cancer treatment is done, because of the patients's anaemia and bleeding tendency, blood transfusions are usually given to improve the general health and resistance of the patient.

Chemotherapy and radiation therapy have always been used to treat blood cancer effectively.

Besides these treatments, stem cells infusion and bone-marrow transplants also give patients and their families another source for a cure.
Unlike chemotherapy and radiation therapy that are used to treat all the three kinds of blood cancer, bone-marrow transplants are more frequently used to cure lymphoma and leukaemia only .

It is also more successful for younger patients and when the disease is in the early stage.
Patients shuold know that dangers and side effects of bone-marrow transplants exist.

In extreme cases when the transplant fail, death may occur.

What are the Prevention measures for Blood Cancer?
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1.When exposed to dangerous chemicals and radiation, take extra precautions by wearing protective and appropriate clothing.

2.The threat of contracting lymphoma can be reduced by avoiding the risk of HIV. Patients infected with HIV are known to have a higher rate of lymphoma because of their low immune-system cells to fight infections.

3.Any family member of a leukemia patient should go for genetic testing and regular check-ups to spot the symptoms early.