Hepatitis-C - Assignment Example

Hepatitis-C Hypotheses XXXXXXXXXXXXXX XXXXXXXX XXXXX XXX The hepatitis- C Virus; being smaller than the wavelength of visible light and only 50 nanometers in diameter is a known mutating virus with six known genotypes, currently having 21 variations of the genotype which make it extraordinarily tricky to develop a vaccine that would be effective against all the variations. The virus has a ‘slow’ tendency to kill the host and mostly claims the host after decades of infection. HCV is known to proceed in accordance with a two phase progression in a host; Acute phase (first six months after infection) and the Chronic phase (after six months of infection). About 80% of subjects exposed to HCV progress to chronic phase. Present reports indicate “more than 170 million chronic hepatitis C patients worldwide” (Kamal SM). In accordance with W.H.O. fact sheets of October, 2000; “3 to 4 million people are infected with HCV yearly”. The HCV virus is known to be accountable for “8000 to 10,000 deaths and about an average of 4000 liver transplantations on an annual scale” (National Foundation for Infectious Diseases). Let us consider a group of people living with HCV and being sexually active. For reasons pertaining to research, the following questions would be elucidated: 1. What chance is there; of the people knowing their being HCV positive in-time? 2. Does sexual activity in HCV positive people promote the chance of HCV transmission to others? 3. What consequences could come off; HCV positive people being sexually active? 4. What ‘type’ of sexual activity would be considered dangerous for the HCV positive people? All the four questions restrict to the study of the sexually active group of HCV positive people. What chance is there; of the people knowing their being HCV positive in-time? Considering the fact that more than 80% of infected subjects progress to chronic phase of the hepatitis C virus; it is quite obvious that most of the people do not undergo treatment in the acute phase which would be because of the mere fact that the symptoms of HCV in the acute phase are barely discernible. Fatigue, muscle-aches, body-aches, depression, flu, nausea, anxiety, head-aches are known symptoms of Hepatitis C, which also happen to be experienced by us in our daily lives; thus making it difficult to take notice of any irregularity off the normal routine. The ‘occurrence’ of these symptoms also has a rather irregular pattern leading to further uncertainty. Moreover indications like fatigue, anxiety and other similar to these are also thought to be ‘in our mind’ and are taught widely to be treated mentally; the concept being that fatigue, anxiety, etc are merely psychic ‘images’ in our mind made by none but ourselves. These factors play a major role in predicting if a person would realize whether he/she is suffering from common fatigue from his/her work and emotional distress (both of which happen to be very common in our lives) or his/her fatigue and all other symptoms are extraordinarily ‘out of routine’. People undergoing the acute phase of HCV infection are mostly unable to discern their symptoms in-time and progress over to the chronic phase of infection – indeed some people come to know of the infection after decades of its original happening. Hepatitis C; widely thought to be treatable in the acute phase, is mostly diagnosed in the chronic phase which is reason enough for the people having a very low chance of finding their being HCV positive in-time. Does sexual activity in HCV positive people promote the chance of HCV transmission to others? Sexual transmission of the virus in HCV positive people does not occur while the topic remains somewhat controversial. Hepatitis C virus is a blood-borne virus and is mostly transferred through blood to blood contact. The contact might be due to cuts or injuries or damaged skins or bleeding gums, etc. Normally no blood to blood contact takes place during sexual activity due to which the chances of transmission of the virus are fairly low. Studies conducted in the Hepatitis C Support project revealed that the chance of the presence of Hepatitis C Virus in Vaginal fluids or Semen is fairly low. Further studies indicate that the presence of the Virus (i.e. if present) in Semen or Vaginal fluids, would be fairly inadequate for transmission and there’s a fair chance that the virus present would be in a non-infectious state. Hence sexual activity in HCV positive people does not promote the chance of transmission. However, studies do indicate a very low percentage of people in whom transmission did take place by sexual activity, but that too would be because of blood to blood contact during the interaction. What consequences could come off; HCV positive people being sexually active? Blood to blood contact being the fundamental mode of transference of the virus; it can be deduced that if blood-blood contact does take place during sexual activity then the chance of transmission from a potential HCV infected patient would be fairly high. If no blood to blood contact takes place during the intercourse then the chance of transmission would be very low. What ‘type’ of sexual activity would be considered dangerous for the HCV positive people? Anal sex has been considered more dangerous with regards to HCV transmission due to the sensitive lining of the rectum which is more susceptible to damage and consequently would lead to blood to blood contact. There are no known cases of HCV transmission through kissing; which could be the case (theoretically) if mouth sores or bleeding gums are present. But transmission through this mode is considered very rare. Summing up, all those types of sexual activity which involve blood to blood contact pose a danger of transference. Now let us consider a group of HCV positive people who are not sexually active but live their normal lives in a society. The following questions would elucidate the effects and consequences of having HCV positive people in a society. 1. What danger does a person verified HCV positive pose to a society? 2. What could be the possible modes of transmission? 3. What psychological effects does a person’s being HCV positive have on other people? 4. Does a person’s “not-being-sexually-active” have any effect on the transmission of HCV? What danger does a person verified HCV positive pose to a society? The danger posed by a HCV positive person living in a normal social structure is little due to the fact that blood to blood contact isn’t that common amongst us in our daily lives. Working side by side, serving in a restaurant, sharing utensils with people does not transmit the virus. However, if the person comes in contact with another, medium being blood, the chances of Virus transmission would be very high. Hence if an HCV positive person is living amongst a society, care should be taken at all levels to strictly avoid blood to blood contact. What could be the possible modes of transmission? The possible modes of transmission of HCV from an infected host to another person include people working in industries side by side and face an injury in which blood to blood contact takes place with an HCV positive worker. Similarly, doctors and nurses working around HCV positive patients, who happen to be bleeding, somehow come in contact with the HCV positive blood thorough a minor cut on their hands. Using already used syringes for narcotic uses or any other also pose a high level of infection. In short, any possible way in which blood to blood contact takes place is a high level risk for the transmission of the virus. What psychological effects does a person’s being HCV positive have on other people? Any exemplary society if is aware of the fact that an HCV positive person is present amongst them would certainly be cautious and if told exactly who that particular person is bound to be avoided or treated differently. People might as well go to the extreme and try to block him out of the society in certain cases even by force. However, as we all know that HCV is only contagious through blood to blood contact; there is no such base or a strong reason that the particular HCV positive person should be edged out. Co-existence with an HCV positive person is totally logical and highly implementable. Nonetheless caution should be taken at all costs to avoid blood to blood contact. The HCV positive person is bound to suffer psychological dilemma owing to his/her being ignored or edged out of the society. The society on the other hand is bound to over react owing to their fear of being infected as well. Does a person’s “not-being-sexually-active” have any effect on the transmission of HCV? HCV transmission is totally dependent on blood to blood contact. Unless until contact via blood does not take place; the virus has an extremely low chance of transmission. Evidently it is found that sexual transmission does not occur that commonly. However if an HCV positive person is not sexually active, he/she would be avoiding that very little chance of HCV transmission through Sexual activity. References Kamal S.M. Acute Hepatitis C: A systematic Review. Department of Gatroentrology and Liver Disease. AIN Shams Faculty of medicine, cairo, Egypt. Carmen Vandelli and others. Lack of Evidence of Sexual Transmission of Hepatitis C among Monogamous Couples: Results of a 10-Year Prospective Follow-Up Study. American Journal of Gastroenterology 99(6): 855-859. May 2004. Franciscus Alan, HCSP Fact Sheet 2006(Version 2.0), HCSP Publications, Hepatitis C support project. Ahmad N, Asgher M, Shafique M, Qureshi JA. An evidence of high prevalence of Hepatitis C virus in Faisalabad, Pakistan. Saudi Med J. 2007 Mar;28(3):390-5. Bukh J et al. High prevalence of hepatitis C virus (HCV) RNA in dialysis patients: failure of commercially available antibody tests to identify a significant number of patients with HCV infection. Copenhagen Dialysis HCV Study Group. J Infect Dis, 1993, 168:1343-1348. Civeira M-P, Prieto J. Early predictors of response to treatment in patients with chronic hepatitis C. Journal of Hepatology, 1999, 31:237-243. Read More