Viral Hepatitis Medical certificate - Research Paper Example

? Viral Hepatitis: Social Programs & Community Intervention Table of Contents Table of Contents Introduction 2 Viral Hepatitis – Medical Background 3 Viral Hepatitis – U.S. Statistics 5 Viral Hepatitis – Research Projects 6 Viral Hepatitis – Community Programs 7 Viral Hepatitis – Interventions 8 Conclusion 10 References 11 Introduction Hepatitis is a general medical term that indicates “inflammation of the liver” in patients and can be caused by a number of factors, including alcohol and drug abuse, viral diseases, environmental toxins, or problems with the body’s immune system. (NYT, 2011) Viral Hepatitis refers specifically to the transmission of a number of RNA viruses that live in and replicate themselves in the human liver tissue, causing a particular series of symptoms in patients who are infected with these viruses. Scientific research currently recognizes as many as 7 different main types of Hepatitis viruses, and these are labeled with a letter from the alphabet in order to differentiate the characteristics of each for study and treatment. In this manner, Hepatitis A, B, C, D, E, F, & G have all been identified by researchers in medicine, though the Hepatitis F virus has not fully been confirmed. (Lee & Marks, 2011) The varieties of Hepatitis viruses have different means of transmission in human communities, as well as promoting a variety of negative symptoms and destructive effects over time in the body. There are immunizations available for some of these viruses on the market currently, though these are not generally accorded a mandatory status for children and adults in the United States. The statistics on Hepatitis infections vary greatly, from 80,000 to 700,000 new cases per year reported in the United States. (CDC, 2011 & Hunt, 2011) The Hepatitis B Foundation reports that 2 billion people worldwide, or 1 out of every 3 people, have been infected with this virus. (HBF, 2009) In recognition of the seriousness of this disease, the United Nations for the first time in 2011 inaugurated the “World Hepatitis Day” in order to build awareness, understanding, and treatment programs to eradicate this disease. (WHA, 2011) Viral Hepatitis – Medical Background Medical research has recognized as many as 7 main and distinct types of the Hepatitis virus and classified these strains with an alphabetical notation that the study and diagnosis of this disease can be fully understood in healthcare facilities around the world. The symptoms, transmission, and long-term effects of each strain of the Hepatitis virus can be classified according to the following taxonomy: Hepatitis A Virus (HAV) – Hepatitis A is known as the most common and least severe of the Hepatitis viruses. This form is typically spread through contaminated food products, though it may also be transmitted by the “fecal-oral” route or through direct contact between people sexually. (Avert, 2011) The symptoms of this disease are similar to the other forms of Hepatitis and include dark urine, fever, jaundice, fatigue, joint pain, and digestive problems. (WebMD, 2011) This form of the Hepatitis virus does not produce a chronic condition, and there is an available vaccine that will prevent it. (WebMD, 2011) Hepatitis B Virus (HBV) – Hepatitis B is also common worldwide and typically spread through the exchange of bodily fluids in IV drug users, tattoo and piercing equipment, sexual activity, or blood transfusions. (Avert, 2011) Hepatitis B shares most of the same symptoms as other forms of the disease. “Most adults infected with the hepatitis B virus fully recover and develop life-long immunity. Between 2% and 10% of individuals infected as adults will become chronic carriers, which means they will be infectious to others and can develop chronic liver damage.” (Avert, 2011) There is also a vaccine available that will prevent the disease. (WebMD, 2011) Hepatitis C Virus (HCV) – Hepatitis C is one of the most serious varieties of the virus found in humans, and “number one reason for liver transplant. At least 80% of patients with Hepatitis C develop a chronic liver infection. Approximately 2.7 million people in the U.S. are chronically infected with hepatitis C, according to the CDC. It often does not show any symptoms. No vaccine is yet available to prevent hepatitis C.” (WebMD, 2011) Hepatitis C is also spread through the exchange of bodily fluids in IV drug users, tattoo and piercing equipment, sexual activity, or blood transfusions. (Avert, 2011) Hepatitis D Virus (HDV) – Hepatitis D is unique from the other strains of this virus in that it requires the Hepatitis B virus to be present in the carrier in order to replicate. “Infection with HDV in a patient who is already positive for the Hepatitis B surface antigen (HBsAg) is known as superinfection and results in fulminant liver failure in 5% of patients. Approximately 80-90% develop chronic HDV infection. These patients progress more rapidly to develop cirrhosis and may develop hepatocellular carcinoma.” (Medscape, 2011) The transmission of this virus occurs on the same pathways as the other strains, and the Hepatitis B vaccine will also eliminate the threat of contracting this disease. (Medical Network, 2007) Hepatitis E Virus (HEV) – Hepatitis E is a relatively rare form of the virus, transmitted through sources of water. Hepatitis E shares the symptoms with other strains of the virus, but typically does not become a chronic condition. This form of Hepatitis is generally transmitted by contaminated food (such as shellfish) and the “fecal-oral” route. (WHO, 2011) The main recommendation is to avoid contaminated food and water, for there is no current vaccine against this disease. (WHO, 2011) Hepatitis F Virus (HFV) – Hepatitis F is an officially delisted form of the virus, at first identified in monkeys but subsequently taken to be a mutation of Hepatitis B. (Medicine Net, 2011) Hepatitis G Virus (HGV) – Hepatitis G appears to exist in combination or association with the Hepatitis C virus, but not to be an infectious or harmful virus independently. (Innvista, 2011) Approximately 20% of people infected with Hepatitis C are also found to be carriers of HGV, however there is no vaccine currently for this disease. (Innvista, 2011) Viral Hepatitis – U.S. Statistics There is a wide discrepancy in published sources of information as to the total number of Hepatitis cases present in the population, as well as the number of new cases contracted annually. The CDC reports, “An estimated 4.4million Americans are living with chronic hepatitis; most do not know they are infected. About 80,000 new infections occur each year.” (CDC, 2011) Other sources report as many as 500,000 to 600,000 new cases of Hepatitis in the United States each year, with 150,000 attributed to Hepatitis A, 200,000 to 300,000 related to Hepatitis B, and 150,000 linked to Hepatitis C. (Lee & Marks, 2011) Infection with the other types of Hepatitis virus is relatively rare in comparison to the three main types of HAV, HBV, and HCV. Nevertheless, the Hepatitis B Foundation reports figures such as: “12 million Americans have been infected (1 out of 20 people).” “More than one million people are chronically infected .” “Up to 100,000 new people will become infected each year.” “5,000 people will die each year from hepatitis B and its complications.” “Approximately 1 health care worker dies each day from hepatitis B.” (HBF, 2009) The range of distance between the published statistics on Viral Hepatitis and the discrepancy between sources points towards the need for more efficient testing and evaluation of the population for the prevalence of this disease in the United States. Viral Hepatitis – Research Projects Research projects in Viral Hepatitis take many forms with some of the most helpful and promising involving the development of new drugs and pharmaceutical products to combat the disease. The Merck Company recently received FDA approval for the Victrelis (boceprevir) drug to be used in the treatments of Hepatitis C. This drug functions as a Protease Inhibitor. “The FDA approval of VICTRELIS is based on the efficacy and safety results from two large Phase III clinical studies that evaluated approximately 1,500 adult patients with chronic HCV genotype 1 infection... Final results of the HCV RESPOND-2 and HCV SPRINT-2 studies were published in the New England Journal of Medicine on March 31, 2011.” (Merck, 2011) Vertex Pharmaceuticals has also received approval for a new drug to treat Viral Hepatitis known as Incivek. “INCIVEK™ (telaprevir) is a prescription medicine used with the medicines peginterferon alfa and ribavirin to treat chronic (lasting a long time) hepatitis C genotype 1 infection in adults with stable liver problems.” (Vertex, 2011) The testing for this drug included three Phase-III clinical trials named ADVANCE, ILLUMINATE, and REALIZE. (Vertex, 2011) The critical aspect of Incivek is that it must be prescribed alongside of peginterferon alfa and ribavirin in the treatment of Hepatitis C only. (Vertex, 2011) Together, these two drugs and the associated clinical research show that there is significant investment in the pharmaceutical sector being dedicated to the advancement of new drugs to treat Viral Hepatitis in all of its forms, and that this research remains a promising field of study with a critical need in patients. Viral Hepatitis – Community Programs The U.S. Department of Health and Human Services has developed an “Action Plan for the Prevention, Care & Treatment of Viral Hepatitis” starting from 2011 with a target of meeting a number of benchmarks for disease reduction by the year 2020. The main goals of this program are listed as: “an increase in the proportion of persons who are aware of their hepatitis B virus infection, from 33% to 66%;” “an increase in the proportion of persons who are aware of their hepatitis C virus infection, from 45% to 66%;” “a 25% reduction in the number of new cases of HCV infection;” “elimination of mother-to-child transmission of HBV.” (HHS, 2011) This program is national in scope, announced by the White House, and an umbrella program that will combine a variety of targeted community education, treatment, and testing initiatives to accomplish the listed goals. (HHS, 2011) The negotiations for the 2012 budget are ongoing in Congress, and according to the Department of Health and Human Services, “the FY 2011 Budget includes an increase of 10 percent over the FY 2010 Omnibus to support these activities.” (HHS, 2011) These funds would also include cooperation with the FDA, CDC, and other local and national groups for the meeting of anti-Hepatitis benchmarks and goals. The CDC Foundation has launched the Viral Hepatitis Action Coalition in partnership with “Abbott Laboratories, Boehringer Ingelheim, Bristol-Myers Squibb, Genentech, Gilead Sciences, GlaxoSmithKline, Janssen Therapeutics, Merck Sharp & Dohme, OraSure Technologies, and Vertex Pharmaceuticals.” (CDCF, 2011) This coalition is attempting to build private and public partnerships to combat the Viral Hepatitis epidemic in the U.S. The goals of this coalition are to: “increase data collection on Hepatitis B and C to provide a better overall understanding of how many people are infected, how they become infected, if and when they get tested and treated and the outcomes of their treatment” “educate populations at-risk, healthcare providers and the general public about hepatitis to promote vaccination and prevention strategies and encourage screening and testing” (CDCF, 2011) The budget for the Viral Hepatitis Action Coalition has not been publicly made available, but the pharmaceutical companies that have joined this group will be providing drugs, facilities, staff, knowledge, research, and other resources in addition to private funding for the aforementioned goals of the foundation. These programs will also be developed in tandem with public programs such as the U.S. Health and Human Services initiative, with the majority of the community programs organized through the Center of Disease Control. (CDCF, 2011) Viral Hepatitis – Interventions Many of the most successful community intervention programs developed to target Viral Hepatitis have been coordinated with local anti-HIV and anti-STD programs. This approach allows for the combination of resources, the integrated presentation of information on diseases that are transmitted through sexual activity, risky drug use such as IV needle sharing, and also allows for the broader perspective of disease control to be disseminated to students through publicly funded educational campaigns in the U.S. Many Viral Hepatitis patients are not aware even that they have contracted the disease, which makes the increase in testing in the community very important. One community initiative that should be considered seriously by healthcare administrators is the standard integration of Viral Hepatitis testing in association with HIV testing. For example, instead of requiring separate tests for HIV, Hepatitis, and STDs, the single visit to the physician or clinic should include a test that covers all of these diseases in one blood sample taken for laboratory analysis. The simplification and integration of these tests will also raise the profile and awareness in the community of the threat of Viral Hepatitis. Another necessary community intervention is the making available of the Hepatitis vaccine shots to the public on a no-cost basis in association with educational programs and initiatives. These vaccines should be publicly funded and used to directly decrease the threat of Viral Hepatitis to the community at large. As many students and families may not be aware of the existence of anti-Hepatitis vaccines, the combination of education programs and vaccine accessibility can be beneficial. An example of this would be the establishment of vaccination days at public clinics, hospitals, and educational institutions where the vaccines will be administered on a specific day. This activity can then be advertised and promoted as part of the community education programs, and families or individuals can choose to receive the vaccine based upon their own increased awareness of the threat of Viral Hepatitis. Conclusion In summary, the Department of Health and Human Services estimates that 3.5-5.3 million people in the U.S. are currently infected with Viral Hepatitis, and that 65%-75% of those affected are critically unaware that they are carriers of the virus. (HHS, 2011) Because Viral Hepatitis, particularly Hepatitis B and C, is a major cause of liver cancer and leads to cirrhosis of the liver over time which can result in death of the carriers, the disease should be taken as a major health threat and addressed through appropriate measures by both public and private programs. (HHS, 2011) The World Health Organization, Center for Disease Control, Department of Health and Human Resources, and innumerable other groups working together across the country and internationally are currently attempting to promote greater awareness of Viral Hepatitis through community initiatives, testing, drug treatment programs, and other measures. Pharmaceutical companies are also attempting to develop new drugs to use in the clinical treatment of affected individuals. The combination of these elements should lead to tangible reduction of the disease across the world in the next 10 years, but the availability of the vaccine to the general population must be increased as this is the main method through which Viral Hepatitis will be prevented. References Avert (2011). Hepatitis A, Hepatitis B & Hepatitis C. Avert.com, 2011. Retrieved from http://www.avert.org/hepatitis.htm CDC (2011). Viral Hepatitis. Center for Disease Control and Prevention, 2011. Retrieved from http://www.cdc.gov/hepatitis/ CDC (2011). Viral Hepatitis Education and Training Projects. Center for Disease Control and Prevention, 2011. Retrieved from http://www.cdc.gov/hepatitis/Partners/VHNET.htm CDC Foundation (2011). The Viral Hepatitis Action Coalition. CDCFoundation.org, 2011. Retrieved from http://www.cdcfoundation.org/vhac Department of Health and Human Services (2011). Combating the Silent Epidemic of Viral Hepatitis: Action Plan for the Prevention, Care and Treatment of Viral Hepatitis. U.S. Department of Health and Human Services (HHS), 2011. Retrieved from http://www.hhs.gov/ash/initiatives/hepatitis Hepatitis B Foundation (2009). Statistics. HepB.org, 2009. Retrieved from http://www.hepb.org/hepb/statistics.htm Innvista (2011). Hepatitis F-G-H Viruses. Innvista.com, 2011. Retrieved from http://www.innvista.com/health/microbes/viruses/hepatf.htm Koh, Howard K. (2011). Testimony. U.S. Department of Health and Human Services (HHS), 2011. Retrieved from http://www.hhs.gov/asl/testify/2010/06/t20100617b.html Lacey, Sean et al. (2011). Hepatitis D. Medscape, 2011. Retrieved from http://emedicine.medscape.com/article/178038-overview MedicineNet (2011). Definition of Hepatitis F. MedTerms.com, 2011. Retrieved from http://www.medterms.com/script/main/art.asp?articlekey=11462 MedicineNet (2011). Viral Hepatitis. MedTerms.com, 2011. Retrieved from http://www.medicinenet.com/viral_hepatitis/article.htm Merck (2011). FDA Approves Merck's VICTRELIS™ (boceprevir), First-in-Class Oral Hepatitis C Virus (HCV) Protease Inhibitor. Merck.com, 2011. Retrieved from http://www.merck.com/newsroom/news-release-archive/prescription-medicine-news/2011_0513.html NYT (2011). Hepatitis. Times Health Guide, 2011. Retrieved from http://health.nytimes.com/health/guides/disease/hepatitis/background.html Vertex Pharmaceuticals (2011). Clinical Studies. Incivek.com, 2011. Retrieved from http://www.incivek.com/hcp/clinical-studies Vertex Pharmaceuticals (2011). Important Safety Information. Incivek.com, 2011. Retrieved from http://www.incivek.com/ Viral Hepatitis Action Coalition, The (2011). The Coalition. ViralHepatitisAction.org, 2011. Retrieved from http://www.viralhepatitisaction.org/about WebMD (2011). Hepatitis Health Center. WebMD.com, 2011. Retrieved from http://www.webmd.com/hepatitis/digestive-diseases-hepatitis WHA (2011). World Hepatitis Day 2011. World Hepatitis Alliance, 2011. Retrieved from http://www.worldhepatitisalliance.org/WorldHepatitisDay/WorldHepatitisDay2011.aspx WHO (2005). Hepatitis E. World Health Organization, 2005. Retrieved from http://www.who.int/mediacentre/factsheets/fs280/en/ Read More