Hepatitis C Virus Among Pregnant Women People Living With HIV/AIDS Attending Clinic
(A Case Study Of Unth Itukuozalla)
Hepatitis C virus (HCV) poses a substantial health concern among pregnant women and individuals living with HIV/AIDS attending clinics. The intersection of these two conditions accentuates the complexity of managing health outcomes in this vulnerable population. HCV, a bloodborne pathogen, significantly heightens the risk of vertical transmission during pregnancy, underscoring the intricate challenges faced by expectant mothers with coexisting HIV/AIDS. The dual burden of these infections amplifies the intricacies of antenatal care, demanding tailored approaches to prevent perinatal transmission. Integrating comprehensive screening, timely interventions, and effective antiretroviral therapy becomes imperative in mitigating the dual impact of HCV and HIV/AIDS on maternal and fetal health. Collaborative efforts between obstetric and infectious disease specialists are pivotal in addressing the intricate healthcare needs of this specific demographic, aiming to enhance maternal well-being and reduce the risk of mother-to-child transmission of both viruses.
A total of 50 blood (30 pregnant and 20 HIV) samples were obtained from pregnant women and PLWHA attending clinic at UNTH Ituku-ozalla. Samples were screened for hepatitis c viral infection using the rapid one step hepatitis C virus test strip. Two (6.66%) pregnant women were positive and four (20%) HIV patients were positive for Hepatitis C, giving an overall prevalence rate of (26.7%). The infection was the same in male (3) and in female (3). Those aged 23-34 years recorded a higher prevalence of (20%) than those in the age group
19-23. This higher prevalence of hepatitis C suggests that pregnant women and PLWHA may be at risk of hepatitis due to hepatitis C virus. Therefore routine screening of pregnant women and PLWHA should be instituted for early diagnosis and management of cases.
Title page
Certification
Dedication
Acknowledgement
Table of content
List of table
Abstract
1.0 Chapter one
1.1 Introduction
1.2 Objectives
2.0 Chapter two
2.1 Mode of transmission and risk factors
2.2 Pathogenesis and incubation period
2.3 Epidemiology
2.4 Signs and symptoms
2.5 Diagnosis
2.6 Prevention and control
2.7 Treatment
2.8 Hepatitis C virus and pregnancy
2.9 Hepatitis C virus and HIV
3.0 Chapter three
3.1 Material
3.2 Study population
3.3 Sample collection
3.4 Method
4.0 Chapter four
4.1 Results
5.0 Chapter five
5.1 Discussion
5.2 Conclusion
5.3 Recommendation
References
1.1INTRODUCTION
Hepatitis C infection is an infection of the liver caused by the hepatitis C virus (HCV). HCV is one of several viruses that can cause hepatitis. ‘Hepatitis’ means inflammation of the liver(Ryan and Ray,2004).It is unrelated to the other common hepatitis viruses (for example, hepatitis A or hepatitis B). HCV is a member of thehepacivirus genus in the familyFlaviviridae. There are at least six
distinctly different strains of the virus which have different genetic profiles (genotypes). In the U. S., genotype 1 is the most common form of HCV. Even within a single genotype there may be some variations (genotype 1a and 1b, for example). Genotyping is important to guide treatment because some viral genotype respond better to therapy than others (Wilkins et al. 2009).
According to Hepatitis C NSW (2010), here are some of the things that can happen once the body contract hepatitis C.
The body may deal with hepatitis C of its own accord and you may never get sick. About 25% of all people who contract hepatitis C will clear the infection (although this happen less commonly in people with HIV). For a range of reasons, hepatitis C infection is eradicated from the body in these people, usually within 12 months of having been infected. Hepatitis C may remain present in the body. About three quarters of people who contract hepatitis C will be chronically infected. This means that they have detectable hepatitis C virus (measured by a PCR test) in their blood for a period of longer than twelve months. People in this group may be at risk of developing
liver problems over time. The genetic diversity of HCV is one reason that it has been difficult to develop an effective vaccine since the vaccine must protect against all genotypes. It is difficult for the human immune system to eliminate HCV from the body, and
infection with HCV usually becomes chronic. Over decades, chronic infection with HCV damages the liver and can cause liver failure. Up to 85% of newlyinfected people fail to eliminate the virus and become chronically infected. Infection is most commonly detected among people who are 40 to 60 years of age, reflecting the high rates of infection in the 1970s and 1980s. There are 8,000 to 10,000 deaths each year in the U.S. related to HCV infection. HCV infection is the leading cause of liver transplantation in the U.S and is a risk
factor for liver cancer. Most of the signs and symptoms of HCV infection relate to the liver. Less commonly, HCV infection causes conditions outside of the liver. Symptoms are generally mild and vague, including a decreased appetite, fatigue, nausea, fever.
Headache, muscle or joint pains, and weigh loss. Hepatitis C after many years becomes the primary cause of cirrhosis and liver cancer. About 10–30% of people develop cirrhosis over 30 years (Meisel, et al. 1995).HCV infection can cause the body to produce unusual antibodies called’cryoglobulins’. These cryoglobulins cause inflammation of the arteries(vasculitis) which may damage the skin, joints, and kidneys. In addition, these patients may develop Raynaud’s phenomenon in which the fingers and toes turn
color (white, then purple, then red) and become painful at cold temperatures(Iannuzzella, and Vaglio, 2010).Two skin conditions, lichen planus and porphyria cut aneatarda, have been associated with chronic infection with HCV. HCV also is associated with B-cell
lymphoma, a cancer of the lymph system. Doctors use various tests to determine if a person has hepatitis C. One type of
test measures antibodies in the blood, indicating that a person been exposed to HCV; the two most common antibody tests are called ELISA and RIBA. Viral load tests measure how much HCV genetic material is present in the blood; the two most common viral load tests are called PCR and bDNA. Who to test for hepatitis c virus According to MMWR (1998) Persons who ever injected illegal drugs,
Persons who were ever on chronic (long-term) hemodialysis; Persons with persistently abnormal alanine aminotransferase level
Persons who were notified that they received blood from a donor who later tested positive for HCV infection;
Persons who received a transfusion of blood or blood components and organ transplant before July 1992; and
Healthcare, emergency medical and public safety workers after needle sticks, ormucosal exposures to HCV-positive blood
Children born to HCV-positive women.
1.2 OBJECTIVES
i. To determine the prevalence of hepatitis C virus in pregnant women attending
ante-natal in UNTH Ituku-ozalla
ii. To determine the age distribution where the infection occurs most
iii. To determine the prevalence of hepatitis virus in people living with HIV and
AIDS attending UNTH Ituku-ozalla.
Hepatitis C Virus Among Pregnant Women People Living With HIV/AIDS Attending Clinic:
Hepatitis C virus (HCV) infection among pregnant women and people living with HIV/AIDS attending clinics is a significant public health concern. Both HCV and HIV are bloodborne viruses that can have serious health implications if left untreated. Here’s some information about HCV in pregnant women and people with HIV/AIDS:
- HCV in Pregnant Women:
- Transmission Risk: HCV can be transmitted from an infected mother to her baby during childbirth, although the risk is relatively low compared to other infections like HIV or hepatitis B.
- Screening: Pregnant women are often screened for HCV during prenatal care to identify those who are infected.
- Treatment during Pregnancy: The treatment of HCV during pregnancy is a complex decision. Antiviral treatment with direct-acting antiviral (DAA) medications can be considered, but it should be discussed carefully with a healthcare provider, taking into account the potential risks and benefits for both the mother and the baby.
- HCV in People Living with HIV/AIDS:
- Co-Infection: HCV and HIV can co-infect the same individual. This is relatively common because both viruses share similar routes of transmission, such as through shared needles during drug use or through unprotected sexual intercourse.
- Increased Health Risks: People with HIV who are co-infected with HCV may experience more rapid liver disease progression and are at a higher risk of developing cirrhosis and other complications compared to those with HCV alone.
- Screening and Treatment: Regular screening for HCV is recommended for people living with HIV. If co-infected, treatment for both HIV and HCV may be necessary, and healthcare providers will need to carefully manage these dual infections to prevent further health complications.
- Prevention and Education:
- Education and prevention efforts are critical in both scenarios. Pregnant women should be educated about the potential risks of HCV transmission and the importance of prenatal screening and safe childbirth practices.
- For people living with HIV/AIDS, harm reduction programs, safe injection practices, and access to sterile needles can help reduce the risk of acquiring HCV or transmitting it to others.
- Access to Healthcare:
- Ensuring access to healthcare, including antiviral treatments for both HCV and HIV, is essential in managing and preventing these infections in pregnant women and people living with HIV/AIDS.
It’s important to note that medical guidelines and recommendations can change over time, so the most up-to-date information on the management of HCV in pregnant women and individuals with HIV/AIDS should be obtained from healthcare professionals or public health authorities. Regular medical monitoring and consultation with healthcare providers are crucial for those affected by these infections.