The hepatitis C virus is spread through blood-to-blood contact, which inflames the liver and is thought to affect about 185 million individuals globally. In 2018, the US alone recorded over 50,000 cases of Hepatitis C (CDC, 2023). the infection can be either an acute infection or a chronic condition. The majority of cases of hepatitis C these days are caused by sharing syringes or other supplies used to produce and inject narcotics. For many people, hepatitis C is a temporary illness, but more than half of those who have the virus go on to have chronic, lifelong infection. Chronic hepatitis C can lead to serious, perhaps deadly, health complications such as liver cancer and damage (Lazarus et al., 2023). People who have chronic hepatitis C often have no symptoms or appear not to be sick at all. When symptoms do appear, they are usually the result of severe liver disease. No vaccine can prevent hepatitis C. The best protection against HCV is avoiding activities like drug injection that could spread the illness. Having a hepatitis C screening is crucial since most patients may recover from the disease in eight to twelve weeks with therapy. The following paper addresses the importance, prevalence, and monitoring of this grave illness to improve outcomes for the surrounding community, state, and nation. It also offers insights on how to prevent and treat diseases using evidence-based approaches.
Background and Significance
The virus that causes hepatitis C is spread by direct contact with infected blood or bodily fluids; this occurs mostly when a person shares contaminated needles while using IV drugs recreationally or when a woman transmits the virus to her unborn child after childbirth (Ogawa et al.,2023). Patients with recently acquired HCV often have no symptoms for two to twenty-four weeks before developing symptoms. Abdominal discomfort, an eating disorder, yellowing of the skin, urine that is dark in color, vomiting, fever, exhaustion, and clay-colored stool are among the symptoms that patients may exhibit. Approximately 30 percent of infected people spontaneously recover from the virus without therapy within six months of exposure, as reported by the World Health Organization. A higher death risk and chronic, persistent medical issues are expected for people infected with Hepatitis C. Liver disease, hepatocellular malignancies, cirrhosis, and even mortality are linked to persistent HCV infection (Ogawa et al.,2023). Despite the decline in cases of HCV infection in developed nations, research indicates that throughout the next 20 years, death from the connected disease processes will increase if a Hepatitis C diagnosis is made.
Incidence and Prevalence State and Country
The CDC reports that Illinois’s Hepatitis C incidence increased from 1.2/for every 100,000 people in 2019 to 1.6/for every 100,000 in 2020, above the national average (IDPH). Illinois’s hepatitis B infection prevalence has varied over the past five years; however, in 2020, they are still lower than in the US. Hepatitis B and C infections have been increasing in Illinois, according to the most recent statistics (CDC, 2023). According to the data, there were 2,873 confirmed instances of hepatitis C and 388 confirmed infections of hepatitis B in 202. However, many patients with these illnesses go undetected. The leading cause of organ transplantation and the main root cause of cancer of the liver is hepatitis C virus infection. It has been estimated that 4.4 million people in America suffer from chronic hepatitis. Although hepatitis is a condition that affects everyone, some groups are more susceptible to particular strains of the virus, like those who inject drugs or their offspring.
Surveillance and Reporting
According to Illinois’ Control of Communicable Disease Code, hepatitis C is an illness that has to be reported. In addition to being useful in tracking and analyzing healthcare trends in specific locations, surveillance also aids public health workers in identifying potential outbreak sites and the effects of viruses on populations, states, and nations. Reporting a case of Hepatitis C commences when a positive test result confirms the presence of a hepatitis C virus infection to the regional or state health authority. Policies that ensure every instance is found must be in place for reports to be factual (IDPH, 2023). Accurate reporting of acute Hepatitis C is not usually possible since the symptoms of acute Hepatitis C are nebulous and broadly applicable. A comprehensive understanding of the epidemic is essential for focusing preventive and treatment initiatives and detecting acute cases that may be connected to outbreaks.
The CDC uses a probability-based model to consider report differences because of the under-ascertainment. Based on the CDC methodology, approximately 13.9 percent of infections are computed for each report of severe Hepatitis C (CDC, 2023). Acute Hepatitis C illnesses are a condition that requires reporting; cases in the state are required to be recorded as soon as the virus is identified, according to the Illinois Hepatitis Coalition and the Illinois Department of Public Health (IDPH). The implementation of a Hepatitis-specific collection of information in 2015 resulted in improvements to baseline statistics. Dr. Sameer Vohra, director of IDPH, states that to buck the current trend and place Illinois on a path to completely eradicate new instances of these illnesses, the state must unite committed experts and community collaborators (IDPH,2023).
After the laboratory testing, chronic Hepatitis C cases have to be reported. Registering both previous and present instances of HCV infection is necessary by inputting the data into the NEDSS. Laboratory reports are either electronically or on paper. However, there is little monitoring of Hepatitis C since not enough data is put into these systems. The CDC uses the NNDSS to obtain information collected by state health departments, while the NEDSS facilitates communication between public health agencies and the health care system (CDC, 2023). The state’s health department also maintains a connection with the CDC to get the most reliable reports of positive cases.
Epidemiological Analysis
One of the main causes of persistent liver damage is the hepatitis C virus. After two to three decades, liver cirrhosis often affects between 20 and 30 percent of people with persistent infections. In 1%–4% of people with cirrhosis, cancer of the liver develops annually. Among the main associated risks for liver cancer is hepatitis C, which infects 130–210 million individuals globally (Tan et al., 2018). About 350000 individuals worldwide pass away from HCV-related illnesses each year, and over thirty percent of instances of liver cancer are linked to the infection with HCV. Globally, HCV infection varies greatly by geography, and different nations have different risk factors for the disease (Tan et al., 2018). Diverse research populations experience varied rates of progression from chronic hepatitis C virus infection to end-stage liver failure. However, since HCV is occult, the majority of infected individuals are unaware that they have the virus; as a result, it is unclear how common long-term hepatitis C is worldwide.
The most common way that Hepatitis C is spread is through coming into touch with the infected individual’s blood. Donors of blood, particularly those who donate plasma, are therefore at a higher risk of contracting HCV. Research including paid blood donors found that using contaminated medical equipment, among other factors, raised the risk of becoming infected with HCV by 15.53% (Tan et al., 2018). In impoverished rural communities with poor economic standing, compensated donated blood has been empirically documented during the late 1980s and early 1990s. Furthermore, the majority of these people with hepatitis C had not sought medical attention in the past and were unaware of their Hepatitis condition. However, a significant percentage of illnesses among people who developed cirrhosis were discovered.
Compared to the hepatitis B virus, the evolutionary trajectory of Hepatitis C is not as thoroughly studied. According to certain epidemiological research, around 55%–85% of people with chronic hepatitis C disease will go on to develop CHC, and within the next twenty years, approximately 5%–15% of CHC individuals will develop liver cirrhosis. According to Tan et al. (2018), these epidemiological research findings diverge greatly and don’t include extended epidemiological studies. The primary cause is the absence of a comparatively stable epidemiological demographic for CHC. The time and location of infection are often constant in a CHC demographic acquired by plasma apheresis donation. The majority of these hepatitis C-infected individuals chose not to get medical attention. These traits have produced a special benefit for researching the hepatitis C virus’s evolutionary trajectory.
Screening and Guidelines
Even without symptoms, screening for Hepatitis C is advised for all adults between the ages of 18 and 79. A blood sample is used in Hepatitis C screening to identify and treat it before it causes long-term health problems. HCV screening tests have a full specificity of one hundred percent and ninety-eight percent sensitivity, according to Tang et al. (2017). The majority of insurance providers pay for the screenings, but for those who must pay out of cash, they are reasonably priced at $50 apiece. Hepatitis C-positive people live in the poorest areas, as was previously indicated. Anyone living in a high-risk population is advised to have a blood test (WHO, 2023). The WHO has also created guidelines for HCV infection screening, management, and therapy. Among them are DAAs that are safe and effective, as well as the usage of DAA drugs that have received regulatory body approval. It also encourages ongoing price reductions for various treatment alternatives so that lower-income communities can access them more easily.
Treatments for hepatitis C are cost-effective and available. The two primary goals of medical treatment are to cure the sickness and avoid irreversible liver damage. Antiviral medications, including sofosbuvir and daclatasvir, are prescribed for treating hepatitis C (WHO, 2023). Emerging diseases do not always need medical care, and the body’s immunity may heal certain illnesses independently. Persistent hepatitis C constantly needs treatment. Lifestyle modifications, such as abstaining from drinking along with maintaining a normal weight, might be beneficial for those with hepatitis C. A lot of hepatitis C patients can be cured and have happy lives with the right care.
The World Health Organization (WHO) suggests pan-genotypic DAAs as a treatment for prolonged hepatitis C virus in all adults, teenagers, and kids less than three years old. The short-term, oral DAA therapy regimens are curative and seldom cause negative effects. The majority of HCV patients may be cured with DAAs, and therapy only takes a short while if cirrhosis is not present (WHO, 2023). The World Health Organization updated its guidelines in 2022 to treat kids and adolescent patients with the same pangenotypic therapies as adults. The cost of pan-genotypic DAAs is still exorbitant for numerous high- and upper-middle-income nations.
Nevertheless, the emergence of substitutes for these medications has resulted in a sharp decline in price in various nations. The most popular and reasonably priced pan-genotypic DAA combination is daclatasvir and sofosbuvir. Less than 50 dollars can be spent on a curative medical session in several nations with low or middle incomes. Although it is still scarce, accessibility to Hepatitis therapy is increasing. According to WHO (2023), by the end of 2019, more than 62 percent of the 58 million people who had HCV infection worldwide who were initially diagnosed with persistent HCV infection had received treatment with direct-acting antivirals. Of those individuals, around 21 percent were aware of their diagnosis.
Up until recently, complicated treatment for hepatitis C was provided in medical facilities using specialist-led treatment approaches in various nations. Minimal skill and supervision are now necessary with the oral Hepatitis C DAA therapy regimens with few to no adverse effects. WHO advises employing streamlined service delivery incorporating decentralized management, integration, and job shifts to enable skilled non-specialist physicians and nurses to test, care for, and treat patients with persistent hepatitis C infection (WHO, 2023). Medical care, prevention programs, and jails are better places to implement this since they are more patient-friendly and accessible. Healthcare settings, prevention programs, and institutions may safely administer testing, treatment, and therapy treatments, making these venues more convenient and practical for patients.
Plan: Integrating Evidence
The US and other industrialized nations may be able to eradicate Hepatitis C through preventative measures, testing, diagnosis, and medical care for all phases of the virus, according to (Tskhomelidze et al.,2023). Testing and diagnostic tests, accessibility to efficient treatment, and implementation of cost-effectiveness strategies for patients and healthcare providers are essential for this concept to become a reality. Providing sterilized needles to communities that are at risk and educating individuals with a greater prevalence of HCV infection, considering there is an upward correlation connecting Injectable use of drugs and positive numbers of HCV infections.
All three levels of preventive methods will be essential to helping my patients avoid and treat hepatitis C infection in my future work as a certified nurse practitioner. Creating a secure and trustworthy atmosphere will be a major preventive measure in my future practice. This will help me get to know my patients better, assess them for risky behaviors and academic obstacles, and provide information in a way that they can all understand. As a nurse practitioner, you should do serum blood tests as the CDC advises for all people between 18 and 79, along with any individual who exhibits relevant symptoms or known risk factors (CDC, 2023). To stop the disease from becoming worse, persons with chronic HCV need to see a doctor frequently for continuous evaluation and therapy. This type of care is known as tertiary preventive care.
Hepatitis C virus medical care requires prior authorization, which puts undue strain on both patients and healthcare professionals and delays accessibility to care, worsening medical results. PA standards for state Medicaid programs are particularly onerous and exacerbate already-existing inequities in access to care, given the costly nature of Hepatitis C treatment (O’Kelley, 2023). Those on Medicaid are forty-six percent less likely than private insurance holders to undergo treatment for HCV. People from minority backgrounds on Medicaid are twenty-seven percent more unlikely than White Medicaid participants to receive medication on time, making this a racial equity concern as well. Regrettably, Illinois has the lowest grades nationwide for Medicaid treatment for hepatitis C availability. It ranks as one of only two states to get an F from the HCV State of Medicaid availability study. Eliminating PAs for hepatitis C treatment under Illinois Medicaid will significantly reduce access barriers and result in patients receiving more prompt and fair care.
To accomplish the aim of eradicating infectious diseases such as viral hepatitis by 2030, the healthcare system is guided in adopting strategically targeted actions by the international health sector plans on viral hepatitis over 2022–2030. The GHSS recommends national programs that are well-coordinated and tailored to a particular illness, supported by efforts by stakeholders and the WHO (WHO, 2023). They give opportunities to learn about various diseases, consider how epidemiology, technological advances, and context have changed, and consider how discoveries and tools might be used to fight disease (WHO, 2023). In addition to tackling gaps and disparities, they advocate for scaling up viral hepatitis prevention, assessment, and treatment, emphasizing reaching the individuals and groups most impacted by and susceptible to each illness. They support collaboration within the context of basic healthcare and complete health coverage and aid in accomplishing the 2030 Plan for Sustainable Development goals.
Conclusion
In conclusion, it can be seen that over 58% of individuals globally are infected with the hepatitis C virus. The continuing opioid crisis and rising IV drug misuse have both led to increases in HCV prevalence. Since acute symptoms are ill-defined, many HCV-positive patients are often in the stage of chronic illness before an identification is made. Liver-related malignancies and cirrhosis are two outcomes of chronic HCV infection. The management of this persistent public health emergency revolves around early identification, prevention, and inexpensive treatment. Hepatitis C can be transmitted when a person comes in contact with an infected person’s body fluids or blood. According to the Illinois Department of Public Health, cases should be reported through paper documentation or electronic means after diagnosis. Preventative measures must be implemented to curb the issue of HCV and prevent an increase in cases. It’s important to note that with early diagnosis and treatment, it’s possible to prevent further complications caused by hepatitis C
References
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Illinois Department of Public Health. (n.d.). Viral hepatitis. https://dph.illinois.gov/topics-services/diseases-and-conditions/hepatitis.html
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Tan, Y. W., Tao, Y., Liu, L. G., Ye, Y., Zhou, X. B., Chen, L., & He, C. (2018). Epidemiological features of chronic hepatitis C infection caused by remunerated blood donors: A nearly 27-year survey. World journal of gastroenterology, 24(11), 1250–1258. https://doi.org/10.3748/wjg.v24.i11.1250
Tskhomelidze, I., Shadaker, S., Kuchuloria, T., Gvinjilia, L., Butsashvili, M., Nasrullah, M., … & Walker, J. G. (2023). Economic evaluation of the Hepatitis C virus elimination program in Georgia, 2015 to 2017. Liver International, 43(3), 558–568. https://doi.org/10.1111/liv.15431
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