ABSTRACT
A total of 82 blood (54 female patients and 28 male patients) samples were obtained from patients attending clinic at Daughter of Mary Mother of Mercy Medical Clinic. Samples were screened for Hepatitis C Viral infection using the rapid one step hepatitis C virus test strip. Out of the fifty four female patients with HIV virus, Nine (16.7%) female patients were positive for Hepatitis C Virus, giving an overall prevalence rate of (26.7%), in male, out of the 28 patients with HIV virus 5 (17.9%) male patients were positive for Hepatitis C Virus. From the finding of the research was observed that the prevalence of hepatitis C virus was higher in those within the age range of 19-25 than in those within the age range of 26-35 and 36-40. The finding in the research work also shows that male and female patients living with HIV virus out of 82 (100%) in this study, 14(17.1%) were Co-infection positive, while 68 (82.9%) were tested positive to HIV virus. It is hereby recommended that secondary prevention activities such as identifying HCV infected persons through diagnostic test, medical management and anti-viral therapy and providing appropriate medical follow-up and promoting healthy life styles and behaviour can reduce risk for chronic infection.
TABLE OF CONTENTS
Title
Page
Certification
ii
Dedication iii
Acknowledgements iv
Table
of Contents v
List
of Figures vii
Abstract
CHAPTER ONE
1.1 Introduction 1
1.2
Aims and Objectives 3
CHAPTER TWO
2.1 Short
History and Biology of the Human Immuno Deficiency Virus (Hiv) 5
2.1.1 Structure
of HIV (Human Immunodeficiency Virus). 6
2.1.2 Types
of HIV Virus and its Mechanism of Replication/Action 7
2.1.3
How HIV Spread 8
2.1.4
Signs and Symptoms of HIV Infection: 9
2.1.5
Preventive Measures 10
2.1.6
Management and Control Measures 10
2.2
Future Prospects for Production of Hiv/Aids Vaccine 13
2.3
Current Epidemiology of Hiv Disease 17
2.3.1
Mode of transmission and risk factors 17
2.3.2
Pathogenesis of hepatitis C virus 19
2.4
Signs and Symptoms 20
2.5
Diagnosis of Hepatitis C 20
2.5.1
Serology 20
2.5.2
Biopsy 21
2.5.3
Screening 21
2.6
Prevention of Hepatitis C 22
2.7
Treatment of Hepatitis C 22
2.8
Hepatitis C Virus and Pregnancy 23
2.9
Hepatitis C Virus and Hiv 26
CHAPTER THREE
3.0
Materials and Methods 27
3.1
Study Population 27
3.2
Sample collection 27
3.3
HCV Screening 27
CHAPTER FOUR
4.1
Results 29
CHAPTER FIVE
5.1 Discussion `34
5.2
Conclusion 34
5.3
Recommendation 35
References
LIST OF TABLES
TABLE TITLE PAGE
Table 4: Sex distribution of patients with HIV/AIDS 29
Table 2: Age
distribution of HCV in patients with HIV/AIDS
30
Table 3: Prevalence of HCV among female Patients living with HIV/AIDS 31
Table 4: Prevalence of HCV among male
Patients living with HIV/AIDS 32
Table 5: Prevalence of HCV among male and
female Patients living with HIV/AIDS 33
CHAPTER ONE
1.1 INTRODUCTION
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 the hepacivirus genus in the
family Flaviviridae. 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 New South Wales (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 newly-infected 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 2000s
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. 2005).
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 cutaneatarda, 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 has 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.
According to Morbidity and Mortality Weekly
Report (2008) Persons who ever injected illegal drugs, Persons who were ever on
chronic (long-term) hemodialysis; Persons with persistently abnormal alanine
amino transferase 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 2002;
and Healthcare, emergency medical and public safety workers after needle
sticks, or mucosal exposures to HCV-positive blood Children born to
HCV-positive women are those likely to be infected with HCV.
1.2 Aims and Objective of the Study
The aim of the study was to:
Determine the prevalence of Hepatitis C Virus
among HIV patients attending Mercy Specialist Hospkjjh ital, Ahiaeke Ndume.
Umuahia. Abia State. While the specific objective included;
i.
The
verification of Hepatitis C Virus occurrence in patients attending Mercy
Specialist Hospital, Ahiaeke Ndume Umuahia Abia State.
ii.
The
determination of the occurrence of the Virus amongst the various age groups and
sex.
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