PREVALENCE OF HEPATITIS C VIRUS AMONG PATIENTS LIVING WITH HIV/AIDS ATTENDING MERCY SPECIALIST HOSPITAL AHIAEKE NDUME, UMUAHIA, ABIA STATE.

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                                                                                                           TABLE OF CONTENTS

SECTION ONE

1.1 Introduction                                                                                                                      1

1.2 Aims and Objectives                                                                                                        3

SECTION 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

SECTION 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

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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