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Tag Archives: hepatitis

HCV, briefly

Viral Hepatitis comes in a number of flavors, named HAV, HBV, HCV, HDV, and HEV (not to mention any subtypes). HCV, identified as recently as 1990, is a serious form of Hepatitis causing cirrhosis of the liver, chronic infection, and often hepatocellular cancer. Prior to 1990, the most common way to become infected was through transfusion with contaminated blood. However, after identifying the virus, tests became available to prevent this form of passage, leaving the primary mode of transmission being sharing of needles between IV drug users and sexual contact.
Unlike other viruses (HAV), few people ever clear HCV and, instead, become chronically ill. This may, in part, be due to the inability of the body to generate protective, neutralizing antibodies. Those antibodies that are produced are mostly usable only as markers of disease. Symptoms of disease include fatigue, nausea, vomiting, loss of appetite, abdominal pain, jaundice, dark urine, and clay colored feces. The CDC definition of a case is: (sorry this isn’t clearer)

acute-hcv-infection-cdc2012-case-definition.jpg

Serum alanine aminotransferase (ALT) levels greater than 400 IU/L indicate hepatocellular damage. This enzyme is normally found only in
liver cells, but is released into the blood when these cells are injured. Normal ALT should not exceed 60 IU/L, providing a fairly clear altmeasure of cell injury.This can be seen clearly below as serum levels of ALT spike with symptoms of disease and then return (however not down to normal, ‘healthy’ amounts) to lower levels following resolution of symptoms.

symptoms-acute-hepatitis-c-infection.jpg

There is no vaccine against HCV, so the best way to avoid it is to avoid contact with blood or other bodily fluids that may be contaminated.


Don’t forget to check out my comments on the novel ‘Rosemary’s Baby’ on my other blog. I highly recommend this book to anyone who enjoys thrillers / light horror (a la Stephen King).

 
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Posted by on April 12, 2015 in Uncategorized

 

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This Week in MicroBiology Class

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Jaundice

Instead of starting our chapter on Eukaryotic micro-organisms / parasites, we spent much of Thursday’s class discussing the second Chapter of ‘Vaccinated’. This chapter digs in and discusses how a number of vaccines were tested in the children of the Willowbrook institution in New York. We talked about how researchers must balance the (sometimes) competing interests of doing the best experiments to answer a question and looking out for the interests of those who can not look after themselves (the children of Willowbrook, in this case).

This chapter looked at the work of several investigators; Most evaluating vaccines, but one (Krugman) was also doing experiments to investigate how Hepatitis was spread. His work included the infection of a number of children with live virus, but no attempt at protecting them from infection.

This is presented as the most condemnable work of the lot as it presented no potential benefit to the children. In saying this we define the principle by which other work was done, ‘does the study do no intentional harm and does it provide at least some potential benefit┬áto the subjects?’

This principle provides a challenge to doing the (scientifically) ideal experiment outlined below.

A basic, direct vaccine test would divide patients into two groups (vaccinated and unvaccinated) and then challenge half of each group with live virus (or whatever the vaccine is to protect against).

Ideal results:

vaccinated –> unchallenged –> 100% healthy

vaccinated –> challenged –> 100% healthy

unvaccinated –> unchallenged –> 100% healthy

unvaccinated –>challenged –> 100% sick

However, this means that the researcher would be knowingly (assume s/he is not blinded) injecting unprotected patients with live virus – an obvious ethical issue.

In looking through some old work done to investigate how hepatitis is spread, there was a mention of work conducted in just such a manner:

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Bellin and Bailet J. Ped 1952

It’s unclear from this reference to a personal communication what, exactly the word ‘volunteer’ means.

I’ll bring up this paper in class the next time we discuss Vaccinated. I have an interesting person connection to it.

Instead of a experimentally controlled challenge, modern vaccine tests (as the other work described in this chapter) use much larger populations chosen because of their ‘at risk’ nature and then we wait and see if there are statistical differences between the infection rates of each group.

 
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Posted by on September 6, 2013 in Uncategorized

 

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