Hepatitis C Virus Among Pregnant Women People Living With HIV AIDS Attending Clinic (A Case Study Of Unth Itukuozalla)

Project and Seminar Material for Public Health

Hepatitis C Virus Among Pregnant Women People Living With HIV AIDS Attending Clinic (A Case Study Of Unth Itukuozalla)


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.

Table of Content

  • Title page
  • Certification
  • Dedication
  • Acknowledgement
  • Table of content
  • List of table
  • Abstract

Chapter One

  • 1.1 Introduction
  • 1.2 Objectives

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

Chapter Three

  • 3.1 Material
  • 3.2 Study population
  • 3.3 Sample collection
  • 3.4 Method

Chapter Four

  • 4.1 Results

Chapter Five

  • 5.1 Discussion
  • 5.2 Conclusion
  • 5.3 Recommendation
  • References

List of Tables

  • 4.1 Age distribution of HCV in pregnant women
  • 4.2 Sex distribution of HCV in PLWHA
  • 4.3 Age distribution of HCV in male HIV patients
  • 4.4 Age distribution of HCV in female HIV patients

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 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 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 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 10โ€“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 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 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

  1. According to MMWR (1998) Persons who ever injected illegal drugs,
  2. Persons who were ever on chronic (long-term) hemodialysis;
  3. Persons with persistently abnormal alanine aminotransferase level
  4. Persons who were notified that they received blood from a donor who later tested positive for HCV infection;
  5. Persons who received a transfusion of blood or blood components and organ transplant before July 1992; and
  6. Healthcare, emergency medical and public safety workers after needle sticks, or mucosal exposures to HCV-positive blood Children born to HCV-positive women.

1.2 Objectives

  1. To determine the prevalence of hepatitis C virus in pregnant women attending ante-natal in UNTH Ituku-ozalla
  2. To determine the age distribution where the infection occurs most
  3. To determine the prevalence of hepatitis virus in people living with HIV and AIDS attending UNTH Ituku-ozalla

Chapter Five

Discussion, Conclusion and Recommendation

5.1 Discussion

The result showed that a total of 50 samples were collected; 30 from pregnant women and 20 from PLWHA. It was observed that the prevalence of hepatitis C virus was higher in those within the age range of 24-34 than in those within the age range of 19-23 and 38-40due to exposure to exposure to the risk factor of hepatitis C virus (Alter 1990).

It was also observed that (42%) of the men living with HIV and AIDS tested positive for HCV than the women (7.69%) because men are mostly infected than women due to men are likely to have risk factor for exposure to hepatitis C virus (alter 1990).

The prevalence of HCV is higher in PLWHA (20%) than in pregnant women (6.67%) and this can be due to reduced immunity and similar routes of transmission for HIV and HCV.

5.2 Conclusion

Though the prevalence of hepatitis C virus is high from this work, the infection has an adverse effect in all susceptible individual; men, women and children. Though there is no vaccination against this virus, medical management and ant-viral therapy should be employed to reduce or control this infection.

5.3 Recommendation

Since the prevalence of hepatitis C virus is high, it is recommended that Primary prevention activities such as screening and testing of blood, organ, tissue and semen donors can reduce the potential risk of HCV transmission from blood or blood component, intravenous drug use, multiple sex partners, tattooing.

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 behavior can reduce risk for chronic infection.

Professional and public education; Health care emergency medical and public safety workers should be educated regarding the risk for contacting HCV.

Immunization against HCV is not available; therefore identifying persons at risk but not infected with HCV provides opportunity for counseling on how to reduce the risk of becoming infected.

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