Hepatitis C

Hepatitis C: Brief Overview and Statistics
1. The nature of the problem
Hepatitis C refers to an infectious disease of the liver: it can manifest as either mild or severe and lasting in term for a few weeks or for as long as the infected individual might live (cdc.gov, 2018). It develops within the individual as a result of a contamination via the Hepatitis C virus, spread mainly via blood-to-blood contact (cdc.gov, 2018). This disease can be either acute or chronic, though acute infections often develop into chronic ones; around 75-85% of acute cases eventually develop into chronic cases (cdc.gov, 2018). This disease can cause long term liver damage that sometimes lasts a lifetime and leads to even more serious conditions such as scarring of the liver or cancer of the liver (cdc.gov, 2018).
By referring to Hepatitis C as a blood-to-blood illness, this refers to the way in which the virus is spread: someone whose blood is already infected with Hepatitis C makes contact with uninfected blood. Hence, intravenous drug use is the most common means of transmission. Thus, if someone has a Hepatitis C infection, it would be reasonable to infer that they have a drug problem that involves narcotics consumed via syringe. Before 1992, it was possible to become infected with Hepatitis C via blood transfusion: however, nowadays that really isn’t possible, given how rigorously blood is screened. However infrequent, infection can still occur via needle stick injuries in hospitals and clinics, along with being born to a woman who already have the disease (cdc.gov, 2018). Finally, it is possible to contract the disease through sexual contact, or by sharing personal items such as razors or even toothbrushes, however these forms of transmission are exceedingly rare (cdc.gov, 2018). When it comes to contracting the disease via sexual contact, the low rate of risk generally increases with the number of sex partners, if the sex is rough, or if one of the partners has other sexually transmitted infections such as HIV/AIDS (cdc.gov, 2018).
2. The prevalence and incidence statistics for the problem in the United States and around the world (no older than 5 years).
“In 2016, a total of 2,967 cases of acute hepatitis C were reported to CDC. Since many people may not have symptoms or don’t know they are infected, their illness is often not diagnosed, reported and therefore counted.  CDC estimates the actual number of acute hepatitis C cases was almost 41,200 in 2016” (cdc.gov, 2018). However, these are just the numbers of new infections in 2016. In total, the number of infected people in America is over 3 million (cdc.gov, 2018). This means that over 3 million people in America are capable of spreading the disease to others. This demonstrates without a doubt, the gravity of the hepatitis c health risk.
It is important to note that Hepatitis C is found all over the world. The areas where rates of infection are most aggravated are in the eastern Mediterranean (2.3%) and European areas (1.5%) (who.int). In other parts of the world, the prevalence ranges from half a percent to one percent (who.int, 2017). Moreover, in various nations around the world, the rates of the virus can be more pronounced around certain collectives (such as drugs addicts or those who work in the sex industry). To make the rates of infection even more complicated and dangerous, more than one genotype of the virus exists and their rate of manifestation varies according to area of the world.
According to a recent study entitled, “Global epidemiology of hepatitis C virus infection: An up-date of the distribution and circulation of hepatitis C virus genotypes” by Petruzziello and colleagues estimates the overall world rate of the Hepatitis C virus (HCV) at 2.5% (2016). This roughly translates to 177.5 million infected adults. More specifically, it varies from “…2.9% in Africa and 1.3% in Americas, with a global viraemic rate of 67% (118.9 million of HCV RNA positive cases), varying from 64.4% in Asia to 74.8% in Australasia. HCV genotype 1 is the most prevalent worldwide (49.1%), followed by genotype 3 (17.9%), 4 (16.8%) and 2 (11.0%)” (Petruzziello et al., 2016). The least prevalent genotypes are five and six, which are accountable for the last half a percent of infections. Even though genotypes one and three are the most frequently encountered all around the world, the greatest rate of genotypes four and five arise in nations that are considered to be lower income (Petruzziello et al., 2016).

3) In which three countries is the prevalence rate highest? What are three factors are contributing to the high prevalence rate in these counties.
Thus, based on all this data provided and on additional research, one can conclude that Egypt, Pakistan and China have the highest rates of infection of HCV (Mohamed, 2015). Egypt has a rate of infection that ranges from 18-22% per year, Pakistan has a rate of 4.9% and China has a rate of 3.2%. Other countries with high rates are Italy (2.5%-10%) and Indonesia (2.1%) (Mohamed et al., 2015). Other infectious disease experts have made the argument that countries like Mongolia and many nations in Africa have exceedingly high rates of the disease. However, none of the nations offer much reliable or consistent data (Mohamed et al., 2015). For these nations, drug use and unsanitary injection techniques doe attribute to the higher rates of infection (Mohamed et al., 2015). However, Egypt, unlike many other nations, engaged in “the prolonged use of parenteral anti-schistosomal treatment (antimony potassium tartrate, tartar emetics) with use of non-disposable glass syringes for more than 30 years” (Mohamed et al., 2015).



















References
Cdc.gov. (2018, April 23). Hepatitis C FAQs for the Public | Division of Viral Hepatitis | CDC. Retrieved from https://www.cdc.gov/hepatitis/hcv/cfaq.htm
Mohamed, A. A., Elbedewy, T. A., El-Serafy, M., El-Toukhy, N., Ahmed, W., & El Din, Z. A. (2015). Hepatitis C virus: A global view. World journal of hepatology, 7(26), 2676.
Petruzziello, A., Marigliano, S., Loquercio, G., Cozzolino, A., & Cacciapuoti, C. (2016). Global epidemiology of hepatitis C virus infection: An up-date of the distribution and circulation of hepatitis C virus genotypes. World journal of gastroenterology, 22(34), 7824.
Who.int. (2017, October 2). Hepatitis C. Retrieved from http://www.who.int/news-room/fact-sheets/detail/hepatitis-c