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Introduction

Hepatitis C is an inflammatory disease that causes the swelling of the liver through the hepatitis C virus (HCV). Once a person is infected with the disease, the liver is automatically affected and it swells causing a lot of other complications in the body. Apart from the virus (hepatitis C) the illness can also be caused by other toxins such as alcohol if consumed excessively. There are also other viruses that can harm the liver such as hepatitis A and B. All the viruses are capable of causing the diseases but they differ in many ways although they are not related in any way. Millions of people in the United States have been diagnosed with hepatitis C, which is known to cause cirrhosis, failure of the liver, as well as cancer (Forton, Taylor-Robinson and Thomas 435). Studies have shown that most of the available literature mainly focuses on the antiviral treatment as the only viable medication for persons suffering from hepatitis C. However, this kind of approach has left a gap of knowledge in the sense that many researchers and medics have failed to explore the broader health needs of the patients suffering from hepatitis C. The most affected group in this gap of medication and knowledge are those with chronic hepatitis C.  

Studies have shown that the estimated number of the people infected with the virus worldwide is three hundred and fifty million, consequently leading to six hundred and twenty thousand deaths worldwide per year (Morrill, Shrestha and Grant 756). The center for disease control (CDC) reported about forty six thousand new cases of the disease in America in 2006 (Loftis and Hauser 94), despite the increased anti-HCV medications employed by the medical practitioners. The ages of the most vulnerable people were said to be between twenty five and forty four years with a ratio of three to one per a thousand people. The less effective one-sided approach to treatment of hepatitis C highlights the need to broaden the approach, with emphasis on the primary care and increase of the capacity to deliver the care, as well as funding for the care givers.

Hepatitis Prevalence

It is estimated that over 4 million people above 6 years of age in America have at one point or another suffered from hepatitis C (Edlin and  Carden 673). Of more concern is the fact that nearly 3.2 million Americans (1.3 percent) have shown signs of chronic infection from HCV. Edlin and  Carden (674), however, argue that the prevalence of hepatitis C may be an underestimation as those data tend to ignore areas known to have high prevalence such as prisons and homeless persons. They two researchers, thus, include those in prison and homeless persons to put the figure at 5 million, and 4 million for those with the chronic version of the disease. The most worrying trend is that only half of those already affected are aware of their status (Bruix and Sherman 1209). 

Hepatitis C is often considered to be an asymptomatic infection that can lead to morbidity and mortality among the infected group. The virus breeds in the liver cells but it is not the virus itself which causes the damage of the liver, but its presence in the liver that provokes the immune response from within the body, as the body tries to fight the virus. The liver is then injured due to the swelling caused by the immune response. This illustrates how there is an unequal balance between the damaging and the protective effects of the hepatitis C immune response. In fact, studies show that before any severe damage of the liver occurs, many of those suffering from chronic hepatitis C show particular symptoms such as lower quality of life, as well as disabilities. In almost all stages of the disease, the patients normally complain about fatigue, that are manifested in memory loss and lack of concentration, and muscle and joint pains. According to Clanon, Mueller and Harank (365), many patients feel neglected and discriminated upon because of the related stigma, with some health care providers also dismissing some cases as lacking medical perspective.   

The damages caused by the Virus occur during the time when the body responds to the infection and tries to fight it (Willis 69 ). The immune system detects the infection, and subsequently releases cells to block the infection. It is the fight by the cells to destroy the infection that causes the inflammation of the liver. When the body is infected with the diseases, a person may not show any signs, and at times they get a bit sick for some days. During this time, the body’s immune system will fight the infections. However, if the immune system fails, the patient may develop chronic hepatitis C (Willis 69).

However, there are inherent uncertainties that come with the chronic hepatitis, considering the historical perspective of the disease and in the question of who needs antiviral treatment in the long run. Many researchers attest that hepatitis C emerges from two epidemiologic perspective, i.e. those infected by transfusions or other forms of exposure and those patients with liver complications (Blumberg 29; Edlin & Carden 675). Many of the patients diagnosed with hepatitis go ahead to live a normal life, with few consequences of the infections, thereby making it difficult to detect early enough.  

Comprehensive Healthcare for Persons Affected by Hepatitis C

Many caregivers agree that the first approach to managing hepatitis C is to provide the patients with adequate information about the complication, how it is transmitted, prevention, stages of illness, symptoms, progression prevention, and available antiviral treatments. Studies show that caregivers can help hepatitis C patients overcome complications associated with the disease, and stagnate the possible progression of the chronic version of the disease. The second recommendation is that a person who has been diagnosed with hepatitis C should be vaccinated against hepatitis A and B, because further infections with either or the two other forms of hepatitis may complicate management of the disease further. It is also recommended that persons diagnosed with hepatitis C should reduce their alcohol intake or better still completely desist from it. Studies have shown that alcohol abuse inflames the effects of hepatitis C, hence the need to screen the patients to ascertain whether they are highly dependent on alcohol (Edlin and Carden 676). It is also revealed that patients who inject themselves with illegal drugs are more likely to transmit the disease to other drug users. It thus follows that these people need to be advised on treatment of substance abuse and how to abstain from drug abuse. There is also the need to screen for HIV hepatitis C patients, as it has been noted that HIV can speed up liver infections.  

Apart from the need for thorough and careful monitoring of the liver and functions of the body through blood tests, the disease will need to be treated in many other ways. Liver infections can, at times, be so severe to an extent where a person will need a transplant, although this usually occurs in rare cases. However, people with chronic cases have a very small percentage of them having to be treated through liver transplant, as it is the only cure in cases of liver failure (Willis 37). Other patients with chronic infection from Hepatitis C may receive treatment through medications such as antiviral or another medication known as peginterferon. They are the kinds of medications that are capable of reducing hepatitis or completely destroying it from the blood, leading to little effect on the liver. This can subsequently cause liver cancer and cirrhosis.

When the infection occurs in the liver and becomes very severe and chronic, it can lead to liver failure in the long run, limiting the treatment option to liver transplant. The liver has to be replaced due to the massive destruction caused by the infections. Such patients whose conditions are serious and suffer chronic Hepatitis C should not use alcohol as it is a substance that is known to equally damage the liver in the same way as the hepatitis C virus. Such people should also follow the right procedures for treatments which must be done only after check up by qualified physicians or nurse to ensure the right medication is obtained(Blumberg 172).

Once successful treatment is accomplished, the liver is then expected to go back to normal functioning well after twelve to eighteen weeks in over ninety percent of all patients infected (Willis 32). Studies suggest that children are equally prone to hepatitis C, and most of the cases occur during birth where an infected mother transmits it to the baby. Children are also known to easily develop chronic hepatitis C due to limited ability of their immune system. This causes the disease to resist leaving the body, thus turns into a chronic complication. This subsequently endangers the health of the affected children. This is most likely the reason why researchers opine that over fifty percent of children with hepatitis C have developed chronic hepatitis C, and that only five percent of the patients with chronic hepatitis C are adults.

The percentage of children developing chronic hepatitis C is very high due to the inability of their weak immune systems to fight it during the early stages. It also means that the immune system in older people is strong enough to fight the virus, and at least destroy it before it destroys the liver. When the infections become chronic, it becomes risky because that is when the liver is destroyed causing cancer of the liver and cirrhosis. It is also risky as chronic hepatitis C can be transmitted easily making it risky for more people who might get infected (Blumberg 34). Persons with chronic hepatitis C are known as carriers even though some may not look sick at all or even show any signs of the disease, because they have the capability of infecting other people.

There is the need to carry out an ongoing care for patients who do not initiate antiviral treatment or those who have not successfully monitored the signs of other complications such as cirrhosis, liver failure, among others. There is also the need to help those who have been diagnosed with hepatitis C to manage symptoms, obtain the appropriate benefits, referring patients with chronic cases to potential liver transplant evaluation, cirrhosis treatment, and where need be, end-of-life care. As has been noted, those with hepatitis C face myriads of stigmatization, thus the need for a multifaceted approach to care and treatment. Such approaches emphasize the need for proactive engagement, building of trust, peer-to-peer care, and culturally focused care.

Primary care approach to management of hepatitis C is meant to provide care to people with hepatitis because this type of care is readily available than the much publicized specialty care. The primary care is also beneficial because it provides more open room for longer and more fruitful relationship between caregivers and the patients. Finally, primary care is also beneficial because it helps provide comprehensive multicultural care that focuses on patient’s physical, psychological, behavioral and family needs. The use of primary care will also ease the burden from the already outstretched specialists of hepatitis C.

Prevention:

There are also other lifestyle methods for preventing transmission and infection of hepatitis C, such as;

  • Using protection during sexual intercourse
  • Restraining from sexual practices with infected people
  • Avoid habits of sharing things such as, razors and toothbrushes
  • Proper cleaning of blood spills using the right measurements of water and household bleach
  • Drug needles should not be shared

Conclusion

Despite the rampant use of antiviral treatment for hepatitis C, medical researchers have found out that primary care for the patients forms the most effective way to manage the disease. Hepatitis C is generally a disease that should not be considered among the most risky diseases. This is because through different measures such as routine check ups and tests, prevention, early treatment among other primary care procedures; it is possible to effectively reduce its impact. These are measures which if followed well; cases of chronic hepatitis C will be scarce (Eisenstein & Millman 1984). Therefore, it is possible to reduce the infection by measures that follow a combination of care process, such as the introduction of various awareness programs. For example, there is need to long term approach to care, in order to reduce disability, provide educative supports and care, reduce alcohol abuse, and aid substance abuse treatments. The challenge is also based on the limited number of available trained personnel to deal with care provision issues for the patients suffering from hepatitis C. In order to curb this challenge, there is need to train more primary healthcare givers to support those in need. The local mechanisms should also be made in order to expand opportunities for the patients. Finally, there is a need for policy makers to create mechanism of care, provision of training, and appropriate care management policies to favor the primary care system.

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