Hepatitis C

Thesis (M.Nurs.), College of Nursing, Washington State UniversityHepatitis C infection results in significant morbidity and mortality due to its high (80%) rate of chronicity (Alter, 1995). Annually, 10,000 deaths are estimated. The mutations of the hepatitis C virus during viral replication could be responsible for the high percentage of chronic cases, a well as impacting on therapeutic efficacy, vaccine development and accuracy of diagnostic testing (Bukh, Miller & Purcell, 1995). Serologic assays, first developed in 1989, made it possible to diagnose hepatitis C. Identification of factors which contribute to the transmission of hepatitis C virus is incomplete. Also, prevalence rates of infection vary due to its vague symptoms and limitations of assays. Chronic viral hepatitis induces hepatocyte inflammation, injury and necrosis, which can lead to cirrhosis or cancer. Chronic hepatitis C is now the primary reason for hepatic transplantation in the United States. There is no supportive treatment for acute hepatitis C. Standard treatment for chronic hepatitis C consists of alpha interferon for 52 weeks. Treatment response is determined by ALT levels and HCV RNA titers, and is assessed three months after inititation of therapy. Only 25% of patients will have a sustained response one to seven years after completion of therapy (Fried & Hoofnagle, 1995). Improved response rates may be achieved with combination therapy with ribavirin. Other therapeutic options are being investigated