Introduction and rationale
Hepatitis C virus (HCV) is a worldwide problem. Globally, it was estimated that in 2005, more than 185 million people had hepatitis C virus (HCV) antibodies (prevalence of 2.8 percent) 1. The condition has been worsened in Egypt as it has the highest HCV prevalence in the world 2. Egyptian Health issues Survey (EHIS) in 2015 estimated a prevalence of 10 % for sampled population 26.172 had positive antibodies to HCV, however only 7 % were found to have HCV RNA 3. HCV also represents an economic burden in Egypt which will continue over the next decade 4.
As far as 2011, the combination of pegylated interferon and ribavirin for 48 weeks was the effective treatment for chronic hepatitis C, but Several HCV
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Accordingly, the European association for study of liver diseases (EASL) recommended Hepatitis C core antigen as alternative to HCV RNA in diagnosis of acute and chronic HCV infection.
Emergence of New DAAs represents a new challenge and a relief of economic burden in developing countries especially Egypt that has high prevalence of HCV infection. According to Egyptian National Virological Campaign protocol for treatment of HCV infection in May 2016, Repeated HCV RNA assays are needed for follow up of patients during and after antiviral therapy which are so expensive. A growing need to look for a cheap and reliable tool for monitoring of the efficacy of DAAs highlights the role of Hepatitis C core Ag assay as an alternative to HCV RNA assays.
A meta-analysis reported many studies that stated the accuracy of diagnosis for five HCV core antigen tests with different qualities and techniques that need sometime specific analyzers with closed system and relatively expensive 8. Thus, the main objective of this study is to evaluate a new Hepatitis C core Ag by ELISA in assessment of sustained virological response (SVR 12) after antiviral therapy in comparison to HCV RNA assay. This ELISA test is relatively cheap and doesn’t need specific analyzers like other HCV core antigen tests which not available in many laboratories in Egypt.
Aim of the work
To improve the health care provided for chronic hepatitis C patients and cost reduction of the
The other kind of test is called the Hepatitis C RNA Qualitative test. This test determines if the virus is currently present in your body. This is the test that is used most often to detect the virus. A positive test result indicates that you have Hepatitis C. A negative result will indicate that the virus is undetected. This could mean that even though your body may have been exposed to the virus it was able to fight the disease
A few years ago, Hepatitis C was a scary term for many of us. But, today the medical problem is curable as there are various and advanced ways available. The improvement in the treatment is especially notable because experts have worked harder to obtain this success. Still, there are some significant changes are left and hopefully they will be completed soon. Presently, the HCV treatments get rid of the virus in merely slightly more than half of all sufferers. The medicines also have unnecessary side effects that make it complicated or not possible for some patients to get them. HCV medication online available, but it is not worthy to take them without the concern of the doctor.
Hepatitis C is an inflammation of the liver’s cells and tissues caused by the hepatitis C virus (HCV).
A recombinant-based assay for the hepatitis C virus HCV has been developed, using RNA isolate from the hepatitis C virus.
Hepatitis C virus (HCV) is from the virus family Flaviviridae with an RNA envelope serving as it's genetic material. The genetic material (RNA) is HCV's pathogenic structure. The genome is positive sense single stranded RNA, which is very similar to mRNA and can be translated quickly to the host cell (Bauman 2012). Hepatitis C is an enveloped virus, and the RNA also lacks a proofreading ability after replication, which results in mutations coding for many genotypes within the host. This genetic variability makes it difficult for the host immune system to clear all the HCV infections. As one infection clears, another strain is being produced (Bauman 2012). The HCV antibody detected by ELISA(Wilkinson
Daclatasvir displayed potent inhibitory activity against all HCV genotypes tested (genotypes 1-6) [18, 19]. In replicon assays, the half~maximal effective concentration (EC5O) values of daclatasvir against HCV genotypes 1a, lb, 2a,3a, 4a and 5a were 50, 9, 71-103, 146, 12 and 33 pmol/L, respectively [28]. Daclatasvir displayed additive or syneregistic inhibitory activity in replicn assays when used in combination with peginterferon-a and ribavirin, NS3/4A inhibitors (danoprevir or asunaprevir) or NSSB inhibitors [EMS-791325 (beclabuvir) or NM-107] [28, 30]
Although we are well aware of the mode of transmission, the hepatitis C virus itself remains a mystery. The genome of HCV is extremely mutable. Because HCV is an RNA virus and does not have adequate proofreading ability as it replicates, virions infecting humans undergo evolution with time, giving rise to the notion that HCV persists as a collection of virus quasispecies. Because it is constantly mutating, HCV is able to escape detection and elimination its human host. HCV undergoes quick mutation in a hypervariable region of the genome coding for the envelope proteins and escapes immune surveillance by the host. As a result, most HCV-infected people develop chronic infection. HCV also knocks out the host’s innate immunity.
If someone is getting tested for Hepatitis C, they will first take an antibody test. This test will detect if antibodies are present in the blood, which will tell if the person has ever had Hepatitis C, not if they currently possess it (“Who Should”). If the antibody test comes back positive, a qualitative test will then be run. This test declares tells if someone is currently infected with Hepatitis C. A quantitative test can also be run, which shows the amount of Hepatitis C that is in the blood (“Who Should”). There are two main medications that are used to treat Hepatitis C. The first being Pegylated Interferon and another being Ribavirin. Both medications are used for the treatment of adult patients with chronic liver disease (FDA). These medications are used in place of the vaccine that has not been created for Hepatitis C. Therefore, Hepatitis C can be detected easily and is treatable.
The increasing number of citizens that are testing positive for Hepatitis C is shocking and the epidemic is just getting worse. One out of every one hundred people in the general population has Hepatitis C, but the ratio is higher in prisons. One out of every six inmates has Hepatitis C (Wegner, Rottnek, Parker and Crippin, 2014). Hepatitis C (HCV) is a blood disease that is caused by a virus and it affects the liver. Unfortunately there is no vaccine to prevent this disease and I have seen first-hand how ugly this virus is. I have worked in the medical field for the past 6 years and I have a very close friend who contracted HCV. Unfortunately, she was one of the many people that needed a liver transplant. HCV has infected four times as
The strain of genotypes is not differentiated by the severity of the disease. However, there will make a distinction in the regimen and the duration of the treatment (CDC, 2016). Treatment for chronic HCV is based on guidelines from the Infectious Diseases Society of America (IDSA) and the American Associations for the Study of Liver Diseases (AASLD). The criteria of who should receive the treatment include how much the virus in the body, the strain of hepatitis C, the degree of liver inflammation or damage, comorbidity, and response to previous treatment (Infectious Diseases Society of America [IDSA], 2016). The highest priority for treatment should give to a patient with advanced fibrosis and compensated cirrhosis (IDSA, 2016). Moreover, treatment priority should provide to the patient who has a high risk of transmitting the disease from and to others, such as individuals who are active injection drug users and hemodialysis patients (IDSA, 2016).
There are a number of individuals who may be suffering from an illness and not even be aware they have an illness. One example of such illness is Hepatitis C (HCV). Hepatitis C is a severe disease of the liver. It is caused by the Hepatitis C virus (Centers for Disease Control and Prevention (CDC), 2015). As a result, Hepatitis C has been termed a silent epidemic (CDC, 2015). This is because a lot of individuals have Hepatitis C and don’t even realize they have the infection (CDC, 2015). As the infection begins to progress over time, it could cause acute issues to the liver (CDC, 2015). Those issues could be things like damage to the liver, the liver could fail to function, cirrhosis, or even cancer of the liver (CDC, 2015). However, screening for Hepatitis C will allow an individual to benefit from treatments that are available, hence eliminating the disease from the body and preventing the liver from undergoing any further damage (CDC, 2015).
About 4.1 million people in Americans have the positive antibody to hepatitis C virus (HCV), and about 75 percent have permeant infection. Additionally, most of the infections happened 20 to 40 years ago, before the finding of HCV. Hepatitis C increased from 7,000 to 13,000 deaths in 2005. Furthermore, HCV develops slowly which increases the risk of severe complications in the infected people. Identification, death, and treatment are predicted to affect 35,000 by 2030. The Center for Disease Control (CDC) used antiviral therapy with PEGylated in clinical trials (Kalichman, Washington, Kegler, Grebler, Kalichman, Cherry, & Eaton, 2015). The CDC recommends a HCV one time test for people born between 1945 and 1965. The objective of this study was to thoroughly evaluate the amount of substance abusers infected with hepatitis C in the United States. Additionally, to observe the treatment of HCV. Currently Medicaid and Medicare repayment standards for sofosbuvir were calculated in all states, including the District of Columbia. Medicaid and Medicare covered the drug based on the following conditions; liver disease stage, HIV, and drug use. Approximately 42 states reimbursed the following criteria up to 74 percent for the drug sofobuvir. About two-thirds of the United States restricted the treatment centered on prescriber type. About 88 percent included drug abuse in their sofosbuvir admissibility measures. Finally, 50 percent required a date of abstinence and 64 percent required
About 4.1 million people in Americans have the positive antibody for hepatitis C virus (HCV), and about 75% of them are persistently infected and most of the infections happened d 20 to 40 years ago, before the finding of HCV. Hepatitis C increased from 7,000 to 13,000 deaths in 2005. Furthermore, HCV develops slowly which increases the risk for severe complications in the infected people. Identification, death, and treatment is predicted to affect 35,000 by 2030. The Center for Disease Control (CDC) used antiviral therapy with PEGylated in clinical trials. The CDC recommends a HVC one time test for people born between 1945 and 1965.They observed testing by birth. The objective of this study was to thoroughly evaluate the amount of substance abuser infected with hepatitis C in the United States. Additional to observe the treatment of HVC. Currently Medicaid and Medicare repayment standards for sofosbuvir were calculated in all states including the District of Columbia. Medicaid and Medicare covered the drug based on the following classes liver disease stage, HIV, and drug use. Approximately 42 states reimbursed the following criteria up to 74% for the drug sofobuvir. About two thirds of the United States restricted the treatment centered on prescriber type. About 88% included drug abuse in their sofosbuvir admissibility measures. Finally 50% required a dated of abstinence and 64% required drug test. The latest drug to HVC is called Sovaldi and it costs $84,000 for the 12
also a critical measure in many HCV high burden countries. Implementation of the WHO injection safety
In general, a patient is infected with only one hepatitis C virus genotype. The strain of genotypes is not differentiated by the severity of the disease. However, there will make a distinction in the regimen and the duration of the treatment (CDC, 2016). Treatment for chronic HCV is based on guidelines from the Infectious Diseases Society of America (IDSA) and the American Associations for the Study of Liver Diseases (AASLD). The criteria of who should receive the treatment include how much the virus in the body, the strain of hepatitis C, the degree of liver inflammation or damage, comorbidity, and response to previous treatment (Infectious Diseases Society of America [IDSA], 2016). The highest priority for treatment should give to a patient with advanced fibrosis and compensated cirrhosis (IDSA, 2016). Moreover, treatment priority should provide to the patient who has a high risk of transmitting the disease from and to others, such as individuals who are active injection drug users and hemodialysis patients (IDSA, 2016).