Hepatitis A
Vincenzo Berghella in Maternal-Fetal Evidence Based Guidelines, 2022
Hepatitis A is usually transmitted through fecal-oral contact with infected persons or contaminated food and/or water. Most cases in the United States are directly transmitted through person-to-person or sexual contacts during outbreaks. The average incubation period is 28 (15–50) days, with peak infectivity 2 weeks prior to an abrupt symptom onset [9, 10]. HAV infection can be symptomatic (adults) but also asymptomatic (mostly children <6 years of age). The vast majority of cases are self-limited (1–2 weeks), though severe cases can last months [11]. Relapse can occur (up to 20% of cases), though the symptoms are often milder, and the average duration is 4.7 weeks, with reported durations up to 4 months [12]. Anti-HAV IgM usually appears 5–10 days before symptoms present, and can persist for 3–12 months [10].
Care of opiate users: maintenance treatment
Berry Beaumont, David Haslam in Care of Drug Users in General Practice, 2021
Where heroin is used by injection, the preferred route for heavy users because of the relative efficiency of this method of delivery, the health risks encountered include deep vein thrombosis, pulmonary embolus and sepsis both local and systemic. Where injecting equipment is shared, there are the attendant risks of transmission of bloodborne viruses, with an estimated 20–70% of injecting drug users being positive for hepatitis C antibodies.2 Although the proportion of injecting drug users who have evidence of hepatitis B and HIV is lower, the risk is nevertheless significant. General unwanted side-effects of heroin use include low salivary flow, leading to severe dental decay, severe constipation and adverse effects on pregnancy outcomes. Death associated with heroin use is common, with injecting drug users experiencing approximately 14 times the mortality rate compared with their non-drug using peers.3 Death is usually the result of coma and respiratory depression from heroin overdose, often in conjunction with other respiratory and CNS depressants such as alcohol, other opiates and benzodiazepines.
Immunomodulatory Therapies
David E. Thurston, Ilona Pysz in Chemistry and Pharmacology of Anticancer Drugs, 2021
Following the success of the national hepatitis B vaccination program in Taiwan, administration of hepatitis B vaccination was recommended for all infants and children up to the age of 18 by the WHO and the US Centre for Disease Control and Prevention (CDC) in 2009. In the UK, it is now routinely given as part of the NHS vaccination schedule to babies aged 8, 12, and 16 weeks. In particular, individuals considered to be at an increased risk of hepatitis B include infants born to those who inject drugs, those who change sexual partners frequently, health care workers with occupations putting them at risk of contact with blood or bodily fluids, such as nurses and doctors, and those travelling to high-risk countries. Once vaccinated, the individual is protected for life.
Microneedle technology for potential SARS-CoV-2 vaccine delivery
Published in Expert Opinion on Drug Delivery, 2023
Megan McNamee, Shuyi Wong, Owen Guy, Sanjiv Sharma
Hepatitis is a category of infectious diseases caused by the Hepatitis virus, which can be contracted through sexual contact, or sharing/second use of needles [118]. The severity of this condition and the high prevalence (355 million people infected with Hepatitis B and C combined in 2021) warrant research into simplified modes of vaccination, improving accessibility and reducing needlestick injury risk [119]. Recently, Cuevas et al., utilized metal and dissolvable MN patches coated with antigen to immunize BALB/c mice and rhesus macaques, with both demonstrating immunogenicity with highly detectable levels of antibodies in the titer (above the 2 mIU/mL detection limit) [120]. Although this has the potential for greater sustainability, high penetration forces induced mechanical failure, potentially impacting the pain experienced upon administration [120].
HIV And HCV adherence and treatment outcomes among people who inject drugs receiving opioid agonist therapy
Published in AIDS Care, 2022
Hadi J Minhas, Matthew J. Akiyama, Brianna L. Norton, Moonseong Heo, Julia H. Arnsten, Alain H. Litwin
People who inject drugs (PWID) are at the highest risk for acquiring hepatitis C Virus (HCV) infection (Murdock et al., 2019). Due to the shared mode of parenteral transmission, PWID are at risk for Human Immunodeficiency Virus (HIV). HCV cure has been shown to improve liver histology, regress cirrhosis, reduce variceal bleeds, and reduce the development of hepatocellular carcinoma (Backus et al., 2011; Lo Pearlman & Traub, 2011; Re et al., 2014; Thein et al., 2008). HIV/HCV co-infection has been linked to increased rates of fibrosis, cirrhosis, and the development of hepatocellular carcinoma (Graham et al., 2001; Sulkowski et al., 2007). Because HCV treatment success is dependent on adequate medication adherence, concerns that pill burden may lead to poor adherence may deter referral to HCV treatment among HIV/HCV co-infected individuals (McGowan & Fried, 2012; Oramasionwu et al., 2014).
The circadian rhythm of viruses and its implications on susceptibility to infection
Published in Expert Review of Anti-infective Therapy, 2022
José-Ramon Blanco, Eva M. Verdugo-Sivianes, Ana Amiama, Sandra Muñoz-Galván
HCV is responsible for inflammation of the liver, causing both acute and chronic hepatitis [55]. Globally, it is estimated that 58 million people have chronic hepatitis C virus infection [55]. HCV replication and clock genes are mutually inhibitory. Thus, by negatively regulating miR122 [56], an essential microRNA in HCV replication [56], REV-ERBα has an indirect role in HCV infection. Furthermore, there is another mechanism by which the PER2 overexpression decreases HCV replication in hepatocytes [46]. PER2 influences interferon signaling as an essential element in the regulation of the antiviral response and in viral replication [57]. In a cohort of HCV-infected patients undergoing liver transplantation, differences in early viral infection kinetics were associated with the time of liver transplant [58]; a higher frequency of subjects transplanted in the morning (4 of 6) showed a rebound in viral RNA levels during the first week post-surgery, but no viral rebound was observed in those transplanted in the afternoon (0 of 7). Other potential parameters that may influence viral replication after liver transplantation were not different. According to the authors, this observation highlights the role of circadian processes in regulating HCV infection.
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