Viral hepatitis in practice - 2015


Eliminating post-transplant hepatitis C
Geoffrey Dusheiko
pp 1-5
Approximately 2.8% of the global population are infected with hepatitis C virus (HCV). It is thought that between 350,000 and 500,000 people die from HCV-related complications each year.
Comment: Management issues
Alastair Miller
pp 2-2
The common theme of this edition of Viral hepatitis in practice is the management of viral hepatitis B and C. There are increasing treatment options and much better outlooks for patients, but this comes with increasing complexity and cost.
The changing role of the viral hepatitis clinical nurse specialist in hepatitis C management
Josephine Schulz
pp 6-7
There has been considerable speculation and anxiety about the role of the viral hepatitis clinical nurse specialist with the advent of new therapies for hepatitis C. Alfa interferon (IFN) plus ribavirin has been the mainstay of hepatitis C virus treatment for many years, with many associated side effects. More recently, the protease inhibitors (PIs) telaprevir and boceprevir were introduced, used in conjunction with IFN and ribavirin for genotype 1 patients. These first-generation PIs worsened the side-effect profile of treatment, with many drug–drug interactions, specific dosing requirements and possible resistance to therapy, making nursing care an important support to facilitate successful completion of treatment.
The evolving role of quantitative hepatitis B surface antigen in the management of chronic hepatitis B
Navjyot Hansi, Upkar Gill and Patrick TF Kennedy
pp 8-10
Hepatitis B surface antigen is the diagnostic marker of hepatitis B virus infection and its detection in the blood on two occasions six months apart confirms the diagnosis of chronic hepatitis B (CHB). An estimated 300 million people worldwide have CHB and are at risk of developing the complications of chronic infection; that is, liver cirrhosis and/or hepatocellular carcinoma.
Assessing the need for baseline resistance testing before initiating hepatitis C therapy with direct-acting antiviral agents
Annalan MD Navaratnam, Daniel P Webster and Tanzina Haque
pp 11-13
Chronic infection with hepatitis C virus (HCV) is one of the major causes of cirrhosis, hepatocellular carcinoma and liver failure that leads to transplantation. Worldwide, HCV affects more than 80 million people and it continues to increase in incidence. The percentage of people who are seropositive for anti-HCV antibodies worldwide is estimated to have increased from 2.3% to 2.8% between 1990 and 2005. The introduction of direct-acting antiviral agents has revolutionised the management of chronic HCV infection, as treatment with pegylated interferon and ribavirin is associated with significant side effects and a poor sustained virological response ranging from 50–60%.
A patient on haemodialysis treated for hepatitis C virus infection
Janet Catt
pp 14-15
Hepatitis C virus (HCV) acquisition continues to occur in patients undergoing haemodialysis. Anti-HCV screening of blood products has had a significant impact, reducing the number of patients infected, as have improved hygiene and isolation strategies. However, nosocomial spread still remains a potential problem.

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