Theory assignment: clinical pharmacy

Submitted to:
Sir qasim khan
Submitted by:
MUHAMMAD JAMAL
Reg#
fa17-phm-077
Date of submission:
17-06-2021

“Novel Therapeutic Strategies for the Treatment of Hepatitis B & C”

  What is hepatitis B?

Hepatitis B (also known as hep B or HBV) is part of a group of hepatitis viruses

that attack the liver. It can be passed on via unprotected sex (sex without a condom
or dental dam), through contaminated needles and from a pregnant woman to her
baby during birth.

You may be more at risk of getting hepatitis B if you inject drugs, are a sex
worker, are a man who has sex with men, change partners frequently, are in close
contact with someone who has chronic hepatitis B, or your occupation exposes you
to the virus, for example, a nurse.

Vaccines for hepatitis B are routinely offered to infants. Adults at a higher risk of
getting hepatitis B may also be offered the vaccine.

Hepatitis B does not always cause symptoms and can pass in a few months without
treatment (acute infection). People can also have a lifelong infection (chronic), and
without appropriate treatment and care, it can become more serious and lead to
liver damage or death.

How do you get and prevent hepatitis B?

Hepatitis B infection can happen when the blood, semen or vaginal fluids of an
infected person gets into someone else’s body. It’s really infectious and can last
outside the body for up to seven days.

 Contaminated needles:

Hepatitis B can be passed on through sharing contaminated needles and syringes

during recreational drug use. You can also get it from unsterilised tattoo, body-
piercing or medical/dental equipment. Very occasionally, you can get it from
sharing a towel, razor blades or a toothbrush if there is infected blood on them.

You can protect yourself by:

 Never share needles and syringes or other items that may be contaminated
with blood, such as razors, toothbrushes and manicure tools (even old or
dried blood can contain the virus).
  Only have tattoos, body piercings or acupuncture in a professional setting,
and make sure new, sterile needles are used.
 Getting vaccinated if you think you may be at an increased risk.

 Mother to child:

Pregnant woman with hepatitis B can pass the virus on to their unborn baby, which
is why women are routinely tested for hepatitis B as part of prenatal care. In almost
all cases, an infection can be prevented if the infant receives the recommended
vaccinations in time.

Infants infected at birth are more likely to develop chronic hepatitis B and go on to
develop liver complications, so it’s important to talk to your doctor if you have any
questions and follow any advice they give.

What are the symptoms of hepatitis B?

Many people with hepatitis B don’t have any symptoms. If you do get symptoms
you may not notice them until two or three months after infection and they can last
up to three months. There are two types of infection – acute and chronic.

Acute (or short-term) symptoms include:

 flu-like symptoms, including tiredness, fever and aches and pains

 feeling and/or being sick
 loss of weight/appetite
 diarrhoea
 tummy (abdominal) pain
 jaundice, meaning your skin and the whites of your eyes turn yellow
 dark urine (pee)
 pale faeces (poo).

People who can’t fight off acute infection after six months, such as babies, young
children and people with a weakened immune system because of HIV, can go on to
develop chronic hepatitis B. This is when people are at higher risk of liver failure,
liver disease and cancer of the liver.
How do you test for hepatitis B?

A simple blood test carried out by a healthcare professional will show whether you
have the virus. You may also be given extra tests to see if your liver is damaged.

If you’ve got hepatitis B you should be tested for other STIs. It’s important that
you tell your recent sexual partner/s so they can also get tested and treated. Many
people who have hepatitis B don’t notice anything wrong, and by telling them you
can help to stop the virus being passed on. This can also stop you from getting the
infection again.

How is hepatitis B treated?

 Acute hepatitis B infection:

There is no specific treatment for acute hepatitis B, and most people recover within
one to two months. Usually, you can manage symptoms at home with painkillers if
necessary. Your healthcare professional should advise you to have regular blood
tests and physical check-ups. Most people make a full recovery from acute
hepatitis B.

 Chronic hepatitis B infection:

If you develop chronic hepatitis B, you’ll be given treatment to reduce the risk of
permanent liver damage and liver cancer. Treatment does not cure chronic hepatitis
B and most people who start treatment need to continue for life.

Without treatment, chronic hepatitis B can cause scarring of the liver (cirrhosis),
which can cause the liver to stop working properly.

A small number of people with cirrhosis develop liver cancer, and these
complications can lead to death. Other than a liver transplant, there is no cure for
cirrhosis. However, treatments can help relieve some of the symptoms.

Hepatitis B and HIV

If you are living with HIV, or if you are at risk of HIV – for example, if you’re a
man who has sex with men, sell sex or use drugs – you should ask a healthcare
professional about getting the hepatitis B vaccine. That’s because people living
with HIV are more likely to go on to develop chronic hepatitis should they become
infected. They are also more likely to develop liver complications if chronic
hepatitis is left unmanaged.

Having hepatitis B won’t make your HIV any worse. However, it's still important
to let your doctor know if you test positive for hepatitis B so that they can more
closely monitor your liver. Taking your antiretroviral treatment as prescribed is the
best way to stay healthy with HIV and hepatitis B co-infection.

“HEPATITIS C SYMPTOMS & TREATMENT”

Hepatitis C (also known as hep C or HCV) is part of a group of hepatitis viruses

that attack the liver.

It’s mainly passed on through contaminated needles, either from injecting drugs or
from needle stick injuries in healthcare settings. It can also be transmitted sexually,
especially during anal sex or other types of sex that may involve blood.

Some groups are more at risk of getting hepatitis C than others, including people
who use drugs, people in prisons, men who have sex with men, health workers and
people living with HIV.

Chronic hepatitis C can be serious and without appropriate treatment and care, can
cause liver disease and liver cancer leading to death. Treatment, where available,
can cure hepatitis C in most cases.

 How do you get and prevent hepatitis C?

Hepatitis C is passed on when infected blood gets into another person’s body. It is
very infectious and the virus can stay alive outside the body for up to several
weeks.

 Contaminated needles and infected blood:

You can get hepatitis C from sharing contaminated needles, syringes and other
injecting equipment during recreational drug use. Banknotes and straws used for
snorting may also pass the virus on.

Being exposed to unsterilised tattoo and body piercing equipment can also pass
hepatitis C on. Occasionally, you can get it from sharing a towel, razor blades or a
toothbrush if there is infected blood on them.
Hepatitis C infection is also passed on in healthcare settings, from needle stick
injuries or from medical and dental equipment that has not been properly sterilised.
In countries where blood products are not routinely screened, you can also get
hepatitis C by receiving a transfusion of unscreened blood and blood products.

You can prevent hepatitis C by:

 never sharing needles and syringes or other items that may be contaminated
with infected blood (even old or dried blood can contain the virus)
 only having tattoos, body piercings or acupuncture in a professional
setting, where new, sterile needles are used
 following the standard infection control precautions, if you’re working in a
healthcare setting:.

 Sex:

Hepatitis C can be passed on via sex without a condom or dental dam with
someone who has the virus, even if they don’t have symptoms. Hepatitis C has
been detected in semen and vaginal fluids, but infection via these routes is thought
to be unlikely.

Sex which leads to blood exposure is the main way hepatitis C is passed on
sexually. These types of sexual activities include anal sex, fisting, when a woman
is on her period and rough sex which leads to tearing or cuts. Sharing of uncovered
or unwashed sex toys can also pass it on.

Because of this, sexual transmission of hepatitis C is more common among

populations that practise anal sex, such as men who have sex with men. Sexual
transmission during vaginal sex is thought to be very rare.

The risk of hepatitis C infection is increased when you have another STI –
especially one that causes sores. People living with HIV are also more likely to get
hepatitis C.

How do I protect myself from getting hepatitis C during sex?

 Test for hepatitis C and know the status of your sexual partners.
  Use condoms, especially during anal sex, rough sex or if you’re
menstruating. If you’re having sex with a new partner or if you have
multiple partners, it’s a good idea to use condoms consistently.
 Use dental dams and latex gloves for rimming, fingering and fisting.
 Test regularly for STIs.

If you’re living with HIV, taking your antiretroviral treatment for HIV keeps your
immune system strong so you’re less likely to get other infections, including
hepatitis C.  

from condoms, other types of contraception such as the contraceptive pill and pre-
exposure prophylaxis (PrEP) for HIV offer no protection against hepatitis C or
other sexually transmitted infections.

If you’ve been diagnosed with hepatitis C, it’s advised that you avoid sex until you
have finished your treatment and a health care professional says it’s safe.

 Mother to child:

Hepatitis C can be passed on from a pregnant woman to her child during

pregnancy and birth, although this is rare. The risk of passing hepatitis on is
slightly higher for mothers living with both HIV and hepatitis C (called co-
infection).  

Antivirals used to treat hepatitis are not currently recommended for pregnant
women because there isn’t enough information to know if the drugs are safe for
your unborn baby.

If you have hepatitis C and are pregnant speak to your doctor. They will be able to
give you advice on how to keep yourself and your baby safe during pregnancy and
birth.

If you’re planning to have a baby, your doctor may recommend that you treat the
hepatitis C before you get pregnant.

Breastfeeding with hepatitis C is considered safe. But if you have cracked or

bleeding nipples, it’s generally recommended to stop breastfeeding until they have
healed.
How do you test for hepatitis C?

A simple blood test carried out by a healthcare professional will show whether you
have the virus. You may also be given an extra test to see if your liver is damaged.

If you’ve got hepatitis C you should be tested for other STIs. It's important that you
tell your recent sexual partner/s so they can also get tested and treated. Many
people who have hepatitis C do not notice anything wrong, and by telling them you
can help to stop the virus being passed on. It can also stop you from getting the
infection again.

How do you treat hepatitis C?

People with acute infection do not always need treatment, because their immune
system may clear hepatitis C on its own. If you test positive during the acute stage,
your doctor may ask you to come back after a few months to re-test and to see if
you need any treatment.

If people develop chronic infection, they will need treatment to help clear the virus.
Where available, treatment with drugs called direct-acting antivirals (DAAs) can
cure hepatitis in most cases. These are usually taken for 8-12 weeks. Your doctor
will also check your liver for any damage.  

If you’ve had hepatitis C in the past, you’re not immune to future infections –
which means you can get it again. You can also still get other types of hepatitis,
and having hepatitis C together with another type is more serious.

If you’ve already had hepatitis C, it’s advisable to have the vaccination against
hepatitis A and B to protect your liver from further damage.

Whether you have symptoms or not, don’t have sex until your healthcare
professional says you can.

 Hepatitis C and HIV

Co-infection with hepatitis C and HIV is common because they are both
transmitted in similar ways. While both infections can be treated, it can complicate
things, so it’s important that your doctor is fully aware of your infections.
That’s because if you’re living with HIV and become infected with hepatitis C,
you’re more likely to develop chronic hepatitis C. The infection is also more likely
to progress quickly and become serious. This is even true when you are taking your
antiretroviral treatment for HIV and your viral load is low.

If you think you’ve been exposed to hepatitis C, it’s important to get tested and
treated with DAAs if necessary. In some cases, your doctor may make changes to
your antiretroviral treatment while they are treating your hepatitis C infection.

Refrences:

 Wikipedea
 Pharmacology book
 Clinical pharmacy