Viral hepatitis in practice - 2013


Managing hepatitis B in resource-poor areas
David Chadwick
pp 1-4
Around one third of the world’s population has been infected with hepatitis B virus, which is estimated to cause 600,000 deaths annually, mostly in resource-poor countries. The areas with the highest prevalence are predominantly in Africa and Asia. In some regions, up to 20% of the population is hepatitis B s antigen-positive (HBsAg+).
Comment: Food for thought
Alastair Miller
pp 3-3
In this issue of Viral hepatitis in practice, we examine the management of hepatitis B, both in a global resource-poor and a parochial UK setting. We learn more about the worldwide burden of hepatitis E. We are enlightened about a competence programme for liver nursing. And we gain knowledge about a pilot scheme to treat hepatitis C in people who inject drugs.
Chronic hepatitis B in children, young people and adults: summary of the new NICE guideline
Grammati Sarri, Maggie Westby, Amy Kelsey, Gill Ritchie, Grant Hill-Cawthorne and Howard Thomas
pp 4-7
Between 250,000 and 500,000 people in the UK are thought to have chronic hepatitis B. In around 20% of people infected by CHB, the virus causes liver fibrosis and cirrhosis, leading to a 1–4% risk per year of developing hepatocellular carcinoma; in others, it is inactive and does not lead to significant health problems. It is during the ‘immune clearance’ and ‘immune escape’ phases that the immune response to virus-infected hepatocytes causes liver damage and progressive fibrosis.
Hepatitis E: where does it come from and how does it transmit to man?
Harry R Dalton and Kathy L Woolson
pp 8-11
Hepatitis E virus (HEV) was discovered during the Soviet occupation of Afghanistan in the 1980s. A Russian scientist, Dr Mikhail Balayan, investigated outbreaks of unexplained hepatitis in military personnel and, during his studies, ingested a pooled faecal extract of affected soldiers. Unsurprisingly, he became ill and a new hepatotropic virus, HEV, was seen in his stool using electron microscopy.
Resources: A competence framework to help professionals manage liver disease
Elizabeth Farrington and Lynda Greenslade
pp 11-11
There are thousands of committed healthcare professionals across the country looking after hepatitis C patients, including consultants, specialist nurses, GPs, drug service staff, prison healthcare staff, psychiatrists, public health specialists and commissioners. However, because this is a fairly specialised disease area, and one with a low public profile, there have been limited national attempts to share and drive best practice.
What you told us about VHIP

pp 13-13
In the previous issue of Viral hepatitis in practice (VHIP), we asked you for your opinion on the journal to help us gauge how it is used. Here are the major findings of that survey.
Treating hepatitis C in people who inject drugs – a London pilot scheme
Claire Munro
pp 14-15
In London, at least 34,000 people with a history of injecting drugs are estimated to have hepatitis C. Only around 1,000 of them receive treatment each year. Most other people simply fall through the gaps between services, which are not configured around patients’ needs.

Viral hepatitis in practice was previously supported by Gilead Sciences from 2015 to 2016, by Gilead Sciences and Janssen in 2014, by Gilead Sciences and Roche Products in 2013 and by Gilead Sciences from 2009 to 2012.


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ISSN 2041-1162 (Print)  ISSN 2045-7863 (Online)