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http://www.pharmiweb.com/pressreleases/pressrel.asp?ROW_ID=4576

Family Hepatitis Service: Crossing The Hospital And Community Divide

NHS

Posted on:16 Sep 08

It is reasonably safe to argue that awareness of HIV has increased to a point

where much of the world recognises it as a life-threatening problem. Few people

by now can have missed, at some level, the stories, images, public health

campaigns or evidence attached to HIV/AIDS, the world’s highest profile

blood-borne killer virus.

However, many of those same people might well plead ignorance of the other,

potentially lethal blood-borne viruses. These are Hepatitis B virus (HBV),

Hepatitis C virus (HCV) and, much less prevalent in the UK, Human T-Lymphotropic

virus (HTLV-1). HBV infection is defined by the World Health Organisation (WHO)

as ‘one of the major diseases of mankind and a serious global public health

problem.’ Incredibly, it is 50 to 100 times more infectious than HIV.

Hepatitis actually means inflammation of the liver, and the various strains

produce a range of acute symptoms, from chronic fatigue to jaundice, nausea and

abdominal pain, that can be debilitating and dangerous. Both HBV and HCV, if

left untreated, can go on to kill. The WHO estimates there are two billion

people worldwide infected with HBV, more than 350 million of them with chronic,

lifelong infections that may eventually prove fatal by developing into liver

cancer and/ or cirrhosis of the liver.

The good news is that a vaccine exists against HBV which is 95% effective in

preventing chronic infections from developing. Infants are at high risk unless

they receive a vaccination, with a 90% probability of going on to develop a

chronic infection.

The bad news is that hepatitis is actually a family disease, but is not

generally recognised or treated as such. To provide really effective prevention

and care, a more holistic approach is needed and that is why St ’s Hospital,

Paddington, part of the Imperial College Healthcare NHS Trust, has developed its

own unique Family Hepatitis Service.

Gareth Tudor- has been instrumental in developing the service, together

with hepatologist Brown and Professor Lesley Regan, who got buy-in from

her obstetric and midwifery colleagues to help start the service up.

Tudor- is in no doubt that the service is innovative and currently found

nowhere else in the UK. “We see adults and children together, rather as we do

with our family service for HIV. In fact, we borrowed the idea from our HIV

clinic because chronic viral hepatitis is a family problem,” he says.

HBV and HCV are transmitted through blood to blood contact. This means

significant numbers of babies around the world are born with the virus,

transmitted through the mother in pregnancy or during delivery. But there are

other ways that infection can occur, putting partners and other family members

at risk. These range from uncovered cuts and grazes, used needle injuries,

transfusions with infected blood, unprotected sex and lack of sterilisation of

simple medical instruments.

In the UK, all pregnant women are now tested for hepatitis B. Like HIV,

hepatitis carries its own stigma.

One of the real issues with the virus, according to Tudor-, is that many

people simply don’t know they are infected. “What happens with your liver is a

bit like your car running out of petrol – it seems to run fine until one day all

it’s reserves are used up, and it is only at this point you realise you have a

problem, “ he says.

Whilst HBV screening has been standard practice for many years for expecting

mothers, screening for hepatitis C virus is not, and it is here that

Tudor- believes St ’s may also be leading the pack. “We are now

adding this to the list of tests which we routinely offer pregnant women and

there has been a 98% take-up rate. The logistics are simple since the blood

samples are being taken anyway; it is just a case of ticking one more box on the

blood test form, and is a very minor extra in terms of laboratory on-costs,” he

says.

As many as half a million people in the UK may be infected with HCV, which is

also transmitted blood to blood, though not generally through sexual contact. St

’s is currently collating and analysing data on HCV in the antenatal

population over the last six years and has already presented preliminary

findings to the Department of Health’s Advisory Group on Hepatitis.

Tudor- is anxious to stress the robustness and multidisciplinary

approach of the St ’s Family Hepatitis Service. “This is a truly innovative,

one-stop clinic which offers a seamless service for the whole family. It starts

in pregnancy, provides a high level of multi-disciplinary support and treatment

for those infected and also offers highly effective ways of stopping the virus

spreading. The family-based follow-up involves screening partners and siblings,”

he emphasises.

“We are playing our part in addressing the black hole of knowledge, especially

with testing of anti HIV and anti hepatitis drugs for children. As an academic

health science centre, we can provide additional leadership in this field. While

the mother may be identified in hospital, her baby will require immunisations

and the family members will need to be tested and immunised or referred for

treatment by GPs and Health Visitors, which requires really good communication

with all our colleagues in the community,” he says.

Editor's Details

Clare Byatt

Kinross + Render

http://www.kinrossrender.com

020 7592 3100

cfb@...

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http://www.pharmiweb.com/pressreleases/pressrel.asp?ROW_ID=4576

Family Hepatitis Service: Crossing The Hospital And Community Divide

NHS

Posted on:16 Sep 08

It is reasonably safe to argue that awareness of HIV has increased to a point

where much of the world recognises it as a life-threatening problem. Few people

by now can have missed, at some level, the stories, images, public health

campaigns or evidence attached to HIV/AIDS, the world’s highest profile

blood-borne killer virus.

However, many of those same people might well plead ignorance of the other,

potentially lethal blood-borne viruses. These are Hepatitis B virus (HBV),

Hepatitis C virus (HCV) and, much less prevalent in the UK, Human T-Lymphotropic

virus (HTLV-1). HBV infection is defined by the World Health Organisation (WHO)

as ‘one of the major diseases of mankind and a serious global public health

problem.’ Incredibly, it is 50 to 100 times more infectious than HIV.

Hepatitis actually means inflammation of the liver, and the various strains

produce a range of acute symptoms, from chronic fatigue to jaundice, nausea and

abdominal pain, that can be debilitating and dangerous. Both HBV and HCV, if

left untreated, can go on to kill. The WHO estimates there are two billion

people worldwide infected with HBV, more than 350 million of them with chronic,

lifelong infections that may eventually prove fatal by developing into liver

cancer and/ or cirrhosis of the liver.

The good news is that a vaccine exists against HBV which is 95% effective in

preventing chronic infections from developing. Infants are at high risk unless

they receive a vaccination, with a 90% probability of going on to develop a

chronic infection.

The bad news is that hepatitis is actually a family disease, but is not

generally recognised or treated as such. To provide really effective prevention

and care, a more holistic approach is needed and that is why St ’s Hospital,

Paddington, part of the Imperial College Healthcare NHS Trust, has developed its

own unique Family Hepatitis Service.

Gareth Tudor- has been instrumental in developing the service, together

with hepatologist Brown and Professor Lesley Regan, who got buy-in from

her obstetric and midwifery colleagues to help start the service up.

Tudor- is in no doubt that the service is innovative and currently found

nowhere else in the UK. “We see adults and children together, rather as we do

with our family service for HIV. In fact, we borrowed the idea from our HIV

clinic because chronic viral hepatitis is a family problem,” he says.

HBV and HCV are transmitted through blood to blood contact. This means

significant numbers of babies around the world are born with the virus,

transmitted through the mother in pregnancy or during delivery. But there are

other ways that infection can occur, putting partners and other family members

at risk. These range from uncovered cuts and grazes, used needle injuries,

transfusions with infected blood, unprotected sex and lack of sterilisation of

simple medical instruments.

In the UK, all pregnant women are now tested for hepatitis B. Like HIV,

hepatitis carries its own stigma.

One of the real issues with the virus, according to Tudor-, is that many

people simply don’t know they are infected. “What happens with your liver is a

bit like your car running out of petrol – it seems to run fine until one day all

it’s reserves are used up, and it is only at this point you realise you have a

problem, “ he says.

Whilst HBV screening has been standard practice for many years for expecting

mothers, screening for hepatitis C virus is not, and it is here that

Tudor- believes St ’s may also be leading the pack. “We are now

adding this to the list of tests which we routinely offer pregnant women and

there has been a 98% take-up rate. The logistics are simple since the blood

samples are being taken anyway; it is just a case of ticking one more box on the

blood test form, and is a very minor extra in terms of laboratory on-costs,” he

says.

As many as half a million people in the UK may be infected with HCV, which is

also transmitted blood to blood, though not generally through sexual contact. St

’s is currently collating and analysing data on HCV in the antenatal

population over the last six years and has already presented preliminary

findings to the Department of Health’s Advisory Group on Hepatitis.

Tudor- is anxious to stress the robustness and multidisciplinary

approach of the St ’s Family Hepatitis Service. “This is a truly innovative,

one-stop clinic which offers a seamless service for the whole family. It starts

in pregnancy, provides a high level of multi-disciplinary support and treatment

for those infected and also offers highly effective ways of stopping the virus

spreading. The family-based follow-up involves screening partners and siblings,”

he emphasises.

“We are playing our part in addressing the black hole of knowledge, especially

with testing of anti HIV and anti hepatitis drugs for children. As an academic

health science centre, we can provide additional leadership in this field. While

the mother may be identified in hospital, her baby will require immunisations

and the family members will need to be tested and immunised or referred for

treatment by GPs and Health Visitors, which requires really good communication

with all our colleagues in the community,” he says.

Editor's Details

Clare Byatt

Kinross + Render

http://www.kinrossrender.com

020 7592 3100

cfb@...

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