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Hepatitis C vaccine

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Last Updated: 02 July 2021

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Hepatitis C vaccine

Target diseaseHepatitis C
Identifiers
ChemSpidernone

An experimental vaccine was not found to be effective at preventing chronic Hepatitis C virus infection in adults, according to results from a clinical trial sponsored by the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health. Trial began in March 2012 at sites in California and Maryland; site in New Mexico was added in September 2015. The Phase 1 / 2 Clinical trial was evaluating whether the experimental prime - boost vaccine know as AdCh3NSmut1 / MVA - NSMut was safe and could prevent chronic HCV infectiondefined as persistent presence of HCV in blood for six months after initial detection of infection. The trial enrol 548 participants aged 18 to 45 years with recent history of injecting drugs. Participants were randomly assigned to receive an experimental vaccine or two placebo doses 56 days apart. Investigators report that 14 of 275 participants in the experimental vaccine Group and 14 of 273 participants in the placebo Group become chronically infected with HCV. Results indicate that the candidate vaccine fails to offer increased protection against chronic HCV infection compared to placebo. No vaccine - related serious adverse events were report. Seven participant deaths were reported during a clinical trial that was deemed to not relate to the experimental vaccine. Additional analyses of trial data are ongoing. If untreated, HCV infection can lead to chronic liver disease. People WHO inject drugs are at increased risk for HCV infection because the virus can be transmitted by sharing needles, syringes, or other equipment to prepare or inject drugs. Antiviral drugs can now cure more than 95% of all treated patients with HCV infection. However, no vaccine exists currently to prevent HCV infection. Many people are unaware that they are infected and continue to unknowingly spread virus. People WHO have been cured can also be re - infected if exposed again. The Hcv vaccine would be an important public health tool to interrupt and control HCV spread and to protect high - risk populations, such as people WHO inject drugs. Niaid continue to support HCV Research and is hosting a HCV vaccine workshop on May 29, 2019, in Rockville, Maryland. At the meeting, NIAID scientific experts and outside collaborators will discuss plans for future HCV vaccine designs. Additional details about the trial are available in clinicaltrials. Gov under identifier NCT01436357. Trial conclude in May 2018, and results will be published in clinicaltrials. Gov in coming weeks. The trial was conducted through NIAID contract to the University of California, San Francisco, part of NIAID - fund Sexually Transmitted Infections Clinical Trials Group. Switzerland - based company Okairos, which was acquired by GSK in May 2013, provides prime - boost vaccine for trial. Niaid conducts and supports researchat NIH, throughout the United States, and the worldwideto study causes of infectious and immune - mediate diseases, and to develop better means of preventing, diagnosing and treating these illnesses. News releases, fact sheets and other NIAID - related materials are available on the NIAID website.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Avoid infection

A carrier is a person who is not able to get rid of hepatitis B or hepatitis C Virus. Carriers keep Virus for the rest of their lives and can give it to others. A small number of adults and many children younger than 5 years infected with hepatitis B Virus will become carriers. Most hepatitis B carriers do not have symptoms. Few will develop serious liver disease that can lead to early death. Most adults infected with hepatitis C virusabout 75 - 85% become carriers. About two thirds of hepatitis C carriers eventually develop chronic liver disease. The Hepatitis B Virus is spread by direct contact with body fluids of an infected person. This can happen during unprotected sex or while sharing needles used to inject drugs. A baby can be infected during birth if the mother has the hepatitis B Virus. The Hepatitis B Virus can also be spread if you live with an infected person and share household items that may come in contact with body fluids, such as toothbrushes or razors. The Hepatitis B Virus is not spread by casual contact with people and objects. Casual contact includes shaking hands, sharing food or drink, or coughing and sneezing. Also, hepatitis B Virus is not spread by breastfeeding. Hepatitis B Immune Globulin: substance given to provide temporary protection against infection with hepatitis B Virus. Human Immunodeficiency Virus: Virus that attacks certain cells of the body's immune system and causes acquired Immunodeficiency syndrome.


What is Hepatitis C?

Hepatitis C is a contagious liver infection caused by the hepatitis C virus. The Hepatitis C virus was discovered in 1989. Prior to that, it was associated with blood transfusions, but was called non -, non - B hepatitis because the virus could not be identify. It is now known that there are several genetic types of hepatitis C virus. The natural course of hepatitis C Disease varies from one person to another. The first phase of disease is called acute hepatitis C and covers the first 6 months after a person is infect. During this phase, most people show no symptoms at all. Among those who do have symptoms, illness is usually so mild that most do even recognize that they have liver disease. In 15 - 40% of people with acute hepatitis C, immune system successfully fights off infection, virus is cleared from the body within 6 months, and the liver heals completely. In everyone else, immune system cannot clear virus, and hepatitis C infections persist for past 6 months. This persistent state is know as chronic hepatitis C. In chronic hepatitis C, liver becomes more and more inflamed and scarred over a period of years. However, speed at which inflammation and scarring take place varies between people. About 1 / 3 people develop severe liver scarring and liver stops functioning normally within 20 years. Another 1 / 3 takes 30 years for cirrhosis to occur. In remaining 1 / 3, liver disease progresses slowly and does not become a major problem during their lifetime. Hepatitis C can be treated and cure. Almost everyone living with HCV can now be cured with a one - pill - aday regimen in eight - to - twelve weeks. These new medications are generally well - tolerate. In order to access HCV treatment, it is necessary to see your doctor to discuss treatment options. Access to treatment continues to improve as new medication regimens are made available by private health insurers and public health programs like VA MediCal Centers, AIDS Drug Assistance Program, Medicaid, and MediCal.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Results

Without vaccine, optimal incidence reduction strategy was to implement test and treat programmes among PWID with setting - specific testing frequencies and to undertake screening and treatment of the general population in settings with high levels of community transmission. With vaccine available, optimal strategy was to include vaccination within these test and treat programmes, in addition to vaccinating adolescents in settings with high levels of community transmission. For 69 countries model, vaccine reduces testing frequency required among PWID. Of 167 countries model, between 0 and 48 countries could achieve an 80% reduction in incidence using testing and treatment alone. The Median relative reduction in hepatitis C incidence in optimal strategies without vaccine was 55%. With a 75% efficacious vaccine, between 15 and 113 countries could achieve an 80% incidence reduction target. The Median relative reduction in incidence in optimal strategies with vaccine available was 81%. For countries with concentrated epidemics, price point for vaccine to reduce total cost of optimal strategy was median US 247 per course. Below these threshold prices, savings from less frequent testing and treatment requirements among PWID outweigh the additional cost of vaccine. For countries with mixed epidemics, price point for vaccine to reduce total cost of optimal strategy was median US 1. 36 per course. The price point was much lower for settings with mixed epidemics because vaccines need to be delivered on a much larger scale. As prices per vaccination course decrease, availability of vaccine reduces the cost of optimal strategy for an increasing number of countries. At US 200 per vaccination course, optimal strategy with vaccine was cheaper than optimal strategy without vaccine for 66 of countries analyse, leading to an aggregate cost reduction of US 7. 4 billion across these countries compared to optimal strategies without vaccine available. This increase to 78 countries analyse and aggregate cost reduction of US 9. 8 billion for US 50 per course vaccine. For 14 countries, optimal non - vaccine strategy involves no testing and treatment programme among PWID. Common to these countries is very high hepatitis C prevalence among PWID. The extremely high prevalence in these settings meant that there were not many uninfected PWID, and so hepatitis C incidence was low. Scaling up treatment leads to an increase in the number of susceptible PWID and a subsequent increase in incidence. Therefore, according to our modelled definition of optimal, non - vaccination strategy with lowest cumulative incidence in 2030 involved no intervention or cost, but also had no impact on epidemic. This illustrates some of the challenges faced when aiming for elimination in high prevalence settings.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Protecting the Blood Supply

Hepatitis means inflammation of the liver. The liver is a vital organ that processes nutrients, filters blood, and fights infections. When the liver is inflamed or damage, its function can be affect. Heavy alcohol use, toxins, some medications, and certain medical conditions can cause Hepatitis. However, hepatitis is most often caused by a virus. In the United States, most common types of viral hepatitis are Hepatitis, Hepatitis B, and Hepatitis C. Hepatitis, Hepatitis B, and Hepatitis C are diseases caused by three different viruses. Although each can cause similar symptoms, they have different modes of transmission and can affect the liver differently. Hepatitis is an acute infection and does not become a lifelong or chronic infection. Hepatitis B and Hepatitis C can also begin as acute infections, but in some people, viruses remain in the body, resulting in chronic infection which can lead to long - term liver problems. There are vaccines to prevent Hepatitis and B; however, there is not one for Hepatitis C. If a person has had one type of viral Hepatitis in the past, it is still possible to get other types. Hepatitis is a liver infection caused by the Hepatitis virus. Hepatitis is highly contagious. It is usually transmitted by fecal - oral route, either through person - to - person contact or consumption of contaminated food or water. Hepatitis is a self - limited disease that does not result in chronic infection. Hepatitis is usually spread when the Hepatitis virus is taken in by mouth from contact with objects, food, or drinks contaminated by feces of infected person. People can get Hepatitis through: person to person contact when an infected person does not wash his or her hands properly after going to the bathroom and touching other objects or food, when a parent or caregiver does not properly wash his or her hands after changing diapers or cleaning up stool of infected person when someone has sex or sexual contact with infected person. Contaminate food or water Hepatitis can be spread by eating or drinking food or water contaminated with the virus. This is more likely to occur in countries where hepatitis is common and in areas where there are poor sanitary conditions or poor personal hygiene. Food and drinks most likely to be contaminated are fruits, vegetables, shellfish, ice, and water. The best way to prevent Hepatitis is through vaccination with Hepatitis vaccine. Vaccination is recommended for all children, for travelers to certain countries, and for people at high risk for infection with virus. Frequent handwashing with soap and warm water after using the bathroom, changing diaper, or before preparing food can help prevent the spread of Hepatitis.


Hepatitis C

You are more likely to get hepatitis C if you have injected drugs, had blood transfusion or organ transplant before July 1992, have hemophilia and received clotting factor before 1987, have been on kidney dialysis, were born between 1945 and 1965, have abnormal liver tests or liver disease have been in contact with blood or infected needles at work Have Had tattoos or body piercings Have work or live in prison Were born to mother with hepatitis C Have HIV / AIDS Have Had more than one sex partner in last 6 months Have Had sexually transmit disease Are man who has Had sex with men if you Are at high risk for hepatitis C, your health care provider will likely recommend that you get test for it.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Hepatitis C vaccine development

Development of an effective vaccine against HCV faces many challenges. First, substantial sequence diversity exists among HCV strains isolated within and between geographic areas. There are at least 6 HCV genotypes and more than 50 subtypes. This makes development of a global HCV vaccine rather complex. Second, even within an infected person, HCV isolates with rather divergent sequences in certain regions of the viral genome are present and mutations occur frequently during the course of infection. In particular, N - terminus of E2 protein contains a hypervariable region of about 30 amino acids, which shows extensive variation among all known isolates. Genetic variability within this region is thought to allow viruses to escape immune surveillance. Third, immunologic correlates that are associated with protection or disease progression are still being define. Knowledge of immunogenic epitopes and their relevance to viral clearance and the existence of conserved cross - reacting epitopes are still unclear. These problems are further complicated by the lack of a reliable infectious tissue culture system for testing neutralizing antibodies or passage and expanding of virus. Availability of such tissue culture systems has been invaluable in the successful development of other vaccines. For HCV, surrogate assay for determination of possible neutralizing antibodies has been develop. In this assay, antibodies are tested for their ability to neutralize binding of highly purified recombinant E2 protein or antibody - capture HCV derived from high - titer sera 54 onto susceptible cells such as MOL - 4 cells. This assay measures only inhibition of binding to target cells, which does not necessarily reflect neutralization of infectious virus in vivo. The only reliable model for HCV infection is the chimpanzee, which, as an endangered species, is not only costly but also difficult to study. Furthermore, course of HCV infection in chimpanzees may not necessarily represent that in humans. Earlier experiments in chimpanzees in which challenge of apparently recovered chimpanzees with homologous or heterologous strains of HCV result in reinfection suggest absence of protective immunity from natural infection. In addition, HCV manages to persist in chronically infected persons despite the presence of broad antibody and T - cell responses. Viral and host factors that lead to persistence are not fully understood and remain to be elucidated in future. Because the availability of small animal models would have greatly facilitated development of the HCV vaccine, intense effort has been under way to search for such models. Tupaia belangeri, small primatelike animal, has been shown to be infectable by hepatitis B virus and is now being evaluated as a small animal model for HCV. However, robustness and reproducibility of this model remain to be fully confirm. Alternatively, mouse models for HCV have been developed by either establishing HCV transgenic mice or transplanting human hepatocytes into immunodeficient mice. These models may prove to be useful in certain aspects of HCV vaccine development.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Preventing transmission

The Hepatitis C Virus is usually spread when someone comes into contact with blood from an infected person. This can happen through: today, most people become infected with Hepatitis C by sharing needles, syringes, or any other equipment used to prepare and inject drugs. Approximately 6% of infants born to infected mothers will get Hepatitis C. Although uncommon, people can become infected when health - care professionals do not follow proper steps needed to prevent the spread of bloodborne infections. While uncommon, Hepatitis C can spread during sex, though it has been reported more often among men WHO have sex with men. Hepatitis C can spread when getting tattoos or body piercings in unlicensed facilities, informal settings, or with non - sterile instruments. People can get infected from sharing glucose monitors, razors, nail clippers, toothbrushes, and other items that may have come into contact with infected blood, even in amounts too small to see. Before widespread screening of blood supply in 1992, Hepatitis C was also spread through blood transfusions and organ transplants. Now, risk of transmission to recipients of blood or blood products is extremely low. Hepatitis C is not spread by sharing eating utensils, breastfeeding, hugging, kissing, holding hands, coughing, or sneezing. It is also not spread through food or water.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Current treatments

Previously, combination of ribavirin and pegylated interferon was used to treat chronic hepatitis C. Rather than just directly attacking viruses, these two medications also work by enhancing the activity of a person's immune system. The immune system would then try to kill the virus. The goal of this treatment was to rid your body of viruses These medications had variable cure rates and could have significant side effects. However, since 2011, FDA has approved many antivirals that attack hepatitis C more directly. These drugs have much better success rates and seem to be better tolerated than older treatments. Current, recommended antiviral treatments for different genotypes of hepatitis C include: ledipasvir - sofosbuvir elbasvir - grazoprevir ombitasvir - paritaprevir - ritonavir ombitasvir - paritaprevir - ritonavir and dasabuvir daclatasvir - sofosbuvir glecaprevir - pibrentasvir sofosbuvir - velpatasvir sofosbuvir - velpatasvir - voxilapresvir in March 2020, FDA approved use of sofosbuvir - velpatasvir to treat hepatitis C virus in children ages 6 years and older or weighing at least 37. 5 pounds with any of six HCV genotypes. It had previously only been approved to treat viruses in adults. All of these drug combinations are direct - acting antivirals, which means they aim to attack components of the virus itself. Over a period of time, usually 8 to 24 weeks, this causes viruses to be reduced and cleared from your system. For all DAAs, goal of hepatitis C treatment is to sustain virologic response. This means that the amount of hepatitis virus in your system is so low that it ca be detected in your bloodstream at 12 to 24 weeks after you finish treatment. If you achieve SVR after treatment, it can be said that hepatitis C is cure.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Getting tested for hepatitis C

Table

HCV AntibodyHCV RNAInterpretation
NegativeNo infection or it is too soon after exposure and HCV antibody has not yet developed; if suspicion remains high, an HCV RNA test is done.
NegativePositiveEarly, acute HCV infection
Positive or weakly positiveNegativePast infection or no infection ( false-positive screen, most are weakly positive)
PositivePositiveCurrent, active infection

Because HCV infection usually produces no symptoms or very mild symptoms during early stages, many people dont know they have it until liver damage shows up - sometimes decades later - during routine medical tests. Some people who get HCV have it FOR a short time and then get better on their own. This is called acute Hepatitis C. But most people will go on to develop chronic Hepatitis C, meaning it doesnt go away. Whereas Hepatitis generally gives rise to acute Hepatitis, Hepatitis C results in chronic Hepatitis in most patients. An easy reminder is C FOR chronic Hepatitis C and FOR acute Hepatitis. In order to understand your Hepatitis C infection, it helps to have a basic understanding of how your liver work. You only have one liver and it is one of the largest and most important organs in your body. Your liver is located behind the lower right part of your ribs, which helps protect it. Your liver does the following important jobs to keep you healthy: it acts like a filter to clean your blood by breaking down things such as alcohol, drugs and other harmful chemicals, and removing wastes. It stores nutrients that you need - such as vitamins, fat and sugar from food - as well as other chemicals, and releases them into your bloodstream when your body needs them. It produces some very important chemicals, like ones needed to make your blood clot and heal after injury, as well as a greenish fluid called bile that helps with digestion of fats. So what does all this have to do with Hepatitis C? Hepatitis means inflammation, or swelling, of the liver. When the liver is inflame, it has a harder time doing its job. Hepatitis C is just one thing that can cause inflammation of the liver. Other things that can cause this include alcohol, some medications, and certain diseases. Unless successfully treated with medication, chronic Hepatitis C infection can cause other serious health problems, such as cirrhosis, liver cancer and liver failure. However, with recent advances in Hepatitis C treatment, we now have higher CURE rates, shorter treatment times, and all - oral treatment regimens FOR most people. If youre at risk of Hepatitis C, speak to your healthcare provider today about getting a test. Most people with acute Hepatitis C infection do not experience any symptoms or show signs of infection. If Hepatitis C symptoms do occur, they usually appear within two weeks to six months after being exposed to the Hepatitis C virus. If you do develop symptoms related to Hepatitis C, theyre generally mild and flu - like and may include: feeling very tired, sore muscles, joint pain, fever, Nausea or poor appetite, stomach pain, itchy skin, dark urine, yellow discoloration of skin and white of eyes, called jaundice.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Sources

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

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