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An inactivated vaccine has been developed against HEPATITIS A.

It provides a good immune response without the risk of causing disease.

The technique includes vaccine immunization withthe

Havrix 720 one injection and a reminder the following year.

For children from the age of 1 year should be used Havrix720U vaccine / 0.5 ml

One booster injection and between 6 months and 1 year. (Recall protection for 10 years).

Tolerance is good and effective protection to nearly 100% for ten years.

This vaccine can be admnistré the same time as the vaccine against HEPATITIS B but another part of the body.

Hepatitis A affects approximately 10 million people per year in the world and therefore has a certain economic cost, which jusitifie vaccination as well as some forms of hepatitis A, although rare, can be fatal.

Those at risk are:

- Travelers who travel to developing countries,

- Drain cleaners,

- Medical staff,

- Cooks.

- We considèrre it is better to vaccinate family members who are in contact with a patient.

Since late 1994, the vaccination schedule is simplified with the new vaccine. He no longer has a single injection for primary immunization and a booster six months later. The injection should be given intramuscularly in the deltoid. The vaccine protects 10 years.

Since September 1997, a new vaccine against hepatitis A and B has been developed. It allows vaccinated against hepatitis A and B at the same time.

The vaccine called Twinrix, is the first combined vaccine against hepatitis.

Knowing that at-risk populations are almost the same for hepatitis A and hepatitis B, the new vaccine is undeniable progress.

This vaccine provides equivalent to two monovalent vaccines injected into two separate sites protection.

The safety of this vaccine is excellent.

The injection should be made intramuscularly in the deltoid region

Three injections are needed

The second one month after the first and the third six months after the second.

Dual protection is set up between 2 and 4 weeks after the first injection.

At 1 month, seroconversion rates were 94% for hepatitis A and 70% for hepatitis B.

At 2 months, they are 99.5% for hepatitis A and 97.4% for hepatitis B.

After the third injection, they are practically 100%.

In practice, three injections should be performed:

- The first day 0

- The second D + 30,

- And the third in J + 180

So two injections one month apart and the third at 6 months. (Do not change between different vaccine injections)

This vaccine is not yet, reimbursed by the security sociale.en 2001

It can not be dispensed by the pharmacist with a prescription.

View:

- HEPATITIS A

- HEPATITIS B

- HEPATITIS C

- HEPATITIS D

- HEPATITIS E

- CHRONIC HEPATITIS

- VIRAL HEPATITIS

- MARKERS OF HEPATITIS

The pain in the groin three months after surgery are not uncommon. 10 to 15% of surgical patients suffer.

These chronic pain seem more frequent in young patients active and lean.

It is neuropathic pain as evidenced by the language used by the patient to describe it.

(burning, cutting, stabbing).

Pain that is related to a lack of inhibition of spinal system control, which normally interrupts the pain message.

This pain can be related to:

- Injury of a peripheral nerve (neuroma, electric pain or deafferentation pain, this one moving in paroxysms on a permanent foundation).

- It can be a referred pain away from hollow inguinal related example with nerve irritation by a foreign body such as a clip or a prosthesis.

It remains possible that the surgical technique has an influence on the occurrence of pain, but this remains to be proven.

The consequences of these pains are a decrease in physical activity and sport in particular.

This can hinder the standing, walking, and can make up a single hard chair.

The impact of this pain can affect the social or sexual life of the patient.

TREATMENT

The usual analgesics are relatively ineffective as anti-inflammatory.

So treatment depends on the cause.

The removal of staples or prosthetic materials may be considered.

A nerve block can sometimes bring real relief.

Sometimes nerve resection or alcohol may be considered.

Sometimes the removal of adhesions that could grip a nerve is essential.

A bacterium that appears to be linked to the occurrence of duodenal ulcer and gastritis has been highlighted. It is a spiral germ and flagellate which is causing an increase in gastrin secretion, so peptic acidity. This induces the formation hyperacidity in the stomach duodenum beaches METAPLASIA. The germ can fix and causes chronic duodenitis of which may form an ulcer.

Certainly, other risk factors are obvious (smoking, alcohol, stress), but the bacteria act as a cofactor.

It seems that the poultry is a major source of the infection, but other sources have been identified, cattle, water, milk.

A test has been developed by the Institut Pasteur to detect this bacterium called Helicobacter pylori and Campylobacter pylori. This test is based on the technique of gene amplification from an endoscopic biopsy (see ENDOSCOPY).

In addition, other methods, serological in particular, are especially developed for the diagnosis.

It is to look for Helicobacter pylori IgG antibodies in serum or whole blood, knowing it takes a few weeks after infection for these serological tests become positive

These serological tests are not a good way to highlight reinfestation because then positivity can be a simple "scar" HIV old.

Finally it should be noted that it is possible for the presence of the germ in the air exhaled by a quite peculiar way: it is the breath test urea labeled with carbon 13.

It seems germ responsible for duodenal ulcer and especially relapse. The rate of recurrence of duodenal ulcer is much more common when we find the seed at the pylorus. The virulence of this organism is related to its mobility in the mucus and the existence of a ulcerogenic toxin it secretes.

This germ is found:

- In 90% of patients with duodenal ulcer and stomach ulcer

- In 70% of patients with ulcer induced by anti-inflammatory non-steroidal stomach.

- In 30% of adults over 50 years carrying non-ulcer dyspepsia.

- In 80-90% of patients with chronic gastritis.

- Reach For many patients with gastric cancer and gastric malignant lymphoma.

It seems that the eradication of gastric germ would prevent this type of cancer.

Antibiotic treatment to eradicate Helicobacter pylori is simple and very effective in 90% of cases.

We now know that no gastric cancer can develop in the absence of this organism.

- The germ could be involved in SUDDEN INFANT DEATH SYNDROME (see this term)

This germ is present especially in developing countries where 60% of the population is reached at the age of 10 years. However, the vast majority of carriers of the germ never develop ulcers.

Recent studies have demonstrated the beneficial effects of eradication of the germ on ulcer healing and rebleeding. Moreover, the destruction of significantly reduced the relapse rate ulcerative germ.

TREATMENT

The administration of a tri-antibiotic for 14 days (amoxicillin + macrolide or metronidazole for example) associated with antisecretory treatment (eg an inhibitor of the proton pump: LANZOR, Mopral, Ogast or Zoltum, Pariet) currently seems the therapeutic approach of choice, taking antibiotics to be preferably after meals.

For example:

- Clarithromycin 500 mg morning and evening or amoxicillin 1g morning and evening.

- Omeprazole 20 mg morning and evening or lansoprazole 30 mg morning and evening or pantaprazole 40 mg morning and evening

- Metronidazole 500 mg morning and evening or tinidazole 500 mg morning and evening

This regimen is to respect scruipuleusement for 14 days.

Tobacco is a failure of this drug combination factor.

It also appears that the administration of a tri-antibiotic similar to that used in duodenal ulcer is also beneficial in the treatment of non-ulcer dyspepsia (which would be a factor in gastric carcinogenesis, that is to say, would promote occurrence of cancer of the stomach).

Moreover, it appears that this bacterium is involved in the occurrence of certain cerebrovascular accicents especially those occurring in atheroma.

Indeed this bacteria in the digestive tract is also present in the blood, where it is associated with inflammation of the arterial wall in particular ds carotid level.

The toxicity of the arterial wall is due to the presence of a gene (cyto-toxin-associated gene-A) CagA.

This reinforces the hypothesis of the role of infectious agents in the weakening of the plaque.

PREVENTION

It relies on strict hygiene measures for the contagiousness is generally oral-oral or fecal-oral route. It is also worth noting the possibility of nosocomial infection (see CONDITIONS NOSOCOMIAL), in particular the role of the endoscope inadequately sterilized between each patient.

This vaccine protects against tetanus, diphtheria, polio.

Vaccination is carried out on the 2nd, 3rd and 4th months: Polio (Diphtheria, Tetanus, Polio).

Reminders 5-6 years, 11 years and 21 years

It is frequently associated with vaccination against pertussis (Tétracoq vaccine)

Currently, one can associate the vaccine against Haemophilus influenzae type b meningitis and the vaccine against hepatitis B

This is the dreaded complication of all it is inguinal hernia, femoral, or direct.

This narrowing causes INTESTINAL OCCLUSION (see this term) that requires any immediate surgical 

treatment.

SYMPTOMS

Besides severe pain, nausea and vomiting occur accompanied by a cessation of materials and gases.

TREATMENT

SURGERY NEEDED.

This viral disease affects 1% of the population in France.

This virus is responsible for 10% of cases of chronic hepatitis and in 1% of cases of hepatitis fulminans (fatal in a few days).

In addition, it is responsible for 80% of primary liver cancer.

The virus is found in blood, semen and vaginal secretions, like AIDS, but hepatitis B is much more contagious.

The virus is also found in saliva in very small quantities.

The most at risk are drug addicts and homosexuals (as in AIDS).

Also currently, there is a very significant increase in hepatitis B among heterosexuals more than a quarter of hepatitis B are heterosexually transmitted.

B virus is not transmitted by way of the placenta from mother to child during pregnancy but is passed from mother to child during childbirth. This transmission induced in 80% of chronic hepatitis in children.

This is why we must vaccinate at birth of children born to HIV-positive mothers with hepatitis B, especially if they carry markers of replication (HBeAg and DNA).

The incubation period is longer than that of hepatitis A, it can go up to 4 months.

The symptoms are those of hepatitis:

- Jaundice (jaundice)

- ILI

5 to 10% of affected individuals will develop chronic hepatitis. These topics are contagious and will change often to cirrhosis or liver cancer in the following years.

Contamination, in addition to sex, may be by blood. This is why the medical and paramedical staff is a population at risk.

Saliva also contains small amounts of virus, and although no formal experimental evidence can be advanced, it is possible to explain the family repeated contamination by saliva contact. (A sick person to a non-vaccinated person)

Currently it is necessary to vaccinate all subjects at risk:

- People living with HIV HBV, that is to say, carrying the hepatitis B

- Medical staff,

- Subjects with multiple sexual partners,

- Homosexuals,

- Drug addicts,

- Newborns of mothers carrying the virus.

In reality, it is imperative vaccinate adolescents before their first sexual intercourse as the mode of transmission is common. Hepatitis B will become in the coming years a real public health problem if vaccination is not compulsory for all. It would even make mandatory vaccination against hepatitis B in infants, especially those born to mothers with the virus.

You can get effective protection by two injections one month apart and a booster at 6 months 12 months later.

The previous strategy, three injections and booster one year later can be preserved when immunity must be acquired quickly.

We currently have three vaccines:

- GENEVAC B

- Engerix B

- HB vax DNA.

We can consider hepatitis B as an STD, sexually transmitted disease.

TREATMENT

- Treatment of acute hepatitis is bed rest, if fatigue is very important.

There is no diet to follow, if not the elimination of alcohol in all its forms.

A new therapeutic hope is based on results VITRO (see this term).

A cellular protein, 3G Apobec seems capable of inhibiting the replication of HBV.

It will cause the inactivation of the DNA (see DNA (DEOXYRIBONUCLEIC ACID) by incorporating viral during reverse transcription.

This molecule could control viral replication chronically ill and perhaps eradicate the virus during the acute phase of infection.

Against chronic hepatitis B, we can use corticosteroids, interferon alpha and sometimes some antiviral drugs such as lamivudine or Vidarabine acting competitively inhibiting DNA polymerase and thus prevents viral replication.

Interferon alpha can be transient side effects. It can trigger a flu-like illness with fever, fatigue, joint pain, low white blood cells and blood platelets, hair loss, depression syndrome. Sometimes thyroid abnormalities may occur.

These side effects are very well explained because these are the symptoms of the flu. The organization achieved by the influenza virus produces large amounts of alpha interferon. This overproduction intended to kill the virus causes the same symptoms as when administering interferon alpha for therapeutic purposes.

The treatment seems more effective if the patient is young, he is a woman, if the infection is recent, if not the yellow race. The treatment is of course against-indicated if the subject is infected vis-à-vis AIDS.

The adénovir dipivoxil is a new antiviral drug appears to be effective and well tolerated.

It complements the two antivirals are known as alpha interferon and lamivudine.

It remains to wait to assess the preventive effect of cirrhosis and liver cancer.

View:

HEPATITIS A

HEPATITIS A VACCINE

HEPATITIS B VACCINE

HEPATITIS C

HEPATITIS D

HEPATITIS E

CHRONIC HEPATITIS

VIRAL HEPATITIS

MARKERS OF HEPATITIS

We hear this term abdominal pathology whose treatment can not be delayed.

It is usually a surgical procedure.

Without being exhaustive, we mention:

1) PERITONITIS ACUTE partitioned

2) The PERITONITIS ACUTE GENERALIZED

3) APPENDICITIS

4) perforation peritonitis (gastric or duodenal)

5) perforations of Meckel's diverticulum

6) BILE PERITONITIS

7) intraperitoneal rupture of CYST HYDATID

8) the typhoid and paratyphoid peritonitis

9) peritonitis of genital origin in women.

10) Trauma to the abdomen.

11) intraperitoneal bleeding.

12) INTESTINAL OCCLUSION

13) Acute Intussusception

14) VOLVULUS

15) A biliary ileus see ILEUS

16) The expansion peptic acute.

17) MYOCARDIAL MESENTERIC

18) Acute pancreatitis

Ce cancer du foie est souvent en rapport avec une hépatite C aigue qui s'est transformée en hépatite chronique, elle même suivie d'une cirrhose.

Le délai d'apparition de la cirrhose après la contamination initiale de l'hépatite C est d'environ 20 ans et l'apparition de l'hépato-carcinome de 30 ans.

Ce cancer se développe le plus souvent dans un macro nodule de régénération devenu dysplasique  (Voir DYSPLASIE).

La survenue de ce cancer est d'autant plus fréquent en fonction de ces paramètres
Age supérieur à 50 ans
ancienneté de la cirrhose
sexe masculin
présence de varices oesophagiennes
temps de Quick diminué
alpha-foeto-protéine augmentée
présence d'anticorps anti virus C
Consommation d'alcool supérieure à 50 gr par jour.

SYMPTOMES

Souvent de découverte fortuite lors d'un examen échographique de routine chez un patient porteur d'une cirrhose, mais parfois en rapport avec :
- une baisse de l'état général
- des douleurs abdominales
- une ascite
- des hémorragies digestives
- un ictère compressif des voies biliaires

DIAGNOSTIC

Il sera sera confirmé par une imagerie de bonne qualité.
En particulier lors de la découverte d'une lésion d'un diamètre de plus de 20 mm ayant une hypervascularisation artérielle.
Une hyper alpha-foeto-protéine supérieure à 400 ng / ml .

La biopsie pourra être indispensable en cas de nodule d'une taille inférieure à 15 à 20 mm.
L'examen échographique à trois et six mois d'intervalle constatant l'augmentation du nodule peut permettre de confirmer le diagnostic en évitant parfois la biopsie.

Il reste que ce diagnostic de confirmation est parfois difficile à affirmer.
La répétition des examens devenant indispensable.

TRAITEMENT

Un traitement à visée curative reste possible dans environ 10 % des cas.
La transplantation hépatique est la meilleure solution.
En faisant une restriction des indications; en excluant les malades atteints de plus de trois tumeurs de plus de plus de trois centimètres ou d'une seule tumeur de cinq centimètres, ainsi que les malades atteints d'une thrombose portale, ( caillot de la veine porte) le pronostic s'est considérablement amélioré.
Le taux de récidive est inférieur à 15 % et la survie globale à cinq ans est de l'ordre de 70%.
Ces critères de sélection demandent encore à être vérifiés car certains malades porteurs de tumeur plus volumineuses ayant été greffés ont eu une survie à long terme satisfaisante.
Les variables à une survie sans récidive seraient.

La cause de l'hépatocarcinome :
- la présence d'une cirrhose.
- le taux d'alpha-foeto -proteine.
- le taux de gamma-GT.
- le nombre de nodules cancéreux.

Le diamètre maximal du plus gros nodule.
la localisation uni ou bipolaire (un seul lobe du foie ou plusieurs s atteints).
La différenciation anatomo-pathologique de la tumeur.
Les études se poursuivent pour affiner ces indications et contrindications.

La résection chirurgicale peut être envisagée en cas de manque de greffon, mais la mortalité opératoire reste assez élevée et les récidives fréquentes.
Enfin il est parfois possible d'envisager une destruction percutanée par alcoolisation ou par RADIOFREQUENCE (Voir ce terme).
Après traitement curatif la surveillance sera méticuleuse (échographe, IRM, dosage de l'alpha-foeto-protéine).

Des essais sont en cours pour tenter de diminuer la fréquence des récidives (interféron alpha, lipiodol radioactif intra-artériel, ou l'acide polyprénoïque).

En cas ce carcinome évolué, il peut être licite d'envisager un traitement par tamoxifène, androgènes, adriamycine, ou cysplatine.

- Infants,

- Children and tweens who have not previously been vaccinated,

- Infants sero-positive mothers for HBs antigen,

- Health professionals,

- Drug addicts,

- Fans of piercing and tattooing

- People in frequent contact with a patient positive for HBs antigen (family or community)

- HIV-positive people for HIV (AIDS) or HCV (hepatitis C)

- Hemodialysis

- Chronic transfusion

- Patients

- Personal structures for the mentally disabled

- People with multiple sexual partners (homo or heterosexual) or with a recent STD

- Travelers in highly endemic countries

- Detainees

- Candidates for transplant ite B vaccine.

It is the appearance of blood through the anus.

We denote this term bleeding red blood (even sparse or microscopic) whose origin is usually the rectum, but can be located above (sigmoid colon) or lower (anus).

The causes vary widely, for example:

- For HEMORRHOIDS,

- Diverticulosis,

- A CANCER

- A ULCERATIVE Hemorrhagic (see these terms).

RECTAL BLEEDING ALL SHOULD CONSULT YOUR DOCTOR AS SOON AS POSSIBLE. DO NOT SAY THAT HE IS JUST HAEMORRHOIDS THAT EVEN IF ANY, MAY BE ASSOCIATED WITH A MUCH MORE SERIOUS ILLNESS THAT ONLY THE DOCTOR IS ABLE TO DIAGNOSE.

will do when traveling in endemic countries (countries where cholera is present) or when required by local authorities.

Just one injection 6 days before departure, return at 6 months.

YELLOW FEVER VACCINATION

is essential in endemic areas, regardless of the duration of the trip (Africa, South America). This vaccine is a legal requirement for international travel.

POLIO VACCINATION DIPHTERIETETANOS

must be current. 3 vaccine one month apart and return the following year and then every 10 years.

VACCINATION AGAINST HEPATITIS A (see HEPATITIS A VACCINE)

is highly recommended for a trip to tropical or subtropical countries.

Two injections one month apart are required and reminders 1 year and 10 years later.

VACCINATION AGAINST HEPATITIS B

will be done by two injections at 1-month intervals and reminders in the 6th month. It is highly recommended, especially if the stay should be extended.

Contamination is also sexual and blood (surgery, blood transfusion).

VACCINATION AGAINST MENINGITIS

is indicated for long trips (at least 4 weeks), especially if the trip has to be done in rural areas and that the contacts with the local population must be frequent.

One single injection and return to 3 years.

This vaccine has been mandatory since 1987 for pilgrims to Mecca.

The vaccination must be made 10 days before departure.

TYPHOID VACCINATION

It is highly recommended over 2 years for travel to endemic countries (all tropical countries actually).

A new vaccine, TYPHIM VI, there recently. One injection is sufficient to recall three years.

VACCINATION AGAINST JAPANESE ENCEPHALITIS

Currently, there is a very effective vaccination should be recommended that travelers to the Far East because the prognosis of this disease is far from Benin.

Three injections of 1 ml of vaccine should be administered and completed at least 10 days before departure.

Vaccination occurring at J 0, J 7 and J 28.

This vaccination can be performed in children from 1 year.

We do not yet know the dates reminder to make this vaccine is too new and insufficient to establish this calendar reminder decline.

Children 1 to 3 years receive half doses.

The vaccine can be allergenic, medical supervision is advised during the vaccination phase.

Pregnancy is a cons-indication to this vaccination

This vaccine is not marketed in France and is subject to a temporary use permit procedure (ATU, and reserved for international vaccination centers.

VACCINATION TICK-BORNE ENCEPHALITIS

This vaccination is recommended for travelers to Central Europe, especially in highly endemic region (region of lakes and forests), especially from May to September, that is to say, during the period of tick activity .

It is also highly recommended for travelers to Siberia and northern China

The vaccine developed in Austria is available in France under the name Ticovac

Two intramuscular injections at monthly intervals and return to one year.

Half dose for children 3 to 16 years

Pregnancy does not indicate against-vaccination.

VACCINATION AGAINST RABIES

Preventive vaccination is often required in endemic countries

3 injections on D0-D7-D28

recall at 1 year and 5 years.

IT DOES NOT RELEASE THE TREATMENT IN CASES OF SUSPECTED BITE

However it allows a period of some extra days to implement, and its protocol will be simplified.

In practice, we must start the vaccinations 50 days before departure according to this schedule:

- J 0: DT polio and hepatitis B

- J + 12 + 1st yellow fever injection Hepatitis A

- J + 26 second injection DT polio and hepatitis B

- J + 26 typhoid vaccination (TYPHIM VI)

- J + 40 second injection Hepatitis A

- J + 50: 3rd DT polio

These vaccinations are the most important.

For other (meningitis, cholera ENCEPHALITIS TO DATA, JAPANESE ENCEPHALITIS, RAGE and even DENGUE), they are depending on where one goes. These vaccinations should be performed if possible before the calendar.

Vaccination is often overlooked is the INFLUENZA VACCINATION.

You should know that influenza epidemics are now tougher in countries where they started and perpetuated longer than before.

It should therefore be vaccinated if you travel to a country where the epidemic is still rife.

Hepatitis C, including more than 500,000 subjects with France, could pose serious public health problems in the years to come because this hepatitis, most often asymptomatic (no symptoms that giving attention) can cause after a few decades of cirrhosis or liver cancer.

Given that treatment can be very effective, it is very important to screen all subjects at risk.

They are:

- Patients who were transfused before 1991

- Dialysis before 1991

- Hemophiliacs who received blood products before 1991

- Kidney and heart transplant before 1991

- Subjects who underwent surgery to heavy bleeding, even if they do not have the notion that a transfusion could be made before their 1991

- The tattooed,

- The prison population,

- Major road accident before 1991

- Families of patients (it must explain the method of possible transmission by blood, so it is essential that the toiletry items are strictly personal)

- Persons who underwent endoscopy, especially if BIOPSY was performed on the occasion of this review,

- Subjects with unexplained fatigue.

Sexual contamination has been described but remains marginal.

Must advise those people sexual abstention menstrual period or in case of genital sores and wearing a condom for multiple partners.

You should know that 75% of subjects with pass the stage of chronicity, and some of these issues present a CHRONIC ACTIVE HEPATITIS which may progress to cirrhosis or cancer.

The laboratory diagnosis is made on the identification of antivirus antibodies to hepatitis C virus (HCV).

In case of a positive test, qualitative research of viral RNA in serum by the technique of polymerase chain reaction may be useful:

- To establish a pretreatment assessment and evaluation of the usefulness of this treatment,

- To diagnose infection in a child born to an infected mother

- To highlight the viral replication in people with normal transaminases repeatedly

- To make sure the responsibility of hepatitis C in liver disease with many possible causes.

If negative or discordant test:

- In acute liver disease of unknown cause after eliminating possible causes,

- In patients with chronic liver disease of unknown cause after eliminating possible causes, especially in immunocompromised transplant and dialysis,

- In case of a systemic disease that may be associated with HCV,

- To establish an early diagnosis in case of risk of occupational accidental contamination in particular.

If the laboratory diagnosis is positive, it must cause liver BIOPSY that specifies the degree of disease activity, which will lead to the eventual treatment.

View:

- HEPATITIS C

- HEPATITIS C TRANSAMINASES A NORMAL

- HEPATITIS C ACTION TO BE TAKEN

- HEPATITIS C VIRUS DIFFERENT

- HEPATITIS C CLINIC EVOLUTION

- RESPONSE TO HEPATITIS C TREATMENT

- HEPATITIS C SUBJECT TO RISKS

- HEPATITIS C ASSOCIATIONS

It seems that pregnancy worsens liver lesions in women infected with hepatitis C virus.

These are made ​​by histological examinations BIOPSY (see this term) that can be assumed.

It was possible to compare the biopsy done before pregnancy and the postpartum practiced (several months later).

Of necro-inflammatory lesions and fibrosis occur in the following childbirth on average, after one and a half months.

The Knodell (see this term) was used to assess the extent of damage.

According to the team from INSERM author of this report, this could be worsening of autoimmune origin, because at the beginning of the pregnancy hormone synergistic action (estrogen and progestin) stimulates the action of NK (natural killer cells ) mononuclear.

This action decreases in late pregnancy and rises again after delivery (true immune-mediated rebound).

It is possible that adverse action is reversible, due to the ability of liver cells to regenerate.

If pregnancy contrindique treatment with interferon the question remains of a pre-treatment design and delivery by the post interferon.

A - SEX LIFE

The sexual transmission is very low, unless specific risk factors are:

1) traumatic report

2) reports during the menstrual period,

3) pre-existing genital lesions

4) sexually transmissible diseases.

Tips:

1) to prevent the patient from the very low risk

2) for a stable couple should be advised sexual abstention or condom use during the menstrual period or in case of genital lesion,

3) the condom is not necessary out of these cases,

4) find a partner HCV serology,

5) In case of multiple partners, condom is required.

B - ENTOURAGE FAMILY

Transmission occurs primarily through blood, avoid contact with blood, especially fresh blood (cut, nosebleed, etc ...).

Do not share personal grooming items (razors, toothbrushes, nail clippers, scissors).

If wound after disinfection, immediately a small bandage.

Objects plate must not contain prohibited particular.

Saliva is not contaminating the kiss does not pose a risk.

HCV serology may be made in children may have been infected at birth.

C - SOCIAL LIFE

Social life presents no risks.

We must not isolate contaminated with HCV, the nursery and the school sick should not be a problem.

Sports are allowed, but if the wound disinfection and immediate dressing is required.

D - PARENT CHILD TRANSMISSION

In the absence of detectable HCV RNA in the mother, the risk of transmission to the child is practically nil.

Pregnancy is not cons-indicated in women with HIV and HCV even when viral replication.

The risk of transmission, even if significant viral load remains low.

Childbirth can be done by natural means.

Breastfeeding is not recommended.

In the new-born to mothers with HIV HCV, an RNA virus detection of hepatitis C will be performed at 6 months and 1 year.

The anti-HCV research can be done after the age of one year.

E - SICK FOR ITSELF

There is no special diet.

In case of obesity, a reduced calorie diet will be prescribed as treatment with interferon is more effective if the patient has a normal weight.

The prohibition of liquor is absolute (alcohol increases viral replication and has an additive effect on the risk of cirrhosis).

Vaccination against HEPATITIS B is recommended.

No constraint is imposed on the patient in terms of his work