Talk:Hepatitis C

From Wikipedia, the free encyclopedia

This article was previously a Medicine Collaboration of the Week.

I have a question. Why is it that no one wants to deal with this disease. My Husband had a liver transplant last year because of Hep C. It was the worst time of our life. I dont want anyone to have to go through what he went through. But when I try to talk to people about it after they have told me they know someone with it. They seem like their in la la land. They dont want to hear what is going to happen.

 Hepatitis C was a good article candidate, but did not meet the good article criteria at the time. Once the objections listed below are addressed, the article can be renominated. You may also seek a review of the decision if you feel there was a mistake.

Date of review: 12 November 2006


From the article:

As a sample extract of silybum marianum and licorice are known for their HCV related effects. The first provides some generic help to the ephatic functions and the second one have a mild antiviral effect and rises blood pressure.

It is also well known that even small amounts of alcol makes HCV virus proliferation faster.

Can someone check these assertions, please?

http://www.clinicaltrials.gov/show/NCT00030030 suggests that at least the first assertion is unproven, but that there is at least some anecdotal evidence for it.

The link removed from article provides an analisys of the eventual effectiveness of alternative terapies Hepatitis C and Complementary and Alternative Medicine

Why not insert some information into the article body, e.g. the alternative methods used in HepC? Just providing external links is not helpful. JFW | T@lk 09:36, 29 Aug 2004 (UTC)

There is no doubt that alcohol can lead to a more rapid progression of HCV related liver disease, however there is no evidence that drinking alcohol increases viral load. I have altered this in the text.

I would be inclined to remove the line regarding HCV cell surface receptors. LDLR is one of a number of receptors proposed but it's significance is not clear. This is an area of on-going research where we really don't know the answers yet and I'm not sure it is relevant for a general review of the subject.

I will try and add to this page over the next few weeks.--Hog 21:08, Oct 28, 2004 (UTC)

Contents

[edit] Typo?

What is "chronic acute hepatitis C infection"?

Response: Nope, no typo: many hepatitis C infections don't "heal" even if treated (depending on the virus subtype, between 20% and 40%) and become chronic. The illness continues at low activity, but sometimes has activitiy spikes, becoming acute. Then, after a while it reduces its activity again, returning to its chronic non-acute state.

Response to Response
The activity spikes you are referring to are termed "chronic active hepatitis", not "chronic acute hepatitis"Lindenb 19:10, 7 January 2006 (UTC)

[edit] what does this mean?

Approximately 40% of U.S. patients infected with HIV are also infected with the hepatitis C virus (HCV), mainly because both viruses are blood-borne

asking about the "mainly because both viruses are blood-borne", which doesn't seem like a causative agent here

I've improved it. JFW | T@lk 10:10, 20 November 2005 (UTC)

[edit] Pregnancy and breastfeeding

Added new section. The numbers on this vary. I am comfortable with this for now. They match the existing references and external links.--FloNight 10:44, 20 November 2005 (UTC)

[edit] History and future

Added new section about history and future. I changed the discovery date to 1988, CDC articles all use this date. --FloNight 14:44, 20 November 2005 (UTC)

[edit] Endnotes

Please note that inline external links mess up the endnote system. But then you don't need inline external links if you're doing endnotes... Also please note that changing the order of the paragraphs leads to a need for renumbering the notes. JFW | T@lk 16:36, 20 November 2005 (UTC)

Why does note 10 still link to reference #1? JFW | T@lk 22:57, 28 November 2005 (UTC)

Endnotes are still messed up... I just added two new references (Houghton, 1987 european patent; and Ulrich, 1990, semiquantitation of viral loads) and they show up okay in the endnotes but the numbering is messed up in the text. Somebody needs to go through and review all the endnote references and see where the error is; I suspect it's a matter of reordering the appearance of the references in the endnotes section. i'll give it a try soon if I get some time. lanephil 02:13, 15 May 2006 (UTC)

[edit] Images & graphs

I downloaded some Hepatitis images and graphs to my user page. I put one in the article. Does this work? Do any of the other ones work better?--FloNight 15:05, 21 November 2005 (UTC)

[edit] Hepatitis C image gallery

I started a Hepatitis C image gallery for the images in the article and others. --FloNight 15:39, 27 November 2005 (UTC)

[edit] number of genotypes

I took the liberty of changing the number of genotypes from eleven to six based on the Oct 2005 Simmonds paper in Hepatology. I am not sure how to add the reference. Could some kind person add it? B.Joppa

Well, the Single Citation Matcher on PubMed [1] effortlessly generated:
Simmonds P, Bukh J, Combet C, Deleage G, Enomoto N, Feinstone S, Halfon P, Inchauspe G, Kuiken C, Maertens G, Mizokami M, Murphy DG, Okamoto H, Pawlotsky JM, Penin F, Sablon E, Shin-I T, Stuyver LJ, Thiel HJ, Viazov S, Weiner AJ, Widell A. Consensus proposals for a unified system of nomenclature of hepatitis C virus genotypes. Hepatology. 2005 Oct;42(4):962-73. Review. PMID 16149085
I'll stick it in. JFW | T@lk 22:21, 17 December 2005 (UTC)

[edit] Hello

I am an HCV virologist and new to Wiki. I just made a few edits within virology. Feel free to comment. —The preceding unsigned comment was added by Lindenb (talk • contribs).

Fantastic. An expert! Please continue, and don't forget to cite your sources, with which you are likely to be more familiar than us. JFW | T@lk 22:48, 18 December 2005 (UTC)
Would you know if there are five or six types of Hepatitis. I am pretty sure that there is a Hep G so i added that. please verify. I too am new to wiki. do i have to cite sources for that bit of info? i mean, it seems to be knowledge that anyone can pick up, right?

If you look on hepatitis you will see that there is hepatitis A, B, C, D, E and G. However, the six types discussed here are subtypes of the hepatitis C virus depending on their RNA sequence. You are free to add material but do not forget to WP:CITE. If it is incorrect it may be removed or put in another, more relevant article. JFW | T@lk 21:30, 22 December 2005 (UTC)

I am unclear of what you mean, JFW. HCV comes in six "genotypes", or distinct flavors, which differ from each other via sequence variation. They all cause hepatitis C. "Subtypes" is used to refer to subdivisions within a genotype. For more information, see the Simmonds et al reference, above. There are also six different hepatitis viruses, A through G. They are all distinct viruses that are largely unrelated. The one exception to this is that "hepatitis G virus", more formally called "GBV-C", is within the same virus family as HCV, the Flaviviridae. However, the medical literature is still in doubt as to whether GBV-C actually causes hepatitis. We need to clarify this on that page, and I recently added a comment to hepatitis G. Lindenb 19:36, 7 January 2006 (UTC)

You were correct: hepatitis G can cause acute hepatitis[2]. JFW | T@lk 21:31, 22 December 2005 (UTC)

Well, in conflict with the web page you found, in the peer-reviewed medical literature it is still unclear as to whether GBV-C causes hepatitis. I recommend you read the excellent review of Simons et al, "The GB viruses." Current Top Microbiol Immunol 2000;242:241-375. Lindenb 19:36, 7 January 2006 (UTC)


Hey, virons and virions are the same things, right?

"virions" refers to physical virus particles. I have never heard the term "virons". Lindenb 19:36, 7 January 2006 (UTC)


[edit] Hello #2

Hi there to all. I'm also a HCV virologist, albeit from the early days of the virus discovery (1987-1990 timeframe), also new to Wikipedia. will be working on the page as I get time. cheers. lanephil 02:58, 14 May 2006 (UTC)

Hi, I'm not a HCV virologist, but I do have Hepatitis C. Anybody feel free to ask me any questions that you have on that topic. Yes Hepatitis is deadly, but people get a bit carried away by this term. The only reason that this virus would be deadly is if a the person infected doesn't take care of him/herself. As for me, I had it since I was born. I was born seven months premature so I needed a blood diffusion. I have a rare blood type, blood type O, and the only person who had this blood type was someone infected with Hep C. He donated his blood to me and I was infected with this virus. But my parents and I didn't know about this until I was nine. I was fortunate enough to have a strong liver that was able to fight Hep C. Now, I drink vitamins before or after meals twice a day, eat right, excercise, I don't drink at all (not even a drop of wine), and I basically take care of myself. If anybody with Hep C would do the same, then they would have no problem. —The preceding unsigned comment was added by LeeMulod333 (talk • contribs).

[edit] Move text to talk for discussion

Chronic Hepatitis C The NIH Concensus Statement on Hepatitis C, NIH Concensus and State-of-the-Science Statements, Volume 19 Number 3; published June 12, 2002 states the following: "Currently, persons aged 40 to 59 years have the highest prevelance of HCV infection. In this age group, 6.1% of African Americans are thought to be infected." This contrasts with The Centers for Disease Control documentation stating the infections are most prevalent in the aged 25 to 39 years group. Since the CDC figures are based on the aformentioned reseach paper, there is some motivation for the CDC to report an incorrect age group. Further Stated: "All data is based on chronic infections lasting 20 years, or less. There is little or no knowledge on chronic hepatitis infections lasting more than 20 years." This sharply contrasts with the omission by the CDC that almost all data pertains to infections lasting 20 or less. This omission by the CDC alludes to pacification of HCV infected persons, who are under the illusion that only 20% of HCV infections will ever result in cirrhosis. The figure of 20% pertains only to a 20 year time duration. Given disease models for similar pathogens, it can be reasonably expected that the disease will continue to progress past the 20 year time frame. The NIH further found "HCV treatment sees diminishing returns as the infection progresses. Treatment should be begin as soon as possible after a patient is diagnosed." This is in conflict with the CDC documentation given to health care providers intimating treatment should be held off until digestive or psychiatric complications occur. When these complications occur, treatment is least effective, and the infected individual faces a minimal chance of recovery. The NIH goes on to state: "Psychiatric complications, owing to HCV infection, including depression, are seen in 20% to 30% of cases." This is omitted in CDC documentation. The NIH paper states: 2/3 of new infections are by intravenous drug abuse, yet the sectors of the populayion most effected have extremely low incidences of IV drug abuse, but very high incidences of sodomy. Sodomy is a known mode of transmission of HCV, yet the CDC and NIH make no mention of it. International studies have shown the highest incidence of HCV infection among sodomites, or those who mix blood with sodomites; up to 59%. --FloNight 08:50, 31 January 2006 (UTC)

I notified AwesomeMachine that I moved this text here for discussion. It is interesting but needs to evaluated and then worked in to the flow of the article if needed. The way it is written now, it is a comparison of two U.S. agency papers. I'll look at the papers and see what's up.--FloNight 00:47, 1 February 2006 (UTC)

[edit] # of Infections

"Hepatitis C infects an estimated 150-200 million people worldwide." Is this the number of annual infections? Also, what three countries have the highest number of infections?

Patchouli 03:06, 20 March 2006 (UTC)

[edit] Alfa and Beta interferons

I have a question concerning medicines used to treat multiple sclerosis--particularly inteferons--and those used to treat chronic hepatitis C.

A few years back, I underwent therapy consisting of injections of pegalated alfa 2b interferon and ribaviron to treat hepatitis C. I feel blessed; my therapy was a success and I haven't felt better in years! They say I could be in remission for the rest of my life (I'm 50 years old).

Unfortunately, the side-effects of the treatment were not so kind to me; I even had to quit work for four months. My sister (while being treated with interferons for MS) suffered little or no side-effects while being treated for her MS.

So often people ask the question, "Aren't the medications for both illnesses the same, and if so, why did you suffer so severely while your sister's side effects have been so minimal?"

So, are both the meds(interferons) for MS and HCV basically the same?

I'd like to be able to supply and answere once and for all; because, frankly, I'm getting a little tired of the question?

A professional (or knowledgable) opinion would be welcomed.

Thanks,

--Debbie122756 18:22, 16 May 2006 (UTC)

Your Immune system is probably not exactly the same. Interferons are immunoimodulators. If you have a different immune system, then side effects will have differences too. I think this is the answer for your first question. The others: I don't want to answer, I'm not a doctor (just 4th year :)). NCurse work 20:03, 7 August 2006 (UTC)
I'm not a doctor either, just a hep C nurse and I have no experience with MS. But I do know that MS is generally treated with beta interferons, as opposed to alpha interferons for hep C, and they do have somewhat different effects (beta has more anti-inflammatory action); and hep C patients also get ribavirin, which MS patients don't, and a few of the side effects in hep C treatment (anemia, mostly) are due to ribavirin. But as NCurse said, everyone is different. I've had hep C patients on identical treatment, with similar health prior to treatment, and they had very different levels of side effects. ←Hob 16:49, 16 November 2006 (UTC)

[edit] Article split

I would like to propose splitting this article into hepatitis C and hepatitis C virus, just like HIV and AIDS, EBV and mononucleosis infectiosa. What do others think??

I'm all for it. There is certainly a ton of information about the virus which would simply overwhelm this article when we start to add it. We will have to discuss the virology quite a bit still in the hepatitis C article due to the treatment differences, epidemiologic differences, and the non-curative role of liver transplantation. But I think that there's much more to be said that shouldn't all be said here. I think that this page can stay hepatitis C instead of hepatitis C infection (etc) but I would be open to discussion if others felt strongly otherwise. InvictaHOG 01:08, 17 August 2006 (UTC)
I second that proposal. I planned to propose the same. Kpjas 08:53, 17 August 2006 (UTC)
Me too. It won't be an easy work. :) NCurse work 09:03, 17 August 2006 (UTC)
As a first cut, I've split out the 'virology' section into the new hepatitis C virus page. --Arcadian 10:31, 17 August 2006 (UTC)

[edit] Lymphoma

Should we mention lymphoma? PMID 12954572 suggests a strong link + implications for treatment. JFW | T@lk 22:15, 10 September 2006 (UTC)

Didn't look properly. Samir has been working on this behind my back (it's been off my watchlist). JFW | T@lk 22:28, 10 September 2006 (UTC)

[edit] Steven Tyler

It seems every Aerosmith fan in the whole world is pushing for Steven Tyler to be mentioned here. As I have elsewhere, I will also dispute here the need for a long list of people who have stated they have hepatitis on the record. We may never hear of it again. In contrast, Naomi Judd, Pamela Anderson and Phil Lesh have engaged in activism to increase awareness of the disease or its treatment. I will continue to remove Steven Tyler, with an RFC if necessary. JFW | T@lk 06:53, 27 September 2006 (UTC)

Any plans to have an RfC on the whole celebrity disease thing? We've been doing the separate list thing on other pages. It would be nice to better codify it. Otherwise you're fighting a losing battle, I'm afraid. InvictaHOG 12:00, 27 September 2006 (UTC)
FYI: I've compliled a small list of informal RFCs related to this under JFW's post at Wikipedia talk:WikiProject Clinical medicine#Notable patients. I think most agree that the Steven Tyler factoid does not belong here, but there doesn't yet appear to be any consensus on whether or not a separate list should be created. -AED 21:40, 2 October 2006 (UTC)

I am opposed to "lists of patients" for reasons of WP:NOT, WP:V (sometimes there is no adequate proof rather than word-of-mouth) and WP:N. I have never bothered with an RFC, but this may be the time to do this. JFW | T@lk 16:42, 27 September 2006 (UTC)

It's a continually vexing problem. The list of epilepsy patients is a great article, but most lists of patients are unverified and seemingly unverifiable. InvictaHOG 16:46, 27 September 2006 (UTC)
  • Maybe we need that RfC on the appropriateness of "List of people (famous or not) who have had X"....InvictaHOG is right, the problem is just with Steven Tyler fanboys here, its creeping-up on many pages. -- MarcoTolo 02:51, 28 September 2006 (UTC)
In general I am critical of list sections in articles which begin as a tangential topic but develop into unwieldy and often unverified exhaustive lists. In this particular case (and similar cases with other medical conditions), I think it is appropriate to list only those patients/sufferers who are known at least in part for having the disease; for example, Brooke Shields and post-partum depression. All entries should be verified and cite a reliable source, of course. Listing sufferers who are famous for other reasons and happen to have the disease is not appropriate, in my opinion; it is enough (assuming verification is done) to mention it on the person's article. --Ginkgo100 talk · e@ 20:36, 2 October 2006 (UTC)
I'm a bit unfamiliar with the RFC thing. Is this the place to discuss, or somewhere else? I have some sympathy with JFW, having fought a battle to keep computer-game trivia out of Diazepam. However, the argument (regardless of merit) for this particular article/RFC needs to be strengthened. Weaknesses:
  • The RFC says "not famous because of that disease". Almost nobody is famous because of a disease. The Elephant Man perhaps. But certainly not Steven Hawking or Christopher Reeve, for example. Nobody would have heard of them if they weren't a genius or a famous actor. Lots of people know they have certain medical conditions, but not everybody. Likewise, anyone with a radio or TV currently knows Steve Tyler has/had hepatitis. Who knows if this particular "notability" will last. Probably longer in the hep community than outside, if other diseases are anything to go by.
  • A quick Google hasn't turned up any more support for Pams activism than Steves. In fact, this press release by The American Liver Foundation, and other quotes that suggest he may go on Oprah to discuss it, indicate that Steve is just as public about it as Pamela.
  • The text currently reads "Celebrities Naomi Judd and Pamela Anderson have been infected with hepatitis C and gone public with their experiences." The same is true of Steve Tyler. So is it really fair to blame editors for adding just one more name to the list. How are they to know where to draw the line? A list on Wikipedia needs clear entry criteria (not a hidden HTML comment).
  • The article current has no sources for any of the celebrities (only one obscure Chilean biologist). WP:BLP#Remove_unsourced_or_poorly_sourced_negative_material is crystal clear about this. Remove it without question or hesitation.
  • Wikipedia:Avoid trivia sections in articles contains some wisdom on the practicalities of such sections.
Colin°Talk 23:16, 2 October 2006 (UTC)
In general I agree that notable people not notable for a disease should be removed, but Colin makes a good point here... --Steven Fruitsmaak (Reply) 12:19, 3 October 2006 (UTC)

The complete "prominent patients" section should be deleted. --Pjacobi 16:10, 3 October 2006 (UTC)

[edit] A modest proposal

Instead of deleting the information, I suggest branching it into a daughter article. What Colin modestly refrains from mentioning is that he created the featured List of people with epilepsy and made vast improvements to the featured List of notable brain tumor patients. Patients and families who cope with a serious illness often gain comfort from knowing they're not alone. This type of list can also be a useful tool for educators who want to put a human face on a condition. Durova 03:58, 4 October 2006 (UTC)

This would be acceptable to me as long as the important issues of verifiability are addressed. --Ginkgo100 talk · e@ 17:38, 4 October 2006 (UTC)
It's been pretty much the de facto rule that's been followed from prior discussions. There are circumstances, such as when there are not enough referenced people to make a nice list, that this RfC should try to address. InvictaHOG 18:35, 4 October 2006 (UTC)
There is now a modest List of people with hepatitis C. I think there is a consensus forming that having a section for a list of notable people within a medical article is usually a bad idea, largely for the reasons discussed in Wikipedia:Avoid trivia sections in articles. That's not to say that the article mustn't mention notable people at all. Sections covering the history of the disease, its place in popular culture, or social issues such as awareness, stigma and acceptance might well be enhanced by the mention of such people. Dealing with this in prose, within the body of the article, will discourage unsourced and speculative additions. Colin°Talk 20:11, 4 October 2006 (UTC)

If there are too few people to start a list (e.g. POEMS syndrome) are we just going to leave the names on the main article page? "Going public" isn't enough - I hadn't realised that Pamela was not in the campaigning circuit at all. My guiding characteristic has generally been that if mention of a celebrity's name immediately brings to mind his/her diagnosis (Michael J. Fox and Parkinson's, Stephen Hawking and motor neuron disease), then this celebrity might be worth including. JFW | T@lk 23:39, 4 October 2006 (UTC)

What I did with List of notable brain tumor patients was include anyone who was famous enough for WP:BIO and whose case could be confirmed through reliable sources. For this particular condition many don't survive long enough to campaign, but some who might such as Elizabeth Taylor have chosen not to for understandable reasons. What I heard informally was that she had made a long term commitment to AIDS research and awareness and was concerned that additional efforts on behalf of another disease might dilute the value of her AIDS efforts. People who have a serious condition face a variety of pressures. If they're willing to share the diagnosis with journalists, that's good enough for me. Durova 05:30, 6 October 2006 (UTC)

The List of people with hepatitis C is currently being considered for deletion. You may wish to comment here. Colin°Talk 14:20, 15 October 2006 (UTC)

[edit] GA Review

GA review (see here for criteria)
  1. It is well written.
    a (prose): b (structure): c (MoS): d (jargon):
  2. It is factually accurate and verifiable.
    a (references): b (inline citations): c (reliable): d (OR):
  3. It is broad in its coverage.
    a (major aspects): b (focused):
  4. It follows the neutral point of view policy.
    a (fair representation): b (all significant views):
  5. It is stable.
  6. It contains images, where possible, to illustrate the topic.
    a (tagged and captioned): b (lack of images does not in itself exclude GA): c (non-free images have fair use rationales):
  7. Overall:
    a Pass/Fail:


  • 1d: Some technical jaron. like "cirrhosis" is not defined.
  • 3b: The secton "Transmission::Potential sources of exposure" is superflous, as the relative source of transmittion, is blood.
  • 4a: Much of the article is based on "U.S. in specific, rest of the world in generic", either ditch all US specific points of views, or include more different local examples.
  • 5: There has been a reecent edit war, but it seems it's over now, but's it's on the limit.
  • 6a: The only image is showing a cartoon of a person and a liver, the caption is totally non-succinct/descriptive

As I think this is points that you can fix rather quickly, I'll place article on hold in 7 days. →AzaToth 13:38, 15 October 2006 (UTC)

Sorry for the delay. Havking checked out the progress, I must say that the problem arised hasn't been handled totally. →AzaToth 19:15, 12 November 2006 (UTC)
Retrieved from "http://en.wikipedia.org../../../h/e/p/Talk%7EHepatitis_C_7dd8.html"