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Published on: Oct 28, 2020
2 minute read
By: Dr Rajan ( Medical Second Opinion Cell)

Hepatitis C Nobel Prize

Earlier this month the Nobel Prize in Physiology and Medicine was jointly awarded to Harvey J Alter, Michael Houghton and Charles M Rice for the discovery of the Hepatitis C virus. This helped push our understanding of blood-borne hepatitis, a major global health problem that is one of the leading causes of cirrhosis and liver cancer alongside Hepatitis B. It led the way in introducing new tests for chronic hepatitis as well as new treatments that have saved the lives of millions.

HEPATITIS

Hepatitis is the inflammation of your liver, the largest solid organ in your body. Though there are numerous other causes of hepatitis, including alcohol abuse, drugs and toxins (including paracetamol overdose), and autoimmune disorders (such as Wilson’s disease), viral infections are the most common worldwide causes for hepatitis. Hepatitis A was the first to be discovered, transmitted by polluted food and water, and results in a short-term transient hepatitis. Hepatitis B on the other hand is transmitted through blood and is more of an issue as it can lead to chronic cirrhosis and possible liver cancer. It can remain indolent in a person, causing disease long after the initial infection.

Blood borne hepatitis was first discovered in the 1960s, when it was found that some patients would become ill after receiving blood transfusions. Despite this discovery and new tests for Hepatitis B reducing the number of transfusion related hepatitis, a large number of cases remained.

NOT A, NOT B

Harvey Alter, working at the US National Institute of Health, was studying the occurrence of hepatitis in blood transfusion patients. His team showed that blood from these infected patients could transmit the disease to chimpanzees, resulting in hepatitis. This agent had the properties of a virus, one that was “non-A, non B” hepatitis.

Further investigation into the virus would require the input of Michael Houghton, working for Chiron pharmaceutical. His team created a collection of DNA fragments found in the blood of infected chimpanzees. Though the majority of these fragments were from the chimpanzee, enough were from the virus. They were able to utilise this information to identify antibodies against the suspected virus, and ultimately identify it as the flavivirus Hepatitis C.

The final piece of the puzzle was shown by Charles M Rice, a researcher at Washington University, St Louis – could the virus alone cause hepatitis. He studied the RNA of Hepatitis C to identify regions that may be used for replication, and areas that might hinder replication. This was key as the virus can lay dormant for years, replicating at a slow rate before causing damage to the liver. For researchers, this was an issue as it was not feasible to wait years and see if the suspected virus caused hepatitis. By genetically engineering the viral genome, he developed a variant of Hepatitis C that would only multiple rapidly and have no mechanism to inactivate itself for dormancy. This strain caused rapid changes to the livers of infected chimpanzees; the same changes seen in hepatitis patients.

. ;.,hrvxzThe impact was significant. Prior to this, receiving a blood transfusion was like Russian Roulette. You were receiving life saving therapy, but it coZuld also be a hidden death sentence. Now that hepatitis had been discovered, it became possible to screen patients prior to donation, to screen blood transfusion bags, and to start developing treatments for the virus.

The fight is not over yet. There are still over 70 million people who still live with the virus, and it still kills around 400,000 a year. Its only very recently that we have found treatments that can reduce the viral load in patients to levels that they are considered cured. This treatment remains expensive, and we are very far away from eradication itself.

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The Rise of Telemedicine: Revolutionizing Healthcare

In today’s fast-paced world, convenience is key. From online shopping to digital banking, everything is just a click away. The healthcare industry is no exception to this digital revolution, with telemedicine emerging as a game-changer. This new wave of healthcare delivery has not only made medical consultations more accessible but also provided timely care to patients, especially in remote areas. In this blog, we will explore the rise of telemedicine, its benefits, challenges, and the role it plays in shaping the future of healthcare.

What is Telemedicine?

Telemedicine refers to the use of digital technology, such as video calls, phone calls, or messaging apps, to provide healthcare services remotely. Through telemedicine platforms, patients can consult with doctors, discuss symptoms, receive medical advice, and even get prescriptions – all without stepping out of their homes. While the concept of remote healthcare isn’t entirely new, it has gained significant traction in recent years due to advancements in technology and the widespread use of smartphones and internet connectivity.

The Growth of Telemedicine

The COVID-19 pandemic served as a major catalyst for the widespread adoption of telemedicine. With lockdowns and social distancing measures in place, many people were unable or reluctant to visit hospitals or clinics. As a result, healthcare providers turned to telemedicine as a safe and effective way to continue offering care to their patients.

However, even before the pandemic, telemedicine was growing. Factors such as a shortage of healthcare professionals, long waiting times, and the rising cost of healthcare made remote consultations an attractive option. According to a report by McKinsey, telehealth usage in the U.S. increased by 38 times from pre-pandemic levels. Globally, the telemedicine market is expected to grow at a compound annual growth rate (CAGR) of 25.8% from 2020 to 2027.

Benefits of Telemedicine

The rise of telemedicine has brought numerous benefits for both patients and healthcare providers:

1. Increased Access to Care

Telemedicine has made healthcare more accessible, especially for those living in rural or remote areas where access to healthcare facilities is limited. With just a smartphone and an internet connection, patients can connect with healthcare professionals from anywhere, breaking down geographical barriers.

2. Convenience and Time-Saving

For many people, visiting a doctor’s office involves time-consuming travel and long waits. Telemedicine eliminates the need for physical travel, allowing patients to schedule consultations at a time that suits them. This is particularly useful for those with busy schedules, elderly patients, or individuals with mobility issues.

3. Cost-Effective Healthcare

Telemedicine can be a more affordable option for both patients and healthcare providers. Remote consultations typically cost less than in-person visits, and patients save on transportation and other associated expenses. For healthcare providers, telemedicine can help reduce overhead costs by minimizing the need for physical office space and staffing.

4. Continuity of Care

Telemedicine helps patients stay connected with their healthcare providers even when face-to-face visits are not possible. This is particularly important for patients with chronic conditions who require regular monitoring and follow-ups. Remote consultations allow doctors to track their progress and adjust treatment plans without the need for frequent clinic visits.

5. Reduced Risk of Infections

During outbreaks of contagious diseases, such as COVID-19, visiting a hospital or clinic can increase the risk of infection. Telemedicine provides a safer alternative by allowing patients to receive care from the comfort of their homes, thus reducing the spread of diseases.

Challenges Facing Telemedicine

While telemedicine offers many benefits, it also comes with its fair share of challenges:

1. Technology Barriers

Not everyone has access to the internet or the necessary devices for telemedicine consultations. In rural or underserved communities, limited internet connectivity can hinder access to remote healthcare services. Additionally, older adults or those who are not tech-savvy may struggle to navigate telemedicine platforms.

2. Lack of Physical Examination

Telemedicine works well for consultations, but it cannot replace the need for physical examinations in certain cases. While doctors can provide advice based on a patient’s symptoms, there are limitations when it comes to diagnosing conditions that require hands-on assessments or lab tests.

3. Privacy and Security Concerns

Telemedicine relies on the transmission of personal health information over digital platforms. This raises concerns about data privacy and security. Patients need to be assured that their sensitive medical information is protected, and healthcare providers must comply with regulations like the Health Insurance Portability and Accountability Act (HIPAA) to safeguard patient data.

4. Reimbursement and Insurance Issues

In some regions, the reimbursement policies for telemedicine services are not well established. Patients may face difficulties in getting their telemedicine consultations covered by insurance, which can deter them from opting for remote healthcare. On the other hand, healthcare providers may also face challenges in billing for telemedicine services.

The Future of Telemedicine

As technology continues to advance, the future of telemedicine looks promising. With the development of artificial intelligence (AI), wearable health devices, and remote monitoring tools, telemedicine will become more sophisticated and capable of providing personalized care to patients. AI-powered chatbots, for example, could assist doctors in diagnosing conditions by analyzing symptoms and medical history.

Additionally, wearable devices like fitness trackers or smartwatches can monitor a patient’s vital signs in real-time and share the data with their healthcare provider. This continuous flow of information allows for more accurate diagnoses and timely interventions, reducing the need for emergency hospital visits.

Telemedicine in Specialized Care

Telemedicine is also expanding its reach into specialized fields of medicine. For example, telepsychiatry allows mental health professionals to provide counseling and therapy to patients remotely, making mental health services more accessible. Similarly, teledermatology enables dermatologists to diagnose and treat skin conditions by reviewing images sent by patients.

Another emerging trend is the use of telemedicine for post-operative care. Patients recovering from surgery can have follow-up consultations with their doctors without the need for an in-person visit, reducing the burden on both the patient and the healthcare system.

Conclusion

The rise of telemedicine is revolutionizing the way healthcare is delivered. By providing increased access to care, improving convenience, and offering cost-effective solutions, telemedicine is making healthcare more patient-centered and accessible. While challenges such as technology barriers and privacy concerns remain, the continued growth and innovation in telemedicine point towards a future where healthcare is more personalized, efficient, and readily available to all.

As we move forward, telemedicine will continue to play a vital role in bridging the gap between patients and healthcare providers, ensuring that quality care is just a click away.