Nearly 270,000 British Columbians were tested for hepatitis C in 2018, up from approximately 132,000 in 2011, in an effort to eliminate the disease by finding people who don’t know they are infected so they can be treated and cured.
World Hepatitis Day is on July 28 and the World Health Organization has issued a call to find the ‘missing millions’ of people around the world who don’t know they are infected. It is estimated that 71 million people are infected with hepatitis C worldwide and up to 75 per cent are unaware because they have no symptoms.
If left untreated, hepatitis C causes liver cancer, cirrhosis and other complications that could require a transplant or result in death. Thankfully, new treatments available to British Columbians can cure more than 95 percent of hepatitis C infections. Healthy Pathways Forward: A Strategic Integrated Approach to Viral Hepatitis provides a provincial blueprint to complement, guide and support community and ongoing health authority efforts to address viral hepatitis in British Columbia.
“B.C. has been at the forefront of providing British Columbians with the prevention, care and treatment not only for hepatitis C, but for hepatitis B as well. Last year, we took a ground-breaking step and announced expanded drug coverage for anyone in B.C. with chronic hepatits C, regardless of severity and pledged our commitment to this action by further adding the drug Vosevi to the coverage,” said Health Minister Adrian Dix.
Testing and treating people infected is part of a larger World Health Organization goal to eliminate the disease by 2030. More than 20,000 British Columbians have been treated for hepatitis C including more than 3,000 last year, most of whom are now cured.
“Once someone is cured of hepatitis C, not only does it prevent further damage from the virus, it reduces the person’s risk of dying, they feel better and it prevents transmission to other people,” said Dr. Naveed Janjua, senior scientist, Hepatitis Program, BC Centre for Disease Control. “The virus was only identified thirty years ago and today we’re on a path to eliminate it. The fact that elimination is possible is a testimony to scientific research and discovery.”
The BCCDC recommends testing if you:
- Are part of the baby boomer generation (born between 1945 and 1965)
- Use or have used injection drugs
- Spent time in the provincial or federal prison system
- Immigrated from or spent significant time in a country where hepatitis C is prevalent
- Are a man who has sex with men
- Received a blood transfusion, blood products or organ transplant before 1992
- Received health care or got a tattoo where equipment wasn’t sterilized or there was a lack of infection prevention and control practices
- Have a history of sexual contact or sharing of personal care items with someone who is infected
- Were born to a mother who has or had hepatitis C.
While B.C. has made significant strides in identifying and treating people with hepatitis C, there are thousands of people who are unaware and untested. Also, there are many groups, such as people who inject drugs, who require a more comprehensive approach to care. Research shows that people who use injection drugs are at the highest risk of hepatitis C infection and re-infection. Sadly, the leading cause of death in this group is drug overdose, a consequence of the unpredicatable and toxic street drug supply. This group requires not only testing and treatment for their hepatitis C infection, they also need access to harm reduction and support services.
- Until recently, hepatitis C treatment was only available to individuals who were in the late stages of infection because the available treatments cured fewer than 50 per cent of infections and required 48 weeks of gruelling therapy with significant side effects.
- Today’s treatments, called direct-acting antiviral drugs, are effective for 95 per cent of infections, require a shorter eight to 12 weeks of therapy and come with very few side effects.
- Increased testing efforts and improved treatment uptake has started to show their effect by reducing liver-related mortality in B.C. as well as the risk of developing cirrhosis, and liver cancer as shown in recent research by the BCCDC.
- Treatment also reduces the risk of dying from strokes, heart attacks and kidney failure.
- Blueprint to inform hepatitis C elimination effort in Canada: http://www.bccdc.ca/about/news-stories/stories/roadmap-to-eliminate-hepatitis-c-revealed