It’s rare that we have good news to share on a day dedicated to raising awareness about a disease. Particularly for a viral infection like hepatitis C, a silent killer that causes serious liver damage and affects more than 220,000 Canadians. But as World Hepatitis Day (July 28) approaches, we have reason to be optimistic.
New treatments cure most people of hepatitis C with few side effects. For a virus that was discovered only 30 years ago, that’s incredible. This medical breakthrough is so significant that 82 countries have now put in place plans to eliminate hepatitis C, and nine of these countries are on track to eliminate the infection by 2030. So why isn’t Canada one of them?
Canada has an excellent public health care system, and negotiations by provincial governments last year brought down the price of new hepatitis C drugs. Across the country, public health insurance plans are eliminating eligibility restrictions for coverage, and we have dramatically improved access to hepatitis C treatment from coast to coast.
The problem is that almost half of Canadians with hepatitis C won’t benefit from these new treatments because they don’t know they have been infected. A person can live with hepatitis C for 20 to 30 years without any symptoms, only learning they have been infected after their liver has been seriously damaged. In the meantime, they may unknowingly transmit the virus to others.
The only way to know if someone has hepatitis C is to get tested. But until now, screening guidelines in Canada have focused on people who are considered at high risk, missing the large number of Canadians who may have been exposed to hepatitis C much earlier in their lives. This exposure may have been inadvertent or forgotten after many years, or a health care provider may assume their patient has never been at risk.
This year, Canada’s leading liver specialists released new screening guidelines that recommend all Canadians born between 1945 and 1975 be offered a hepatitis C test, along with immigrants and newcomers from countries with high rates of hepatitis C, people who inject drugs, and people living with HIV. These guidelines are based on data showing higher hepatitis C prevalence among baby boomers in Canada, including those who don’t fall into groups that would be considered high risk.
This new approach to hepatitis C screening will help doctors and other health care providers broaden the scope of their testing efforts, diagnosing many Canadians who have been living years with the infection. Adding age-based criteria will also make it easier and less stigmatizing for Canadians to ask their doctor for a hepatitis C test.
Canada is well-positioned to eliminate hepatitis C. We have a strong public health care system. Our innovative harm reduction programs are models for the world. Our governments have cooperated to negotiate the price of hepatitis C drugs down to levels they can afford. And we now have evidence-based screening guidelines that will help us diagnose the 44 per cent of Canadians with hepatitis C who don’t know they have it.
Last month, I attended a consultation on a blueprint for a national plan to eliminate hepatitis C. The optimism in the room was palpable. As the Canadian Network on Hepatitis C laid out the framework of the blueprint, it became apparent how feasible this goal is.
The building blocks are there. The blueprint has been developed. Countries around the world are showing it can be done. All we need is the political commitment and resources to put a hepatitis C elimination plan into action.
Laurie Edmiston is executive director of CATIE, Canada’s source for HIV and hepatitis C information.
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