Tag Archives: British Columbia

Hepatitis C Elimination is Possible and Essential

Hepatitis C Eliminate is Possible and EssentialTwelve years ago a neonatal nurse adopted Kagen, a blonde haired blue-eyed baby boy. He’s now tall, sports a buzz cut, and likes playing Pokemon Go and visiting Build-A-Bear.

With the desire to help people in rural Appalachia, Naomi became a registered nurse and had dreams of one day becoming a doctor. While working in the fast paced ICUs in Nashville, Naomi remembers often being stuck by needles and being covered in bodily fluids while helping patients.

As a boy, Abdel remembers lining up once a month with his classmates for injections against schistosomiasis, a parasitic disease spread by water snails in Egypt, where he lived. As he was afraid of needles, he always tried his best to be last in line and never wondered where the needle had been before it poked him.

Forty years ago, Julia gave birth to her first child, a daughter. After her daughter’s birth, Julia haemorrhaged and was saved by a blood transfusion.

Each one of the above people have families, hopes, dreams, plans to live until they are old and gray — we all do — and they probably still hold on to those dreams. However, until recently, those dreams may have seemed out of reach for them because of something else they also had in common. All four of them, Kagen, Naomi, Abdel, and Julia, had hepatitis C, a virus that easily passes through blood.

Hepatitis C is a serious and potentially life-threatening liver disease that can lead to liver cirrhosis, cancer, or liver failure. However, in many cases those life-threatening developments may only develop after years of having no symptoms at all or having hepatitis C symptoms that can be written off as symptoms of the normal process of aging.

The group most impacted by hepatitis C, some 60,000 in B.C., are baby boomers, those who were born between 1945 and 1965. Many have lived with the infection for years but have never been tested or treated because they have never believed themselves to be at risk. Having the virus has just never crossed their minds as hep C symptoms can often take decades to emerge and when they do can just seem to be normal signs of aging.

Thankfully, testing for the virus is quick, easy, and can be done confidentially and at home. Thankfully, there are now new pills able to cure it.

With these services and treatments, British Columbia now has the opportunity to achieve a huge public healthcare feat. B.C. can avoid the cost of increased rates of liver cancer, end stage liver disease, and the consequences of hepatitis C’s symptoms, just by seeking out those carrying the hepatitis C virus and treating them.

However, as the virus can quickly and quietly spread, identifying those with the virus in B.C. and treating everyone infected, in a relatively short period of time, is the best way to eliminate it. In 2015, Prince Edward Island, for example, as well as other areas around the world, adopted this strategy and proved that hepatitis C elimination is possible. They proved that eliminating the hepatitis C virus should now be the world’s only course of action against the virus and that British Columbia should adopt a strategy of elimination as soon as possible.

For more information about hepatitis C and its cures, please visit the Hepatitis C Treatment Information Project.


Sources:
CBC News. $5M hepatitis C strategy announced by P.E.I. government. Feb 12, 2015. http://www.cbc.ca/news/canada/prince-edward-island/5m-hepatitis-c-strategy-announced-by-p-e-i-government-1.2954701 Accessed on Mar. 2017.
Everyday Health. Singer Naomi Judd Raises Her Voice on Hepatitis C. July 2014, http://www.everydayhealth.com/columns/my-health-story/singer-naomi-judd-raises-her-voice-hepatitis-c/. Accessed Mar. 2017.
“Generation Hep”. Generationhep.com. Accessed Mar. 2017.
McNeil, Donald. “Curing Hepatitis C, In An Experiment The Size Of Egypt”. Nytimes.com, 2015, https://www.nytimes.com/2015/12/16/health/hepatitis-c-treatment-egypt.html?_r=0 Accessed on Mar. 2017.
Southeast Missourian. Thankful people: Kagen Hill cured of hepatitis C, 2016, http://www.semissourian.com/story/2363041.html. Accessed Mar. 2017.

Two BC based Clinical Trials Examined at the Liver Meeting

Two BC based Clinical Trials Examined at the Liver MeetingThis post examines two BC based clinical trials BC for hep C treatments that were presented at the Liver Meeting 2016 earlier this month.

Clinical Trial Abstract #60 – Impact of drug use and opioid substitution therapy on hepatitis C reinfection: The BC Hepatitis Testers Cohort by Nazrul Islam, et al.

Summary: This clinical trial identified the risk factors that may lead to hep C reinfection by looking at those tested for the virus in BC between 1990-2013. It looked at data about their medical visits, hospitalizations, and prescription drugs.  Those who were able to clear the virus on their own were included in this study. The study’s results showed that 11.8% of those who cleared the virus on their own were reinfected within the study’s 19 year time period. This rate was higher in this group than in those who had cleared the virus through treatment. However, this group also had a higher proportion of people who recently injected drugs. Using injected drugs made the risk of reinfection higher, where as, using opioid substitution therapy (OST) reduced the hep C reinfection risk. Also, being younger was seen to increase one’s of reinfection risk, as well as, being co-infected with HIV.  Whereas, being female and being infected with hep B lowered one’s chances of reinfection. From these findings, the study concluded that treatment should be combined with harm reduction programs.

Clinical Trial Abstract #175 – The impact of sustained virological response to HCV infection on long term risk of hepatocellular carcinoma: The BC Hepatitis Testers Cohort by Naveed Z. Janjua, et al.

Summary: The risk of hepatocellular carcinoma (HCC), the most common type of liver cancer, after being cured of hep C in North America hasn’t been looked at in depth. This study assessed the effect of sustained virologic response (hep C cure) on the risk of HCC among a large Canadian population base, by examining the same patient database as the above clinical trial. RESULTS: It found that the risk of HCC was higher in those who weren’t cured than those who were (1.1/1000 person-yr(PY) in the SVR group and 7.2/1000 PY in the no-SVR group). It found that the risk of developing HCC was higher in those with liver cirrhosis, who were older, male, had hep C genotype 3 vs 1, and drank alcohol. The HCC incidence post treatment increase was steeper in the no-SVR vs the SVR group, but that SVR (cure) doesn’t eliminate the risk of HCC.

 The Liver Meeting 2016

The Liver Meeting 2016, the American Association for the Study of Liver Diseases (AASLD)‘s 67th annual meeting, was held November 11th – 15th. Last year’s meeting drew more than 9,500 international hepatologists and hepatology health professionals to San Francisco to discuss the latest treatments and research for liver diseases. This year, Boston, Massachusetts, hosted the meeting and, as always, it was exciting.

More information about The Liver Meeting 2016 or these and other studies can be found in our blog post The Liver Meeting 2016 Hep C Abstract Highlights (Part2) or on the American Association for the Study of Liver Diseases (AASLD)’s website.

What do you think about The Vancouver Sun article?

The Vancouver SunAn article, entitled ‘Hepatitis C treatment skyrocket after pill-based drugs covered by B.C. plan’ and published by The Vancouver Sun on July 29, 2015, highlighted not only the cost and marketing around hepatitis C treatments, but also the demand for those treatments in BC.

The article began with: “About 1,400 British Columbians have been treated for hepatitis C in the first four months since new anti-viral medications were covered by the province’s public drug plan — far above predictions. The Ministry of Health expected 1,500 patients in the first full year for the pill-based medication.”

The Pacific Hepatitis C Network is ecstatic to hear that so many British Columbians are seeking treatment. However, do we still need a clear strategic plan in BC to ensure that those who need treatment now get it as soon as possible and those waiting for treatment get excellent care and support? We think so!

What about you? What do you think?