Diagnosed with Hepatitis: Managing education, treatment and support
Having a diagnosis can be lifesaving. In particular, hepatitis B and C lead to chronic disease in hundreds of millions of people and are the most common cause of liver cirrhosis and cancer
Article content
Hepatitis is an inflammation of the liver that can increase the risk of liver damage and is often caused by a viral infection. You can also develop hepatitis if you have diseases that impact your liver, such as obesity, or you’re exposed to toxins like chemicals, alcohol or drugs.
It’s a significant health threat because you may not experience any symptoms and don’t know you have it. However, it can cause symptoms of diarrhea, fatigue and pain on the right side of the upper belly, that happen suddenly and then go away within six months, which is acute hepatitis. Or you may have hepatitis that doesn’t go away and worsens over time, which is chronic hepatitis.
Recommended Videos
tap here to see other videos from our team.
Diagnosed with Hepatitis: Managing education, treatment and support Back to video
tap here to see other videos from our team.
Understanding hepatitis is the first step
Having a diagnosis can be lifesaving. There are five main hepatitis viruses, referred to as types A, B, C, D, and E. These five are the most concerning because of the burden of illness and death they cause and the potential for outbreaks and spread. According to the World Health Organization, “in particular, types B and C lead to chronic disease in hundreds of millions of people and, together, are the most common cause of liver cirrhosis and cancer.”
While there’s vaccination in Canada for the hepatitis B virus (HBV), typically given to infants, many parts of the world have endemic spread and are working to introduce vaccination. Immigrants to Canada may carry the hepatitis virus, so there’s an increasing push for access to screening and treatment by advocates like Action Hepatitis Canada, a coalition of Canadian organizations committed to holding the government accountable to eliminate viral hepatitis as a public health threat by 2030.
HBV is transmitted through exposure to infected blood, semen, and other body fluids. It can be transmitted from infected mothers to infants at the time of birth or from a family member to a child in early childhood. Transmission through transfusions of HBV-contaminated blood can also be a risk for infection.
Hepatitis C virus (HCV) is mainly transmitted through exposure to infected blood through transfusions of HCV-contaminated blood and blood products, contaminated injections during medical procedures, and injection drug use. Sexual transmission can happen, but it is much less common. It is important to note that there is no vaccine for HCV; however, the virus can be cured with drug therapy in eight to 12 weeks.
“It’s that linkage to care piece that we’re honing in on a lot right now, and prevention because it’s great to cure hep C, but it’s even better to not get in the first place,” says Jennifer van Gennip, executive director of Action Hepatitis Canada.
Work with your care team
See a doctor for access to treatment. That can be challenging if you don’t have a family physician, compounded by the fact that drug access for HCV looks a little different from province to province.
“For about a decade now, we’ve had direct-acting antivirals. They’re all oral, so you just take a pill daily. There are a couple on the market that are covered in Canada. One takes eight weeks and one takes 12 weeks, so either eight or 12 weeks and very low side effects,” van Gennip explains.
Prior to the current antivirals, another treatment that people may be more familiar with, it had a low cure rate of about 40 per cent, she says. Its weekly injections also had severely debilitating side effects, short-term and long-term in many cases, where people were monitored by hepatology nurses for infections and other issues. HCV was considered serious and needed specialty intervention.
While treatment has improved significantly for HCV, the antivirals are not readily prescribed, so there are barriers to receiving care. Education is a key focus for van Gennip, who explains that outdated thinking about HCV treatment prevails.
“We’re trying to overcome these ideas that you could only be treated by hepatologists, so we’re making progress in decentralizing care. In Ontario, any family physician or nurse practitioner could prescribe [antivirals for HCV]. But in Manitoba, there’s a list, depending on who you ask, of three or seven people in the whole province who are allowed to treat it. And in the Yukon, it’s one guy from B.C. who flies up a few times a year. In Alberta, though, a pharmacist can prescribe it.”
For the most part, the majority of people can be treated quite simply and don’t require specialized care.
Monitoring for hepatitis treatment
HBV is more prevalent in Canada. Once people are diagnosed, they need to be monitored with regular bloodwork to detect any progression of the infection and prevent transmission. Some people will need treatment, but not everyone.
“It can lead to liver cancer and needing a new liver, so it’s definitely something you want to have someone keeping an eye on with you.”
As with most infections, starting monitoring and treatment, if required, as soon as possible for both HBV and HBC will make a difference to your health.
Another key point van Gennip makes is the lack of universal screening, so people could be putting their own health and that of others at risk.
“Our screening guidelines are risk-based, so you have to disclose risks to your provider before they will offer you a test, and that is a barrier to people getting diagnosed. But it also perpetuates stigma, which keeps other people from being diagnosed,” she says.
Immigrants and newcomers to Canada are not systematically screened for HBV and HBC, although there’s movement toward improved early detection and treatment services. For everyone, she continues, “Don’t assume your doctor is offering you every test that you should have, and in the absence of national universal screening guidelines, just go ahead and ask your doctor. Tell your doctor you want to be tested for hep C and hep B.
Find your support network
Another part of managing viral hepatitis is connecting with people for support, whether that’s family members, friends or a peer support group. Liver Canada has a mandate to ensure that every Canadian understands the importance of liver health and has access to the resources, support, and education they need.
The organization offers a national helpline, information hub, webinars, expert forums, and peer support groups for managing care.
In addition to Action Hepatitis Canada and Liver Canada, other organizations supporting patients with hepatitis and hepatitis advocacy are:
- Canadian Network on Hepatitis C
- CATIE: Canada’s source for HIV and hepatitis C information
- Hepatitis C Society of Canada
The takeaway here is to not let your liver health go unchecked. A diagnosis of hepatitis requires medical care and attention as a personal and public health issue.
