Editorial: Hep C epidemic can be stemmed

published on April 5, 2016 in Time Colonist

If you have lived a relatively clean life, you might think the odds of your suffering from hepatitis C might be as small as the odds of winning a lottery, but a study released last week indicates that just being a baby boomer is a risk factor.

This is a lottery you wouldn’t want to win. Getting tested for the virus, as recommended by Dr. Julio Montaner, director of the B.C. Centre of Excellence in HIV/AIDS, is a small price to pay for health and peace of mind.

Hepatitis C has long been associated with risky lifestyles — particularly indiscriminate sexual activity, dodgy tattoo procedures or the injection of recreational drugs — with symptoms of the disease sometimes showing up decades after the initial infection. Those are still high-risk factors, but a study released last week dispels the notion that the virus hits only those who were careless during the Summer of Love or who now live risky lifestyles.

The study, undertaken by the Centre of Excellence with the U.S. Centers for Disease Control, discovered the hepatitis C epidemic in North America peaked between 1940 and 1965, with most of those infected coming into contact with the disease in hospitals and by improperly sterilized medical syringes.

Advancements in medical procedures, as well as improved screening of blood products, have helped stem the spread of the virus, but anyone born between 1945 and 1964 is considered to be at risk of carrying the disease.

“Based on our results, the oldest members of the demographic cohort with the highest burden of hepatitis C virus (the baby boomers) were roughly five years of age around the peak of the spreads of genotype 1a in North America in 1950,” wrote the authors of the study. “Thus, it is unlikely that past sporadic risky behaviour … was the dominant route of transmission in this group.”

A 2014 Canada Communicable Disease Report estimated 240,000 Canadians were living with chronic hepatitis C in 2011. Cynthia Carter, a Saanich volunteer with the B.C. Hepatitis C Education and Prevention Society, says B.C. residents account for a disproportionately large chunk at about 80,000.

The sex-and-drug link has led to a stigma against testing among groups thought to be at low risk of infection. The result of that attitude, says the Public Health Agency of Canada, is that 44 per cent of Canadians with hepatitis C are not aware that they are infected and spreading the disease.

“Any baby boomer could be living with HCV [hepatitis C virus], even in the absence of symptoms or any history of high-risk behaviours, and as such they should be encouraged to proactively seek HCV testing,” Montaner says.

Typically, hepatitis C shows no symptoms at the time of infection and takes decades to do its damage. But 75 to 85 per cent of people with HCV develop chronic hepatitis, according to the U.S. Centers for Disease Control and Prevention. Some of those infected outlive the virus and live healthy lives, but up to 20 per cent develop cirrhosis, an incurable disease, and one to five per cent will die of liver disease or liver cancer.

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Hepatitis

Julio Montaner

BC Centre for Excellence in HIV/AIDS

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Editorial: Hep C epidemic can be stemmed

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