As many as 80,000 British Columbians are infected with hepatitis C, upwards of 70% unaware
For the BC Centre for Excellence (BC-CfE) in HIV/AIDS at St. Paul’s, the era of Targeted Disease Elimination is underway.
Thanks in large part to work conducted at the BC-CfE, when consistently treated, HIV is now a chronic, manageable disease-not the killer it once was. The BC-CfE team is setting their sights on hepatitis C, the potentially fatal disease of the liver seen as the world’s next great health care crisis.
Hepatitis C is a blood-borne virus, transmitted through unscreened blood or unsafe injection practices, or (rarely, these days) from mother to child during birth. Hepatitis C attacks the liver, and you can have it for years, even decades, and not know it. When symptoms finally do begin to show, liver disease (cirrhosis) or cancer of the liver is often already present.
The good news is that the BC-CfE has three decades of knowledge gained from the battle with HIV to leverage against hepatitis C, and similar strategies will be carried over. The Targeted Disease Elimination approach so successfully applied to reduce HIV and AIDS mortality and prevalence in BC will now be applied to hepatitis C.
Clinician researcher Dr. Mark Hull’s extensive work at the HIV-Hepatitis Co-Infection Clinic at the BC-CfE involves treating people with both HIV and hepatitis.
“For me,” says Dr. Hull, “when I think about HIV and the lessons we’ve learned, it’s not just a medication approach; it’s a more holistic approach in terms of engaging and retaining people in care. And the strategies are very similar in terms of working with our partners from across BC, as well as in terms of the cascade of care.”
The cascade of care describes the six stages of treatment:
Diagnosis, which entails uptake of testing for those potentially living with Hepatitis C; linking individuals diagnosed with Hepatitis C to care with a multi-disciplinary care team; ensuring they receive appropriate monitoring and evaluation for treatment while engaging in consistent care; the individual deciding to begin treatment; ensuring the treatment regimen is adhered to; and ultimately suppressing the viral load to undetectable levels to eradicate the virus.