Hepatitis is a silent killer – millions around the world are living with this virus unaware. Without diagnosis, these people will lose their lives to a largely treatable infection. In 2016, every government in the world made a commitment to eliminate hepatitis by 2030. With only ten years left to reach that goal, now is the time to act.
World Hepatitis Day isn’t just about raising awareness – it’s about saving lives. Darren Russell, Adjunct Professor at JCU and Director of Sexual Health at Cairns Sexual Health Service, gives us the what, why, and how on viral hepatitis.
What is hepatitis?
“Hepatitis really means ‘inflammation of the liver’ and can have many varied causes,” Darren says. “The main ones we are interested in on World Hepatitis Day are the infectious causes, namely hepatitis B and hepatitis C.”
We are interested in these viruses because if they are not diagnosed and treated, they can cause lifelong infection and serious health problems, including liver cirrhosis, liver failure, and liver cancer.
Hepatitis B is spread by exposure to infected bodily fluids. According to Darren, it is very common in developing countries, often being passed from a mother to her child at birth. Because the virus doesn’t cause symptoms until adulthood, it often goes undiagnosed.
“Often the person who has it has no idea until they have a blood test as an adult, or when they come down with serious liver problems,” Darren says. “Untreated it is a leading cause of death in many countries.”
Hepatitis doesn’t only exist in developing countries. Darren explains that in Australia, there are over 220,000 people living with chronic hepatitis B, representing 0.90% of the population. As far as diagnosis, Darren says that it is estimated that only 68 per cent of those living with chronic hepatitis B in Australia have ever been diagnosed, but that the national target is 80 per cent by 2022.
“There is effective daily treatment for hepatitis B, but no cure yet,” Darren says. “However, not everyone with hepatitis B does need treatment.”
Hepatitis C is spread through contact with contaminated blood. This is most often through injecting drugs with a shared needle, though it could also be spread through unsterile tattoo equipment. Like hepatitis B, it can lie silent for many years and can cause fatal liver problems later in life. Darren says that it has been the leading cause of needing a liver transplant in Australia.
However, those with hepatitis C can have hope.
“Hepatitis C is easy to diagnose with a simple blood test, and there are now amazing new drugs that will cure it in eight to twelve weeks, with an almost 100 per cent chance of a permanent cure,” Darren says.
Image: The Cairns Sexual Health Service Reception team
Why do we need to push to diagnose and treat viral hepatitis?
The number one reason that we must push to diagnose and treat hepatitis B and hepatitis C is because they are a leading cause of death in many countries. This isn’t just a push for diagnosis – this is a push to save lives.
“Treatment means that people living with hepatitis will stay healthy and well,” Darren says. “It also means they will be unable to pass the infections on to anyone else.”
Another reason why we must take action is because of the number of people that are still suffering unaware from a largely treatable infection.
“Studies around the world have looked at general communities, from blood donors to pregnant women, prisoners, and more to give a picture of those who are living with viral hepatitis but have yet to be diagnosed or offered treatment,” Darren says.
According to the World Hepatitis Alliance, there are 290 million people around the world living with viral hepatitis without diagnosis.
In Australia, Darren says that we have done very well to diagnose those living with hepatitis B and hepatitis C, in comparison with most countries. “But we still need to do better to find those who are carrying these viruses unaware and at risk.”
A third reason is that people living with hepatitis are not only carrying the virus – they are also likely carrying the shame that we have assigned to it.
“Because of the stigma associated with hepatitis, many people are reluctant to share their story or even to tell family and friends. It can be a huge burden for a person to carry.
“One of the most important things we can do to combat hepatitis is to fight the stigma and shame associated with these infections,” Darren says.
It is for these people that we must create change – the people that are suffering with or without symptoms, the people that are dying without diagnosis, the people that are carrying unfair shame. These infections are treatable, and these people have a right to treatment.
Image: Flyers for the Cairns Sexual Health Service Hep C Free campaign
How can we help those with hepatitis?
Darren says that to help those with hepatitis, there are three actions that we need to employ:
- Offer blood testing to anyone at risk.
- Offer curative treatment to all those with hepatitis C, and monitor the liver health of those with hepatitis B, offering treatment to those who need it.
- Battle the stigma associated with these infections. Stigma prevents people coming forward for testing and treatment.
Darren and his team at Cairns Sexual Health Service are working hard to employ these actions and make a difference.
“Because we have wonderful new medications that easily cure this virus, we can now work towards eliminating it totally from Cairns and the Far North. We’ve done a lot of work at Lotus Glen Prison, and in the general community, and are getting close to our goal.
“We hope that in the coming year or two we can show that we have eliminated hepatitis C from the Far North.”
This is a hope that we must all strive to make a reality – that we can raise awareness, push for diagnosis and treatment, and offer hope and help to those with hepatitis.
If you want to know more about how you can get involved this World Hepatitis Day, the World Hepatitis Alliance has options for you.
Are you passionate about working to create a difference in the health and the hope of those who need it most? Check out what you can do with JCU Medicine.
Feature image: James Cook University