Testing for hepatitis C should be done on all Canadians born between 1945 and 1975 and on all immigrants, urges the Canadian Liver Foundation. This follows a similar recommendation from the U.S. Centers for Disease Control last year. Hepatitis C is called the silent killer because there are no symptoms until it is too late to treat and the liver fails.
“Certain amount of urgency”
“We have a short window,” says Dr. Morris Sherman, associate professor of medicine at the University of Toronto and chairman of the Canadian Liver Foundation. “If we find these people now there’s very good treatment coming. We’re going to be able to cure all of these people. And if we miss it they’re going to develop bad liver disease and we’re going to have to struggle with all the consequences of that. So there’s a certain amount of urgency to finding cases now when treatment is going to be available.”
More than 300,000 people in Canada are living with chronic hepatitis C but fewer than half of them know it. Testing is currently recommended for people who have used injection drugs (even if it was only once), those who have had blood transfusions before 1990 or those who took part in medical procedures or immunization in countries where hepatitis C is common.
Liver illness increasing
But recent data suggest other people need testing too because there is a demographic bulge of people who were infected many years ago who are now starting to have liver problems. “We’re already seeing a documented increase in liver cancer in Canada,” says Sherman. “In fact it is one of the fastest rising cancers in Canada…There’s also an increase in the numbers of people who have cirrhosis. There’s an increase in the number of deaths related to hepatitis C and hepatitis C is the most common indication for liver transplantation.”
Immigrants have greater risk
Immigrants are at particular risk because they may have contracted hepatitis C while undergoing medical procedures in their home countries. And other Canadians may have contracted the disease while abroad, perhaps through emergency medical procedures, or at home through such things as injection drug use or tattooing in unhygienic conditions. Transmission usually involves blood-to-blood contact.
Blood tests are covered by the public health symptom and treatment is difficult, but available. New, easier treatments are being developed and will be available in the coming few years.
Doctors “ignorant about hepatitis C”
Sherman recommends all baby boomers and immigrants get tested for hepatitis C and if they are found to be positive, to see a specialist. “One of the other problems is that family physicians are really, as a group, ignorant about hepatitis C,” says Sherman. “Many of them still don’t know that it can be cured. So if you find that you do have hepatitis C, speak to a family doctor about it but don’t accept being fobbed by the family doctor as (saying) ‘Oh, it’s nothing.’”
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