By Samantha Johnson Local Journalism Initiative Reporter on July 28, 2023.
reporter@medicinehatnews.com Today is World Hepatitis Day, and in preparation an online forum was held Thursday to call for increased awareness, prevention, testing and treatment services in the province for viral hepatitis, an infectious disease that is spread by blood-blood contact. University of Alberta PhD candidate Alexa Thompson, who is also the founder of the Alberta Hepatitis Elimination Network, explained that hepatitis B (HBV) and hepatitis C (HCV) are the two most common forms of the disease. There were 320 HBV and 601 HCV cases reported in 2020 in Alberta, which are likely much lower than actual numbers. Both HBV and HCV can cause liver cancer if left undiagnosed and untreated. Unfortunately, symptoms are not experienced until liver damage has already occurred. Hepatitis is known as a silent killer as a person can have the virus for decades before symptoms manifest. “We estimate that one out of every 150 Albertans is infected with hepatitis B, but only half are aware,” stated Thompson. While HBV is preventable by vaccination, a vaccine for HCV has not been developed. However, HCV is curable with treatments that take 8-12 weeks. Individuals who use drugs, incarcerated, gay and bisexual men, those born between 1945 and 1975, newcomers to Canada, Indigenous populations and pregnant women are those disproportionately affected by hepatitis. The pandemic curbed efforts toward elimination, which include awareness, education, prevention, testing, connected those infected to health-care providers and treatments. Simmone D’souza, a University of Calgary PhD candidate and fellow with the Canadian Network on Hepatitis C, talked about how the Alberta Health Services strategic framework on sexually transmitted and blood-born infections (STBBIs) has been imperative to achieving elimination. “This has been a great step forward in planning healthcare services for the populations affected by STBBIs, including those affected by hepatitis B and C,” said D’souza. Between 2016 and 2019 there was an increase in the number of needles and syringes ordered for people who inject drugs, along with an associated increase in the general public’s awareness of harm reduction programs, and support for safe-consumption sites. Understanding the contribution of HBV and HCV to morbidity and mortality is vital for education and awareness efforts. “We really have no idea how many people are becoming infected each year, developing liver disease or dying from viral hepatitis on a year-to-year basis in Alberta,” stated D’souza. “This highlights the need to establish effective monitoring, surveillance and data tracking programs in order to understand the true burden of viral hepatitis within Alberta.” HBV vaccination has been available in the province for the past 40 years and is highly effective at preventing infections. The first dose is given at two months old, although the World Health Organization, among others, recommends HBV vaccination at birth. There are three provinces/territories in Canada which have implemented at-birth vaccination, but Alberta is far behind. As there is no cure for HBV, vaccination is vital for prevention, as 84% of children in Canada have been vaccinated against HBV with a 90% vaccination rate required for elimination of the virus. The pandemic caused a decrease to harm reduction services along with exacerbating the opioid crisis. “Because of the correlation between opioid usage and hepatitis transmission, there is currently a strain on our efforts to eliminate viral hepatitis within Alberta,” stated D’souza. Testing is vital for hepatitis diagnosis. Testing rates were about 30% before the pandemic but decreased significantly and have not yet increased to pre-COVID levels. There has been a recent increase in availability and efficiency of testing, with HCV reflex testing now available, which allows the patient to be tested and receive diagnosis with only one drop of blood. For more information, see MyHealth.Alberta.ca and search for hepatitis A or hepatitis B. 19