World Hepatitis Day: Hep can’t wait
On July 28 each year, World Hepatitis Day brings the world together to raise awareness of viral hepatitis and to influence real change. This year’s theme, ‘Hep can’t wait!’ highlights that, even in times of a global pandemic, people living with or at risk of viral hepatitis, should not delay their screening and management.
Lyn McLean-Knight has been a hepatitis nurse at Northern Hospital since 2012.
“You can be infected with hepatitis B or C for a long time without any symptoms or signs of cirrhosis. Cirrhosis is scarring of the liver which can lead to complications including an increased risk of liver cancer and liver failure and some people may end up needing liver transplants. Patients who have developed cirrhosis need to have regular and ongoing monitoring to decrease the chance of complications,” she explained.
A large part of Lyn’s role is following up with people living with viral hepatitis to support them to engage in care and treatment. Not seeking treatment on time can lead to further health complications including liver damage or cirrhosis. Treatment of viral hepatitis is widely available in Australia.
“Today, the treatment for hepatitis C is very simple, with eight to 12 weeks of tablets and very few side effects for most patients. Only five years ago, the treatment for hepatitis C was long and harsh, requiring weekly injections lasting for six to 12 months, with many side effects. With the current treatment, the minimal and manageable side effects mean that people on treatment for hepatitis C can continue working and living their regular lifestyle while on treatment. The current treatment for hepatitis C is very effective with cure rates of 98 – 100 per cent,” Lyn explained.
Although hepatitis B treatment is not a cure, it is also very well tolerated and very effective in reducing progression of liver disease and complications. Unfortunately, rates of treatment for hepatitis B are far lower than they should be in Australia.
“Because viral hepatitis can be present without symptoms, it is important that people of high-risk populations are screened. These include people with a history of sharing injecting equipment, people found to have abnormal liver function tests, people who have not had vaccination against hepatitis B, people who had procedures or blood transfusions overseas in developing countries, those who served a prison sentence, male same-sex couples, persons with tattoos and household members of those already diagnosed. The screening initially involves a simple blood test,” she explained.
Hepatitis B and C are blood borne viruses spread via blood and bodily fluids. In Australia, a high percentage of transmission is via sharing injecting equipment or tattooing with poorly sterilised equipment, with a small percentage of mother-to-baby or vertical transmission.
Preventative and harm reduction play an important part in reducing transmission. Some of these measures include safe injecting drug rooms, screening household members and sexual partners for hepatitis B, and infant vaccination program, which is a world-wide program. In some countries, the mother-to-baby risk of transmission is high, but with appropriate monitoring and treatment, the risk of transmission at birth is very low.
Vaccines are also available for hepatitis A and B and are very highly effective at preventing infection. Hepatitis D only occurs in people living with hepatitis B, therefore, hepatitis B vaccination can prevent both hepatitis B and D infection.
“Stigma, sometimes even from health professionals, combined with limited access to information and difficulty in finding time for hospital appointments, can make it hard for people to seek treatment and advice,” she explained.
In line with this year’s theme, Lyn would like to encourage people not to wait for screening, but to be tested and treated as appropriate.
“We need to increase our rates of testing for viral hepatitis in Australia to ensure people have appropriate treatment, to lower their risks of developing complications. As health professionals, we all have a responsibility to screen high-risk populations,” she added.
For more information on hepatitis, please visit Hepatitis Australia.